Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

December 9, 2017

Dental bonding turning yellow after 5 days


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Dr. Hall,
I had bonding done on 3 front teeth 5 days ago. I used baking soda and wondered if I should’t have because now they look yellow. I was soooo happy to have fairly straight teeth, but now they look yellow. Is there a product available to whiten bonded teeth?

Thank you.
Brianna from Connecticut

Brianna,
Baking soda, unfortunately, used as a toothpaste, is very abrasive, and can damage the polish on the bonding. And no, there isn’t a product available to whiten bonded teeth.

Since this is so recent, I would return to the dentist that did the bonding and ask him or her if they would mind just freshening the polish for you. And then I would switch to Supersmile toothpaste. Supersmile was designed for the maintenance of dental bonding work.

There is a possibility that I should mention and that is that the dentist could have used inferior materials for the bonding. I hope that isn’t the case, but knowing that the vast majority of general dentists have a low level of expertise in cosmetic dentistry, I worry about that. It bothers me a little that it doesn’t seem that they gave you thorough post-operative care instructions for bonding. If you go through this process, use the Supersmile toothpaste, and the yellow comes back (or never goes away), then you may need to check out one of our recommended cosmetic dentists to fix this. The entire bonding probably wouldn’t need to be re-done, but it may need to be re-surfaced in a better material with a better polish.

– 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.

August 10, 2017

This cosmetic bonding went bad


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Dear Dr. Hall,

I recently had four of my front teeth bonded. My two very front teeth overlapped one another slightly and the dentist ground down both of them. The lateral teeth were set back in my mouth, and those are filled out to make it look more like a normal arc. My teeth are very uncomfortable and sharp feeling inside where he did the grinding down of the teeth. In other words, he “sacrificed” the one front tooth by grinding down the side of it in order to make the other front tooth look straighter. In addition, he also made the teeth a shade that is yellowish to “blend in”, no matter how much I protested. I have had such terrible regrets about doing this. I wish I could go back to the way my teeth were before the work because they were still intact and not damaged as they are now. I know there is no going back but would love your opinion on my options at this point. I have also had a problem at the gum line for a couple of years now, with there being a gap that has had to be bonded a couple of times before this work was done. I went with the bonding because I did not want to do anything drastic, but in fact that is what I had happen. I would like my teeth to be whiter and also not have that “damaged” feel to the back and sides of them. They were ground down quite a bit. I am very upset and this dentist is very difficult to deal with. I know this is rambling but if you have any advice for me, I would greatly appreciate it. Thank you for your time and assistance.

Sincerely,
Alani from Washington

Alani,
Your explanation of what happened is clear enough that I can help you with what to do from here.

This type of cosmetic bonding work is really beyond the ability of, I would estimate, 98% of general family dentists. It requires some artistic sensitivity, stocking a variety of dental bonding materials beyond the ordinary inventory that most dentists have on hand, and a fair amount of training and experience beyond dental school in shaping, coloring, and polishing the dental bonding materials, besides the shaping of the teeth.

I would need a photograph to see exactly what went wrong here, but I can tell enough to be able to say, with a fair level of confidence, that you aren’t going to get a pleasing result from this dentist. This is not to disparage him. I imagine he did the best he could and the work is probably up to the standard of care for general dentists. Your case was just over his head.

The good news is that there are a couple of excellent cosmetic dentists in Washington who are not too far from you. Go into our find a cosmetic dentist directory, type in your zip code, and it will pull up the recommended cosmetic dentists near you, either of which I’m confident could get you an attractive, comfortable result.
– 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.

June 15, 2016

My composite bonding is turning yellow


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Hello Dr. Hall, 9 months ago I had dental bonding done on my four front teeth. There is quite a bit of composite on each tooth because I have been re-doing it every 3 or 4 years for 20 years. My question to you is, I see a bit of yellowing, is it possible to just polish them to try and whiten them again since they were done just 9 months ago? Thank you for your time!
– Linda from New Jersey

Linda,
One of the big differences between composite bonding and porcelain veneers is that the porcelain is very hard and stain-resistant (it resists stains better than tooth enamel), and composite is much softer and much more susceptible to stains, so it has a much shorter lifespan.

The good news is that with the composite bonding, usually those stains can be polished out, depending on the type of stains.

Composite is susceptible to two types of staining. The first type, the type that can be polished away, is a surface discoloration. The surface of the composite will get tiny scratches in it and become roughened which causes it to attract stains of all kinds. A good polishing will get rid of the scratches and the accompanying stain and restore gloss to the surface. Below is an example of this type of staining. You can see that the surface of the two front teeth has a matte finish from all the tiny scratches, as contrasted with the gloss of the adjacent natural teeth:

dental bonding with yellow staining

Photo courtesy of Dr. Robert Soto, San Francisco, CA

But composite will also absorb stains into the actual substance of the material. Composite is composed of inorganic filler particles such as quartz or glass bound together in a plastic matrix. Certain colored liquids, such as coffee, tea, cola drinks, or highly pigmented fruit juices, will actually penetrate the plastic part of the material and become a part of it.

dental bonding stained yellow

Photo courtesy of Dr. Mark W. Langberg, Southfield, MI

This type of stain will not come out with polishing. But this staining also occurs more slowly and can take a couple of years to become noticeable. At the right is an example of this type of staining. You can see that the composite has retained its gloss. The discoloration is coming from deep within, as stains have been absorbed by the material.

Preventing This Staining

There are several preventive measures you can take to get the bonding to keep its nice appearance for longer.
1. First, choose an expert cosmetic dentist who stocks a full inventory of esthetic bonding materials. General dentists will typically stock general purpose composites that are actually impossible to polish to the high gloss needed to resist stain and look like enamel. The surface of the bonding should be a microfill composite that is polished to a high shine.
2. Second, don’t use an abrasive toothpaste. While Supersmile toothpaste is quite a bit more expensive than your typical Crest, Colgate, or other drugstore brand, those general brands have abrasives in them that will scratch the surface of your bonding. Some of the abrasives are worse than others. I always provided my bonding patients with a first free tube of Supersmile, because it has no abrasives but rather lifts stains off by chemically dissolving the protein pellicle on the teeth.
3. Third, make sure your dental hygienist is polishing your teeth with a very fine abrasive. Pumice tooth polish is a big no-no. She or he should be using a fine aluminum oxide polish. Ask for this. (See my web page giving tips for maintenance of dental bonding.)
3. Fourth, beware of staining beverages. If you need to drink them, swallow them quickly rather than letting them sit in your mouth. And remember that hot beverages have more staining power than cold ones because they cause a slight expansion of the plastic, opening up microscopic pores that can be penetrated with the stain.

Finally, I would seriously consider switching to porcelain veneers. I don’t know how much your dentist is charging for this bonding, but dentists who do it well will charge quite a bit. Which costs more–doing composite bonding six times over 20 years, or doing porcelain veneers once for those same 20 years? Porcelain veneers done by an expert cosmetic dentist can easily look beautiful for 20 years. Porcelain is harder than tooth enamel and more stain-resistant. But go to an expert cosmetic dentist for porcelain veneers–don’t ask your family dentist to do this.

– 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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