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Cosmetic and
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dentistry

Sonic Toothbrushes and Dental Bonding

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I read that you cannot use ultrasonic toothbrushes if you’ve had dental bonding. Is there a particular type of toothbrush that should be used?

Addy

Dear Addy,

before and after dental bonding

 

I think there is some confusion of terms here. Toothbrushes can be sonic, but I don’t know of any ultrasonic toothbrushes at this point. Could it be you read something about ultrasonic scalers or cleaners?  These are used by dental hygienists. When not done skillfully, they can nick and damage the dental bonding. This is a danger to dental work.

However, if you are going to an office that does a LOT of cosmetic work, then the hygienist is probably trained and highly skilled and your dental work will be safe.

Sonic toothbrushes do not have the same risk. Sonic moves slower than ultrasonic. Plus, the bristles are soft, which also lessens the chance of damage.

You’re fine using pretty much any toothbrush you will use regularly.

That being said, one thing you will definitely want to avoid at your dentist’s office is that the hygienist doesn’t use the power prophy jet or acidulated fluoride. Both of those things will permanently damage your dental work.

Like the scalers, an office that does a lot of cosmetic work will know this, but your average family dentist may not.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Click here to learn about smile makeovers.

Dental Bonding Keeps Falling Off

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I have fluorosis stains and paid my dentist to cover them with dental bonding. It has been a bit of a nightmare and I want to know if I have the right to ask for a refund. When he first placed the bonding, it was a little bit uneven in color, but even worse, you could still see the stains underneath them, which defeated the whole purpose of getting the bonding in the first place. He made them thicker, which did cover the stains. However, they fell off less than a week later. I went back and he did them again and said my bite is the issue and to wear a night guard. So, I paid for one of those and guess what? They fell off again anyway.  He said they’re not permanent and I should not have too high of expectations. I did know they would not last as long as something like porcelain veneers, but he originally hinted they could last around five years. I’m barely getting five days. Is it reasonable to ask for a refund?

Jack

Dear Jack,

A side by side image of mild and severe fluorosis stains

For the benefit of readers who may not know what fluorosis stains are, I’ve placed these two images above. Fluorosis stains result from a child having ingested too much fluoride while their teeth are developing. It is not as common in the United States as it is in other countries but does happen.

While in many cases it is hard to get a refund for cosmetic dental work, yours will be an exception. It is nearly impossible to get a refund just based on not liking how the dental work looks, which is one of the reasons we remind readers of our blog about the importance of going to cosmetic dentists who have invested in the training necessary to do beautiful work.

Cosmetic dentistry is not a recognized specialty, so any general dentist can call themselves a cosmetic dentist and do the procedures. How well they do the procedures varies from dentist to dentist.

Your dentist is obviously in over his head as he can’t even keep the dental bonding on. That is good news for you, though. The basic standard in dental care is that it stays on. Because your dentist seems incapable of that, you should have no problem getting a refund. If he gives you any trouble with that, let him know you’ll be talking to the dental board. That should sober him up.  Then, I want you to get this done by a cosmetic dentist with more expertise.

I suggest you look on the mynewsmile.com website for the dentist to re-do this procedure for you. Each of the dentists listed on this site are pre-screened for both their technical skill and their artistry. They can provide you with beautiful dental bonding that actually stays on your teeth.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dentist Won’t Do Bonding

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I have black triangles that developed after some orthodontics.  I read online that this can be fixed with dental bonding but my dentist is insisting this is a bad idea. I don’t want to leave these holes so what can I say to convince him? I’ve tried showing him an article about it and he really still doesn’t think it is a good idea.

Brenda

Dear Brenda,

example of black triangles

While you are correct that dental bonding will be a good solution for this, I would not push him into this. When a dentist tries to steer a patient away from a procedure, it is usually because they are not qualified to do it but do not want their patient to lose confidence in them.

This is an advanced, tricky procedure to do. In your place, I am going to suggest you see a dentist with the training necessary to do it. The dentists with proven skills and training are AACD accredited. There are other excellent cosmetic dentists as well, but these have already been tested so you know what you are getting into. If I were in your position. That would be the dentist I’d use.

