My fillings at the gumline keep popping out.

Dear Dr.Hall,

I want to thank you for providing a wonderful informative site for FREE to the public. The patients you served during your career must have appreciated your care, talent, and quality of service.

I’m sure you can help direct me with my concerns. I have severe erosion at the gum line of my 3rd, 4th, and 5th teeth back from my center teeth at both top, bottom, left and right sides. I first had bondings done for the erosion areas only and they matched my teeth well and lasted 10-20 years. All my attempts to have them replaced with the same performance and quality have failed. Two years ago I had the majority of them replaced by a young dentist. They began falling out within a month so he replaced a couple and they also fell out quickly.

I’m very skeptical about returning though my family encourages me he will fix it without charge. Do you think it is too late to expect any refund so I can get appropriate help from a Cosmetic Dentist?

Should I attempt bondings again or porcelain veneers? I also have not mentioned that my teeth are discolored from Tetracycline when my adult teeth were developing.
Sincerely, Carolyn from Texas

Carolyn,
Thanks for your question and your kind comments.

The answer to how to restore your teeth is actually quite simple, but dentists who aren’t trained in advanced cosmetic dentistry techniques often don’t know this answer.

Recent research has revealed that these notch-shaped lesions at the gumlines of your teeth are actually caused by FLEXING of the teeth, which is aggravated by clenching of the teeth. They have been given the name “abfraction lesions.”

To get the restorations to stay in, the dentist needs to use a FLEXIBLE restorative material, which is counter-intuitive for most dentists. They think they need to use a very strong, hard restorative, but that type tends to pop out within a month or so.

If your dentist will use a microfill composite for these lesions, rather than a hybrid, that will go a long way toward helping them to stay in. Microfills are more flexible than hybrids. He should use something like Silux Plus, or Renamel. That will bend with the tooth and stay in usually for a number of years, provided that proper bonding techniques are used. Newer composites tend to be hybrids and microhybrids that don’t flex well, which may be why the older fillings stayed in for so long.

If your dentist is humble enough to take some direction, just sharing this information should be enough. If he isn’t, then you may need to seek out a refund and go to a more expert cosmetic dentist.

As far as your tetracycline stains, that is a more complicated issue. A set of beautiful porcelain veneers would totally transform your smile. But you definitely need a highly artistic, very competent cosmetic dentist for that, such as we recommend on our web site. Check our list of Texas cosmetic dentists. Don’t go to your family dentist for this – it is much too difficult, in spite of what they might tell you.

I hope this is helpful.
Dr. Hall.

Related links:
Dental bonding