Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

August 5, 2015

Is the Cavitron safe for use with porcelain veneers?

Dr. Hall,
I just had my first dental cleaning with my new veneers….placed by a cosmetic dentist recommended on your website. The tool used to clean was called a “cavitron.” It seemed to shoot out a lot of water while cleaning the teeth. I’m assuming that this is safe because this is a very good dentist, but after reading your website, I got nervous. Can you let me know if the cavitron is ok, not too harsh on the porcelain…
Thank you for this excellent website.
– Anna from Connecticut

Anna,
Yes, the Cavitron is an ultrasonic scaler, and in my advice for care of porcelain veneers I have written a caution about that, that an ultrasonic scaler can chip the margins of porcelain veneers. It’s not the water that is the cause for concern, but the metal tip that vibrates at an ultrasonic frequency. But thanks to your bringing this to my attention, I have gone over this advice to update it. After some additional years of experience with these machines, I’m going to soften that advice somewhat. Ultrasonic scalers like the Cavitron have gotten very popular with dental hygienists and I believe that most quality offices are now using them. I believe that if hygienists are skillful in using them, are smooth in their motions and don’t dwell on the margin area, that they are fine. So where I used to list ultrasonic scalers as unsafe to use with porcelain veneers I’m going to say now that in the hands of a good hygienist you should be fine.

These ultrasonic scalers are powerful and they not only have the potential to nick the margins of porcelain restorations, but they can nick the cementum of teeth, causing a roughness that will attract plaque and calculus. But I have had the opportunity to observe closely in the past few years at three dental offices where the hygienists have used ultrasonic scalers, and they have all been excellent with them, to where I really don’t think there is a risk of damaging the porcelain.

The two absolute no-no for dental hygienists in maintaining porcelain veneers are no Prophy Jet and no acidulated fluoride treatments. The Prophy Jet sprays an abrasive at the teeth at high pressure and it will destroy the glaze on porcelain veneers. This isn’t a risk, it’s a certainty. And acidulated fluoride will etch the surface of the veneers causing similar though milder damage.

Dr. Hall

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

January 31, 2014

Do porcelain veneers lose their shine that quickly?

A couple of days ago I posted a question from Aaron in Indiana. He had a smile makeover that he said had lost its shine. I invited him to give me more information, because ordinarily porcelain veneers will not lose their shine unless they are abused by a dental hygienist with a Prophy Jet power polisher, or a fluoride treatment with acidulated fluoride. Both of these will remove the glaze on porcelain veneers.

He responded by describing his treatment to me, and enclosed a photograph of the work the way it looks now. Yes, it was porcelain crowns and porcelain veneers. And he confessed to having obsessive-compulsive tendencies.

Here is the photo:

aaron-smile-makeover-going-dull

 

Yes, I would say obsessive-compulsive here. These teeth still have their shine. The glaze is still there and they look fine.

Here’s what I told him:

 

To me it looks like a normal luster on the porcelain – the glaze is still there. There may be some polishing that could be done, but myself, I wouldn’t touch it. Nothing on porcelain is as good as the natural glaze. Porcelain polishes, because porcelain is so hard, have to be a diamond paste, and a polished porcelain surface to me is second best to the original glaze.
– Dr Hall

See Aaron’s reply. His dentist polished the veneers some, and he tried Supersmile toothpaste and loves it.

We thank our advertisers who help fund this site.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

January 29, 2014

After 2 months, my smile makeover is losing its luster. What is going wrong?

Dr. Hall,
I just had a cosmetic total upper smile make over from a very credible cosmetic dentist. I am in love with the results and have been caring for my new smile better than I would my natural teeth. It was a HUGE investment, so one has to be particularly attentive. I am currently brushing with Crest 3D Glamorous white toothpaste, as it was the best toothpaste at the drug store and rinsing with Listerine whitening 6 in one with fluoride. I’ve noticed that the pearly luminescent white sheen is now significantly diminished in just over 2 months from the reconstruction. I read online that a mild baking soda paste could restore the sheen. That was tried with no success. Could my toothpaste be the problem and can the nice sheen be restored by my dentist? Will Supersmile toothpaste restore the sheen at home? And if not will it preserve the sheen if my dentist can restore the luster in office? I have an appointment with my cosmetic dentist next week and intend to ask her the same questions. Hopefully, you can reply so I am fully educated before my visit next week. I really enjoyed reading your website. Thank you for your time and consideration.
– Aaron in Indiana

Aaron,
There are two possible reasons for a loss in luster of a smile makeover within only two months. I don’t have enough information to tell you which of these is the case. If you can give me more information about exactly what was done, what material was used, and about the dentist who did them, I could tell you.

Porcelain itself is extremely hard, harder than tooth enamel, and it would take a pretty potent abrasive to dull its shine. Toothpaste alone wouldn’t do it. Power polishing equipment (such as the Prophy Jet) that is used by some dental hygienists will take away the glaze and cause the porcelain to go dull. Another thing a dental hygienist can do is to give you a fluoride treatment with acidulated fluoride. This form of fluoride has hydrofluoric acid in it, which will etch porcelain, dulling the surface and making it susceptible to stain.

