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Is rinsing with peroxide harmful to veneers?

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Dr. Hall,
I had six porcelain veneers done in South America, and now I have redness and swelling. Someone told me I could rinse with peroxide to help get rid of the inflammation. Will that damage the veneers?
– Claire from Georgia

(See Dr. Hall’s answer below.)


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Dear Claire,
No, peroxide won’t have any negative effect on your porcelain veneers. But let me explain why that won’t solve your problem.

There is something wrong with your veneers and it needs to be fixed or you’ll continue to have serious problems with gum disease on these teeth. While dental tourism is a way to save money on dental care, the risk is that you have a lot of poor quality dentistry in other countries and there are very few legal protections that you get in those countries. I even received one email from a distraught patient who had serious difficulty with dental work done in Costa Rica and discovered that she broke the law and she had to flee the country because they wanted to prosecute her for complaining publicly about the dentist.

Here are the possible issues that could be causing your gum inflammation:

  • The veneers don’t meet your teeth under the gumline precisely. The margin between the porcelain veneer and the tooth needs to be seamless and smooth. If there is what we call an overhang, it will catch food debris, be a breeding ground for bacteria, and be a permanent irritation to your gums.
  • The veneer can be overcontoured at the gumline. If there is an extra bulge in the veneer at the gumline, that can also provide a trap for food debris and bacteria and cause gum inflammation.
  • There can be hardened cement that hasn’t been cleaned off the tooth. This will leave a very rough surface there.

If the underlying problem hasn’t been fixed, there is nothing you can do to protect your gums. If a cosmetic dentist applies for accreditation with the American Academy of Cosmetic Dentistry, one of the first things the examiners will check in examining his or her work is whether or not the gums of the affected teeth are healthy. If they aren’t healthy, the dentist won’t pass.

Then we need to address possible complications in using a peroxide rinse to treat gum inflammation.

Peroxide will kill the bacteria in your mouth and can be used to fight gum inflammation. But there is a complication with that. There are a number of strains of bacteria in your mouth, not all of them bad. There is also a yeast organism in your mouth—candida albicans. This yeast, if it is allowed to predominate, can cause thrush, a painful inflammation of the mucosae in your mouth. Nutritional deficiencies can allow this yeast to predominate. Another way to allow this is to kill off the bacteria in your mouth with a peroxide rinse (peroxide will not kill the yeast). To avoid this, you don’t want to rinse with peroxide longer than two weeks.

So, no, peroxide won’t damage your veneers at all. But that can’t be a permanent solution to gum inflammation.

– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.

About David A. Hall

Dr. David A. 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 advanced internet marketing for dentists.

My crowns are making my gums bleed

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Dr. Hall,
So I had 8 crowns on top put on in 2021. They took them off last year, 2023, because they were causing my gums to swell and bleed.
So they took them back off and re-did them last July. I just got the second set taken back off a week ago because the same thing was happening. So I saw a periodontist and he said to keep my temps on for at least 3 months but the temps are just like the original ones. So I’m not sure if that’s going to help the gums heal?
I asked another doctor and he said they look too bulky and over-contoured up in the gums and aren’t fitting correctly on my real tooth. Do you think that is what’s causing it? I did a deep clean as well and the lady said she had to scrape some cement off up on the gum line.
I’m going to go get them re-done in Mexico here soon and showed them my x-rays so they have an idea. If they re-do them and they do them correctly will that help the gums de-swell do you think? Thanks!
– Ryan from Colorado

(See Dr. Hall’s answer below.)


