Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

July 11, 2019

My porcelain crowns are turning yellow


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Dr. Hall,
I have six porcelain crowns in the upper front. They are six months old and are turning yellow. I don’t smoke or drink any soda. I drink a cup of coffee every morning and water the rest of the day. I brush at least twice a day. They were beautiful when I first got them. I am super disappointed and don’t know what to do. Please help.
– Tonya from Ohio
 
Tonya
Something is definitely wrong, and you need a second opinion about your case from an expert cosmetic dentist. Find someone from our list or ask around to find someone. You may want to check an earlier post in which I include some tips about how to ask for a second opinion. Porcelain is extremely stain-resistant, even more so than natural teeth, and neither smoking nor heavy coffee drinking will discolor it.
I’ll give you a couple of possibilities of what could be wrong, and hopefully an expert cosmetic dentist looking at your crowns can tell you which it is.

•You say the crowns are six months old. That would give you time to have had another checkup and cleaning. The hygienist cleaning your teeth could have damaged the surface of the crowns. There are two things he or she could have done to damage that surface. One would be by using a power cleaning instrument such as a Prophy Jet, which blasts sodium bicarbonate on your teeth to get them extra clean. This will remove the glaze of the porcelain leaving them vulnerable to stain. Another would be giving you a fluoride treatment with acidulated fluoride, which will etch away the glaze chemically.

•The crowns could have been put on with the glazed surface already damaged. If the dentist had to adjust the front surfaces of the crowns, he or she could have ground away the glaze. Or maybe the laboratory didn’t properly glaze them in the first place.

•The crowns could be actually made of another material, not porcelain. As outlandish as this sounds, I have had emails from patients complaining of porcelain crowns or porcelain veneers turning yellow and it was discovered that they were made of composite, not porcelain. If your dentist has misrepresented your treatment to this extent, I probably don’t need to tell you that you have a lot of leverage for getting your dentist to pay another dentist to get this done right for you. A simple refund may not be enough money because your crowns may be discounted—they need to pay the full fee for another dentist to do it right. Otherwise, you could get them in deep trouble.

Anyway, good luck with getting to the bottom of this. I’d be interested in finding out what you learn in your second opinion, if you wouldn’t mind getting back to me.
Thanks,
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.

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December 29, 2017

Too much shine on my porcelain veneers

Filed under: Porcelain veneers — Tags: , , , , , — mesasmiles @ 2:30 pm

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Angela saw my post, “Do porcelain veneers lose their shine?” and wrote the following comment, which deserves its own post to answer:

I don’t know why he wants shine. I just had my porcelain veneers installed and I HATE the shine. That’s how you can tell that those teeth are fake, they have this crazy unnatural shine and spoil every picture. Is it possible to REDUCE shine? Is there anything I can do to make them shine less. Its a blinding shine that looks awful , real teeth don’t shine like that.
– Angela

Angela,
Thanks for a great comment. It opens up an opportunity to discuss an important aspect of a smile makeover that isn’t often discussed, and that is the shine and texture of the surface.

The glaze on the porcelain is very important. That’s what gives the porcelain it’s excellent stain resistance and gives the porcelain its natural sparkle that makes it look so real. But it needs to be applied correctly. In order for it to look lifelike, there has to be some texture. It sounds like what you have is a very flat surface on your porcelain veneers, and that will generally look fake.

Here is a photograph of someone’s smile. Three of these teeth are real and one, the lateral incisor on the right, is a crown.

photo of four front teeth showing the texture and sparkle of porcelain crowns

Notice that the surface of the teeth, while it is shiny, is irregular. This gives the teeth a sparkle, and is one of the characteristics of a beautiful, natural smile. And the amount of texture can be varied to create different impressions. Younger smiles tend to have more texture. As we get older, the teeth wear down and so have less texture on the surface.

But let’s go to your case, Angela. It’s interesting that you say that you just had these porcelain veneers bonded on and you hate them. That will never happen with an excellent cosmetic dentist. I talk with many expert cosmetic dentists and I ask them about the try-in procedure, and every one of them tells me how important it is to them that the patient love the new smile before they bond it on. Even if the patient says they like the veneers but they’re just lukewarm about it, an excellent cosmetic dentist will ask why and, if necessary, will send the case back to the laboratory to be re-done until the patient is enthusiastic about them. That clearly never happened in your case.

You say you want to reduce the shine. There are ways to do that. The quickest way is to have a dental hygienist use a Prophy Jet to polish them. This applies a powerful sodium bicarbonate spray to the teeth and will destroy the glaze from the porcelain. But then your veneers will readily attract stain, and, without the natural texture, they still won’t look natural.

My advice would be to go back to your dentist and see if you can talk him or her into re-doing them. You paid for a beautiful smile—that’s what you should get. And insist that you get to see them temporarily placed on your teeth and that you approve of them before letting the dentist bond them on.
– 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.