The other cause of a loss in luster of a smile makeover would be that the makeover is not porcelain but composite. Composite isn’t nearly as hard as porcelain and is softer than tooth structure. A number of things can dull the shine of composite, including a toothpaste that is too abrasive, or ordinary polishing pumice used by most dental hygienists. Besides that, your mouthwash, the Listerine Whitening 6 in 1 with Fluoride, has alcohol in it. Alcohol will soften the composite so that it is even more susceptible to scratching and staining. I’d skip the mouthwash – most mouthwashes have alcohol in them.

I hope this is helpful.
Dr. Hall

(See the follow-up post: Do porcelain veneers lose their shine that quickly? Aaron tells what was done and sends a photo of the work.)

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

January 29, 2010

21-year-old porcelain veneers are turning dark.

Dr. Hall,
I got porcelain veneers in my two front teeth like 21 years ago because of white calcium deposits on my teeth, but it seems like my teeth are getting darker and darker……it is very apparent in pictures. It really bothers me. What are my options?

Thank you,
Shayna from Georgia

Shayna,
I wouldn’t know for sure what the problem is with your porcelain veneers and your two front teeth without seeing them, but maybe I can be helpful.

Porcelain is very hard and stain resistant. It is actually more stain resistant than enamel, as long as its glaze is intact. But enamel has a certain capacity for self-repair by drawing minerals from your saliva. Porcelain doesn’t do that. This leads me to wonder if the glazed surface of the porcelain has been damaged.

The easiest way to damage them like this is for a dental hygienist to use power polishing equipment such as a Prophy Jet on them – that will destroy the glaze in one short appointment. They’ll look bright and clean when you’re through with your appointment, but within a couple of weeks afterward they’ll begin to attract stain and start to become darker. Or the glaze could be damaged with acidulated fluoride treatments or other means.

If they are darkening because the surface has been damaged, it may be possible to restore the beauty of your smile with sophisticated polishing techniques using diamond grit polishers. I would advise contacting one of our Georgia cosmetic dentists and getting an opinion about it. This is beyond the ability of a family dentist.

The other possibility is that your teeth are darkening under the veneers and the darker color is showing through.

Dr. Hall

Related links:
Read our page: How long do porcelain veneers last?
Read basic information about post-operative care of porcelain veneers.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

May 27, 2008

Will the dental hygienist damage my porcelain veneers?

Dr. Hall,

I have a question would like you to help me. I have 8 veneers on the fronth teeth and I am wondering will the veneers loosen or break when a hygenist use dental tools to clean along the gumline during regular cleaning? Thank you and I look forward to hear from you.
Sincerely,
Vu from Ontario

Vu,
This is a good question. No, the hygienist won’t pull the porcelain veneers off or break them. They’re too strong for that. But yes, you do need to be concerned about possible damage that a dental hygienist can do to your porcelain veneers–she or he could chip them or dull the surface. It’s safest to have your cleaning done in the office of an expert cosmetic dentist, but if you have this checklist of “no-no’s” to give the hygienist, and you’re up front about what you want the hygienist to do and not do, you could have your veneers cleaned in any office:

  1. Power polishing equipment will ruin the surface. Some hygienists like to use Dentsply’s Prophy Jet. It’s a power polishing unit that sprays a mixture of sodium bicarbonate and water on your teeth and gets them really clean very quickly. Your porcelain veneers will look great at the end of the appointment, but the glaze will be completely gone and they will begin to stain as soon as you get home. This is the worst thing a hygienist can do to your porcelain veneers. There are other brands of power polishers that will also harm your veneers.
  2. An ultrasonic scaler can also damage the veneers right on the margins. It can cause little chips on the edges that will then become places where stain and plaque can accumulate and where decay will later start.
  3. Heavy duty manual scalers can also chip the margins, if they are used right on the margins of the veneers. Sometimes your hygienist needs to use these scalers, but she or he just needs to be careful not to be scraping hard right on the margins.
  4. Also, coarse polishing pastes with coarse pumice can scratch the veneers a little, and can scratch the luting composite at the margins a lot. Hygienists should only use fine or ultra-fine polishing pastes, preferably with an aluminum oxide grit–no pumice.
  5. And finally, some dental hygienists like to give fluoride treatments even to adults. Beware, if you have porcelain veneers, that they don’t use acidulated fluoride, which will etch the surface of the porcelain and remove the glaze, similar to what power polishing equipment does. They should use a neutral fluoride gel.

I hope that’s helpful.

For more information, see:
Our page on taking care of porcelain veneers.
We recommend for people with porcelain veneers that they use Supersmile whitening toothpaste daily, because it is so effective at removing stains but yet it is gentle on cosmetic dental work.
Our page on general cosmetic dentistry maintenance, with tips on taking care of various cosmetic dental work.
Click here for a cosmetic dentist referral.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

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