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Ryan,
Not seeing this for myself, I can’t tell you if your crowns are over-contoured, but that sounds like a reasonable explanation. Yes, if the crowns are over-contoured, that will usually cause gum inflammation—swelling, redness, and bleeding. Your teeth have natural contours that provide for optimum health, and a crown should replicate those natural contours.
line drawings showing two crowns. The overcontoured crown promotes food collecting.Here’s a drawing showing a normal contour of the crown on the left, and overcontouring of the crown on the right. The drawing doesn’t show a normal gumline—usually the margin of the crown will be under the gumline. Overcontouring of the crown causes two problems. First, it puts pressure on the gum. Second, it creates a trap for food particles under the bulge of the crown. Both of these contribute to irritation of the gums, causing gum disease which results in redness, swelling, and bleeding of the gums.
But that’s not the only problem. You said that the hygienist scraped off excess cement. The dentist who cemented the crown is supposed to clean off all excess cement before dismissing you. Not doing that is a major flub. To me, that level of sloppiness is unacceptable for dental care.
But I am puzzled by your going to Mexico to have this fixed. Really?! I would think that after getting burned by low-quality dental care, you would be averse to seeking bargain-basement dental care in Mexico. From stories I have received about Mexican dental care, I would not expect that you would get this properly fixed there.

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.

About David A. Hall

Dr. David A. 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 advanced internet marketing for dentists.

I have gum inflammation after getting my veneers

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Dr. Hall

I recently had veneers put on 6 top teeth in Colombia by a NY doctor. But I would like to add more veneers to 4 molars on the sides of the incisors because I have a big smile. However I already feel some irritation around the gums where the veneers were placed. How do I get rid of the redness and swelling also do you know of a dentist who is an Emblem Health participant who also does cosmetic dentistry in Florida? I live in Pasco County.

– Lillian from Florida

(See Dr. Hall’s answer below.)


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Lillian,
The way I’m interpreting the questions you’re asking, it seems to me that you’re making a fundamental mistake as you seek to get a beautiful smile. You seem to be looking for bargains, and that is getting you in trouble. You had your porcelain veneers done in Columbia, which I am guessing you did to save money. And now you’re looking for a dentist who is an Emblem Health participant to finish your smile makeover. You want a dentist who will accept the discounted fees of Emblem Health.

So now you have redness and swelling of your gums. This is gum disease. The reason you have it is that your veneers weren’t done right. They don’t fit right. They should fit smoothly and seamlessly to your tooth with a natural contour that will be conducive to good gingival health. When I am looking at photographs of the work of a cosmetic dentist, that’s one of the first things I look for—any gum inflammation. If I see that, I won’t recommend the dentist. If the dentist is applying to become accredited by the American Academy of Cosmetic Dentistry and there is gum inflammation around their work, they will flunk. Left unchecked, the gum disease caused by poorly fitting porcelain veneers will progress and could result in the loss of those teeth. Fixing this could be a simple matter of cleaning out excess bonding material, but my guess is that it will most likely require replacing the veneers, and I would recommend that you find an expert cosmetic dentist who can do this for you. If you had had this work done in the United States, you could have some legal recourse against this shoddy dentistry.

About your “New York doctor” who did your six veneers, I decided to do a search to find out more. In searching for dental tourism in Columbia, I found two dentists who advertise some connection to New York University, but I wouldn’t call them “New York doctors.” Their connection to NYU is flimsy, and it looks to me like they say this to give some aura of expertise to themselves. My advice would be to not fall for this.

And then, if you have a wide smile, why did they do only six teeth? This is a common mistake made by dentists who only dabble in cosmetic dentistry. Again, this mentality will cause a dentist to flunk AACD accreditation, and I would not recommend a dentist who is too timid or price conscious to tell a patient they need more than six veneers for a beautiful smile makeover that involves any kind of color change. A smile makeover that involves a color change requires eight veneers as a bare minimum, and often ten or even twelve veneers.

You asked if I know a dentist in Florida who is an Emblem Health participant who does cosmetic dentistry. Well, almost every dentist claims to do cosmetic dentistry. But I will tell you that I have interviewed maybe a couple hundred excellent cosmetic dentists and they are all limited in their dental insurance participation. They may participate in one or two of the best-paying dental plans, but it will be with the understanding that their cosmetic dentistry isn’t subject to any of the discounted fees of the plan. Doing quality cosmetic dentistry requires a significant investment in post-graduate training, spending quality time on the case, and using the best materials. I am familiar with a number of patients who have sought discounted cosmetic dentistry and they end up needing the work re-done.