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December 19, 2017

Staining around 1-year-old porcelain veneers

Filed under: Porcelain veneers — Tags: , , , , — mesasmiles @ 6:13 pm

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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

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

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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.

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May 19, 2016

Porcelain veneers turning gray. Is it the Listerine?

Filed under: Porcelain veneers — Tags: , , , , , , — mesasmiles @ 8:59 am

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Hello Dr.Hall
I had 20 porcelain veneers done 8 months ago. I’ve been using Listerine (has alcohol in it) and using a strong toothbrush and using Colgate toothpaste. And lately my teeth look grey so I Google online saying I shouldn’t be using any of this above. Dr. Hall is it because of the Listerine and toothbrush and paste that why my veneers turned grey? When I left the dentist, no one told me anything about what I shouldn’t do. Please let me know thank you so much.
– Thao from California

Thao,
That’s too bad that no one in your dentist’s office gave you any instructions on how to care for your new porcelain veneers. Let me help you out.

As far as what you are doing:
1. Listerine with alcohol is not good to be using with porcelain veneers. There are mouthwashes without alcohol. Click here for the blog tag on alcohol-free mouthwashes for more information on that.

2. Neither is a strong toothbrush good for porcelain veneers. Use a soft brush. Soft toothbrushes clean more effectively anyway.

3. Colgate toothpaste shouldn’t be a problem. Colgate regular (not the super-whitening or tartar-control formula) is one of the toothpastes that is less abrasive than most. I would recommend Supersmile toothpaste for porcelain veneers, but Colgate regular isn’t that bad a choice.

However, none of these practices will cause your veneers to turn gray. The Listerine and the hard toothbrush will damage the margins, which could lead to a ditching at the margin or staining at the margin. If there is a general slight graying of the veneers, I see only two possibilities for that. Either what you got wasn’t really porcelain, or something happened to damage the surface, something stronger than toothpaste or mouthwash or a brush. You say this is after 8 months. If you had a cleaning at 6 months and the dental hygienist used a Prophy Jet or other power polishing machine (see our page on Prophy Jet damage to porcelain veneers), that would certainly do it. If you’ve been in violent sandstorms or you work with sand-blasting equipment, that could also do it. Otherwise, I would suspect that the veneers aren’t really porcelain.

– 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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August 5, 2015

Is the Cavitron safe for use with porcelain veneers?

Filed under: Post-op care for cosmetic dentistry — Tags: , , , , , , , — mesasmiles @ 3:39 pm

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.

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January 31, 2014

Do porcelain veneers lose their shine that quickly?

Filed under: Post-op care for cosmetic dentistry — Tags: , , , , — mesasmiles @ 6:27 pm

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.

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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.

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January 29, 2014

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

Filed under: Post-op care for cosmetic dentistry — Tags: , , , , , — mesasmiles @ 9:46 am

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.

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September 11, 2011

Why are my veneers this horrible yellow color? And they are going black at the top.

Filed under: Porcelain veneers — Tags: , , , — mesasmiles @ 1:12 am

Dr. Hall,
I’m getting married next year and really hate my teeth at the moment. I have veneers on the two front teeth but I have had them since I was 16. I am now 32 and they are going black at the top they are also a horrible yellow colour. I am so depressed. Why do they look like this and what can be done?
– Lisa from Liverpool

Lisa,
Porcelain veneers should be able to last 16 years if they are reasonably well taken care of and shouldn’t be turning yellow. You didn’t say these were porcelain veneers, so let’s assume they are composite veneers. Composite will discolor easily, and they can begin to discolor as soon as a year after they are placed, depending on your eating, drinking, and/or smoking habits. Porcelain veneers, if they are later cleaned with power polishing sprays such as the Prophy Jet, will lose their glaze and will similarly begin to turn yellow. You may want to read my page on yellow porcelain veneers.

The black at the top would probably be from leakage – the bond is failing near the gumline. This is a sign that they need to be replaced. If the dentist isn’t extremely careful in the bonding technique when veneers are placed, the place where that bond will begin to fail will usually be at the gumline. What happens is that fluid seeps up from the gums during the bonding process. Expert cosmetic dentists will pack what is called retraction cord between the gum and the tooth, and this cord will be impregnated with an astringent that will prevent any fluid from seeping in and contaminating the bond. This is a fairly demanding requirement of the bonding process, and dentists who don’t know what they are doing, or who are careless, will get contamination of that bond and over time you will see that blackening of the veneer near the gumline.

Bottom line: You need to get these veneers replaced. Not just for the sake of their appearance, but the leakage leads to decay underneath them, so that needs to be cleaned out before it goes too far.
– 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.

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January 29, 2010

21-year-old porcelain veneers are turning dark.

Filed under: Porcelain veneers,Post-op care for cosmetic dentistry — Tags: , , — mesasmiles @ 2:12 pm

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.

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May 27, 2008

Will the dental hygienist damage my porcelain veneers?

Filed under: Post-op care for cosmetic dentistry — Tags: , , , , , — mesasmiles @ 3:45 pm

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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