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.

Staining around 1-year-old porcelain veneers


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I got veneers almost a year ago now & I am noticing staining between my teeth. I do smoke, but i thought veneers were pretty hard to stain? Should I make an appointment with the cosmetic dentist that did them? I’m still paying on these, almost finished paying them off. I don’t want to continue paying if this is going to get any worse. I can send a pic if you want. Thanks!!
– Kayla from South Carolina

Kayla,
I would like to have a picture of these, because it could be one of a couple of different things going on. Lacking a picture, I will take my best guess.

You’re right that the porcelain itself won’t stain unless the glazed surface is damaged somehow, like with a power polishing machine like Prophy Jet, or with a fluoride treatment with acidulated fluoride. If either of those had happened to you, however, there would be staining across the entire surface of the porcelain veneers.

Since your staining is between the teeth, it seems likely that it is at the margins where the porcelain meets the tooth. There are two or three reasons that this area could be attracting stain. If there is a gap between the porcelain and the tooth, that would be tricky to fix. But my guess is that there is just some area of bonding composite here, and that is pretty easy to polish. But I would go back to the dentist who did these veneers for you and not expect a general family dentist to know how to do this correctly. This area most likely was polished when you had your veneers bonded. It may just need to be re-polished.

When I practiced, I encouraged my porcelain veneer patients to schedule regular re-polishing appointments where my hygienist would use ultra-fine polishing strips in this area and a special ultra-fine aluminum oxide polishing paste, to keep this area as smooth as possible and resistant to stain and plaque accumulation, to prolong the life of the veneers as much as possible. The point is that this is an ingredient of maintenance, and not anything that indicates that the veneers were poorly done. As such, I would expect to pay for this visit. For most patients, any accumulated stain would be minor. If you’re a smoker, though, it would be more obvious.

You can check out my page of tips for porcelain veneers post-operative care where I explain this polishing maintenance and address the possibility of staining.
– 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.

Do I need fluoride treatment as an adult?


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Hi Dr. Hall,
I am wondering if you can help me with a few dental exam questions? When I go to the dentist it seems they insist that I receive x-rays every six months. Is this necessary—what is the recommendation? Also, as an adult, do I need fluoride and if it is not needed will it have a negative effect if I get it?
– Kay from Arizona

Kay,
The general guidelines for routine checkups are to have bitewing x-rays (two or four x-rays taken while you bite on a tab that holds the film) once a year and a panographic x-ray or full series of x-rays (showing the roots of the teeth) once every five years or more.

There are variations from this that can depend on the individual. Some people with aggressive decay problems may need x-rays very 6 months, but that would be rare. In my practice of over a thousand patients, I maybe had a handful of patients for whom I would want x-rays that frequently. I did have some for whom I recommended x-rays less frequently.

As far as fluoride treatment, that is generally given to children and youths up to age 14—in some cases up to age 18. Once the permanent teeth are fully formed and the enamel has matured, the benefits of fluoride treatment are less. Adult fluoride treatment would similarly be justified in the case of some patients with aggressive decay problems.

There are no deleterious effects of fluoride treatment on natural teeth. But if you have any porcelain work, the most common type of fluoride can etch the porcelain, destroying the glaze and possibly removing some of the color. Most fluoride administered in dental offices is acidulated fluoride. The acid in the fluoride assists in its absorption by the teeth, but that same acid will etch porcelain, making the surface more rough which makes it attract stain. Also, the dental laboratory technician who fabricates the porcelain restoration will sometimes place tints in the surface in order to match the coloration of adjacent teeth, and those tints could be dissolved away by acidulated fluoride.

– Dr. Hall

Do you have a comment or a question or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

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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