In retrospect, the best way for you to have saved money on your cosmetic dentistry would have been to simply not do it. But now you have gum disease and a difficult situation that could be quite expensive to fix.

– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.

About David A. Hall

Dr. David A. 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 advanced internet marketing for dentists.

How to know if you can trust your dentist.

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I had a visitor to this blog last month who was responding to a post in which I was critical of Mexican dental care. He wanted to tell me that the Sani Dental Group in Los Algodones was a quality operation. I responded that because of their aggressive marketing strategy, I didn’t trust them. He took issue with that, and I decided to respond to his last comment with a separate blog post. See my response below.


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Grant,

I haven’t changed my opinion about the Sani Dental Group. It is very easy to tell by what they do online that they have an aggressive marketing strategy. And even though every patient doesn’t perceive attempts to “upsell” treatment options, the fact that some do is troubling. Let me give a little more insight into my thinking.

Dentistry is a very ethical profession, on the whole. Most dentists have a sincere desire to help people and their professional goal is to treat patients in a competent and ethical manner. But some of them are driven to make as much money as they can. In the case of the Sani Dental Clinic, it looks to me like they are in this latter group.

Here is what I read on their website about their history:

“SANI DENTAL GROUP is the largest dental group in Los Algodones, Baja California, and one of the largest in Mexico. It was originally established in 1985 by D.D.S. Enrique Jimenez in Guadalajara, Jalisco, Mexico. After years spent honing his skills, he decided to move north to Los Algodones where he established a new office. Since then, SANI has grown from a 2-chair, one dentist office, to a 30+ dentists group with three different offices in Los Algodones.”

While this is worded to present the growth as something that just happened, I know enough about the dental industry to know that this kind of growth doesn’t happen without a strong driving force behind it. This is my first clue that the goal of the clinic is making money—as much as possible.

Their whole online presence shows an aggressive marketing strategy. This has become my prime area of expertise—dental marketing, and our specialty is presenting dentists to the public in a very matter-of-fact way, without any pushy marketing thinking. That’s not what they are doing. Now, you can tell that they are very smart in their marketing and have honed their customer service skills. They cater to the needs of their patients. That’s great. In their aggressive marketing strategy, they know enough to not want to be perceived that way when interacting one-on-one with their patients. As expected, most of their Google reviews are highly positive, and their are only a few complaining about them trying to upsell treatment options. That’s not enough to get me to trust them.

I look at the Yelp reviews and tend to rely on them more so than the Google reviews. Yelp is a different reviews platform, Yelp users tend to be more discriminating, and Yelp is more careful about what reviews it will display. The Yelp reviews for Sani Dental Group are mostly negative. Out of 13 reviews, 3 are 5-star, 2 are 4-star, 3 are 2-star, and 5 are 1-star. Here’s a quote from one of the 1-star reviews:

“My mom and I went to Mexico recently for her to have dental work done. I’m sure mom needed some dental work done but not 10 crowns and a root canal. The 2nd molar that had the crown and root canal fell out 2 months later due to bone loss.”

This is a very troubling review. If it is true that a root canal and crown were done on a tooth that had serious bone loss that would indicate a serious lack of integrity by the dentist—a dentist looking for an excuse to make as much money as possible.

Trust is critical in dental care, and you need a dentist who isn’t driven by monetary concerns. There are too many decisions that a dentist makes where different treatment options are weighed and the patient has no clue about what is really needed. Is a cavity big enough that a crown is warranted, or will a simple filling do? This question can come up daily. If a dentist is driven to make money, that is going to color that decision, and the patient isn’t going to know whether or not the crown was really necessary. Even honest dentists have to resist the temptation to over-treat.

I do have a dentist I recommend who practices just over the border in Mexico. I have spent quite a bit of time on the phone with this dentist and am confident of not only his expertise but his integrity. But sadly, I can’t say the same about the Sani Dental Group.

– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below. Or click here to ask Dr. Hall a question.

About David A. Hall

Dr. David A. 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 advanced internet marketing for dentists.

A victim of shoddy dental work in Croatia

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Dr. Hall,
I had $60,000 worth of dental work done in Croatia for $11,000. It was a great deal until the veneers are starting to fall off. That was in September 2015. I have a 10-yr warranty so I will be going back in September for hopefully permanent repairs.

I was eating a piece of chocolate cake in March when the veneer to the left of my front tooth popped off intact. A week later eating spaghetti the other one on the side of the front tooth fell off. Today after eating spaghetti one of the front teeth popped off. I had all on 6 done on the upper and an implant and replacement crowns on the bottom. I don’t think this should have happened.

I thought we got porcelain and I have not been eating with my front teeth, I cut everything up as instructed. My husband and I are baffled why it is not very strong. Will they have to re do my entire upper teeth or will they glue this back on? I can’t have anyone else touch it as it is under warranty so now I am gluing them on with Polident which lasts 3 hrs. I am so bummed out 4 months before I can get them fixed. Thanks for any insight.

– Cindy from US Virgin Islands

Cindy,
When they told you not to eat with your front teeth, that’s a big red flag. Properly bonded, you should be able to eat anything you want. Your dentist’s instructions remind me of what one patient told me – that her dentist told her that her porcelain veneers would come off every few months. A dentist who is placing these correctly wouldn’t put any of these restrictions on your activities.

I wouldn’t have any reason to believe that if they didn’t know the right way to bond on porcelain veneers in 2015, why they would know now and do it right. Why are you going back to these people?

Knowing that they didn’t know how to do porcelain veneers right, I would question all of the work they did for you–the dental implant and the crowns. I would recommend a second opinion on all of it.

What to do about your smile for now? If the veneers are truly porcelain and if they have fallen off intact, an expert cosmetic dentist should be able to clean them up and get them bonded correctly. But this is beyond the knowledge and abilities of probably 95% of family dentists. You need a dentist with strong expertise in cosmetic dentistry bonding techniques, who knows how to etch the porcelain and bond it correctly. The cost for re-bonding these veneers should be relatively small. I would recommend going to one of the cosmetic dentists we recommend and having them fix this for you.

– 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 A. 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 advanced internet marketing for dentists.

Should I get my crowns done in Costa Rica?

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Dr. Hall,
I am debating on going to Costa Rica to get my 12 crowns replaced. I have 6 on the top and 6 on the bottom. In Costa Rica they do everything in a lab and it takes two weeks ( So I have to stay 2 weeks, which isn’t a bad thing except the time I can go it will be raining). I am just curious what my options are here in Arizona since I just moved here. I am looking for natural-looking teeth and would like a dentist that doesn’t make my teeth look like they came from a cookie cutter so to speak. In Costa Rica I can get all of my teeth done for around $6000. Not including the travel and hotels etc. Is there anything comparable to that here in Arizona that you know of?
– Tanya from Arizona
dentistry in Costa Rica
Tanya,
I have a question for you before you go to Costa Rica to have your crowns done. Do you think there is any possibility that anything could go wrong in the process of getting twelve crowns?

I’ll give you the answer to that question–yes, there are any number of things that could go wrong. Let me list some of them for you, off the top of my head:

These are the first twelve things that came to mind, of problems I have either seen or patients have told me about when they had multiple crowns done. It isn’t an exhaustive list.

And then here is a link to an earlier blog post I wrote about dentistry in Costa Rica. A woman wrote to me about crown and porcelain veneer work she had done there. She ended up having four of these things on the list go wrong, and some things that aren’t on my list. Another dentist told her that what was done to her by this Costa Rica dentist was criminal negligence. But when she tried to get satisfaction, SHE ended up being the person in legal trouble, because of the corrupt legal system in Costa Rica. She has an estimate of $35,000 to fix the damage this dentist caused.

Even with excellent dental care, with that many crowns there is often something that will go wrong during the treatment. It appears that if that happens to you in Costa Rica, you’ll end up stuck.

If you want to save some money and you’re in Arizona, one option could be to go to Dr. Isaías Íñiguez. He is actually AACD accredited and has a practice in Los Algodones, Mexico, just across the border from Yuma, Arizona. He charges Mexican fees for what I believe is high quality cosmetic dentistry. Check him out.

– 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 A. 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 advanced internet marketing for dentists.

Dentistry in Costa Rica

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I’ve written before warning about getting dental work done in Costa Rica. But I just became aware of an incident that truly highlights the risks. Because I am only able to partially confirm this patient’s claims, I am not publishing the name of the dentist, which she had provided, only her story because it illustrates the risks in dental tourism.

dental tourism in Costa Rica

(see the full story below)


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Dr. Hall,
I went to Doctor [name withheld] at [name withheld] Dental Clinic just outside of San Jose Costa Rica for some dental work and to have porcelain veneers placed. The dentist broke one tooth and caused me to need three root canals. He left me with ten open margins, I had crowns pop off, and he screwed up my bite so badly that I now suffer from severe TMJ, constant pain, can’t eat or speak properly etc… I have an estimate of $35,000 to fix my bite (which I don’t have) which doesn’t include the root canals. He refuses to refund the small fortune that I paid him and refuses to pay to have my teeth fixed.

But the story gets worse.

After my follow-up with an American dentist who said that I was the victim of criminal negligence, I hired a Costa Rican attorney. We were able to get three Costa Rican dentists to concur with the American dentist. We met at the Dental Colegio. But all that mattered at the Colegio board meeting was the fact that I complained publicly about Doctor [name withheld]. It was explained to me that it is a felony to speak against the reputation of a Costa Rican citizen unless or until that person has first been found guilty of a crime in a Costa Rican court of law. It did not matter that I filed those complaints online about the dentist from my own home in America. I had to flee Costa Rica immediately to avoid being arrested.

As far as filing criminal charges or a lawsuit, my attorney told me that the dentist would just bribe an official and make the case go away. My only hope was with the Costa Rican dental Colegio and they cared nothing about justice. Their legal system in Costa Rica is very corrupt. There is no justice there for Americans.

I also learned that this dentist didn’t graduate from a dental school in Miami as it claims on his website. He only took a class there.

– Kimberly from Florida

I thought I would just pass on Kimberly’s experience here, as there isn’t much I can do to help other than to help publicize her plight. I did look up the dentist she mentioned, and the website looks very inviting and gives you the feeling that you’re going to get wonderful care. The credentials presented look legitimate. However, as a dentist, I noticed some red flags that I think would escape the normal patient. For example, this dentist claims to have had a minor in implant dentistry from Miami University, as Kimberly mentioned. But there is no such thing as a minor or major or any organized course of study in implant dentistry at any American school—it isn’t a recognized specialty. He also claims to have a minor in Orthodontics and Prosthodontics from the DaVinci Institute. Besides the fact that this makes no sense—there are no “minors” in any dental field in the United States, only majors. And the combination of those two specialty areas in dentistry is made up. If minors did exist, he would have two separate minors—one in Orthodontics and one in Prosthodontics. Besides this, the DaVinci Institute is a think tank in Colorado. It may sound dental because of the famous DaVinci Dental Studio in California (a renowned dental laboratory that makes porcelain veneers), but there is nothing dental about the DaVinci Institute. Then, googling the dentist’s name and the name of his clinic, I discovered that the name of the clinic had been recently changed, a tactic used to escape a bad reputation. Also, there are no Google reviews for this dentist or his clinic, under either of its names, which is very strange. These are all red flags. But they would escape the typical dental patient.

I also found another serious complaint filed against this dentist on the website ripoffreport.com.

Bottom line: Beware! Just don’t do it. Both implant dentistry and beautiful cosmetic dentistry are risky enough in the United States. Don’t compound it by going to a place where you have poor standards of care and absolutely no legal recourse in case something goes wrong.
– Dr. Hall

Do you have a comment? 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 A. 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 advanced internet marketing for dentists.

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