If you are interested in whitening your teeth. Make certain you do it before you have any bonding done. The color can’t be changed on the bonding after it is done, so you want any color matching to be done with the color you are going to keep.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

 

Splotchy Teeth After Braces

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My daughter had braces. Before the braces, her teeth looked uniform in color. Now they are splotchy. Is there something we can do to repair this?

Pauline

Dear Pauline,

Smile with braces

When teeth are splotched after braces, it is generally white spots. These are decalcification spots. It means the enamel in that area is weakened because they didn’t get thoroughly clean during her braces treatment. This happens quite a bit. It is rather difficult getting between all those metal wires and brackets. Plus, they trap things there. Hopefully, her dentist or orthodontist had the foresight to instruct her to keep a toothbrush and toothpaste with her at all times so that she can brush after each meal.

Decalcification spots are pre-cavities, so you do want to treat them. The best treatment is to have the spots gently ground off and then use dental bonding to protect the area.

One word of caution. This isn’t a procedure I would recommend your average family dentist do. You want someone who can blend the composite perfectly to her teeth so that it looks natural. This takes advanced cosmetic dentistry training. Make sure your dentist has that before moving forward.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss. Click here to learn about AACD accredited dentists.

Dental Bonding Turning Yellow in a Week

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I don’t know what is happening. I had dental bonding done on six of my front teeth. It’s been only a week and they’re turning yellow. I really loved them when I first got them and expected them to last a few years. What do I do? Can I whiten them?

Pauline

Dear Pauline,

before and after dental bonding

I am sorry this has happened to you. There are a couple of possibilities here. One is that your dentist used subpar materials. The second is that you did something to damage the polish on them. Either way, the fault will likely lie with your dentist because it is his responsibility to instruct you on your post-operative care.

Is it possible you brushed your dental bonding with something abrasive such as an over the counter whitening toothpaste or some baking soda? This will scratch the polish on the bonding allowing them to pick up stains much more quickly than they would otherwise. Many people aren’t aware that whitening toothpastes that you purchase at the store “whiten” your teeth by using abrasives. This creates a wicked cycle of making your teeth look whiter by scraping off stains, but it also creates micro-scratches on the surface of your teeth that causes them to pick up stains more quickly.

The only type of whitening toothpaste I would ever recommend is Supersmile Toothpaste, which uses a natural enzyme to whiten your teeth without any damage.

Unfortunately, teeth whitening won’t get them any brighter or whiter. It will only work on natural tooth structure. Because it has been such a short time since they provided your dental bonding for you, I am going to suggest you call and ask them to repolish them for you.

Caring For Your Dental Bonding

  • The best toothpaste for any type of cosmetic work is Supersmile Toothpaste. It’s specifically designed to remove stains without doing anything that will damage the work.
  • Like with anything related to your teeth, brushing and flossing is an important part of keeping the bonding healthy and shiny.
  • Make certain your dental hygienist knows how to care for your dental bonding. For instance, during your cleanings it is important she doesn’t use anything like a power prophy jet or acidulated fluoride, which will damage the polish on them.
  • If you use a mouthwash, make sure it is alcohol-free. Alcohol can loosen the bonding.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

 

Cosmetic Solution for Fluorosis Stains

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I have fluorosis stains on my teeth and wondered if teeth whitening is a good cosmetic fix for someone in my position? I want to have a smile I am proud of.

Diego

Dear Diego,

I will say right off that teeth whitening will not be the solution. It whitens teeth evenly and is only more likely to make your fluorosis stains more obvious. For the benefit of those who are unfamiliar with what fluorosis stains are, it happens when someone ingests too much fluoride while the teeth are still forming. The fluoride in the water in the United States is optimized for the right consumption so we don’t see much of it here.

There is good news, though. Your teeth can be attractive again. Which solution depends on the amount of fluorosis you are dealing with. For either repair, you will need an expert cosmetic dentist. My suggestion would be to find an AACD accredited dentist.

If You Have Mild Fluorosis

 

mild fluorosis stains

The picture above is an example of mild fluorosis. If this is what you are facing, then dental bonding can be a sufficient repair. Your dentist will gently shave about 0.5 millimeters of your tooth enamel. Then, he or she will replace it with direct composite bonding. It doesn’t last as long as the next repair I will talk about, but it does cost less.

If You Have Darker Fluorosis

heavier fluorosis stains

In some cases, as in the picture directly above, the stains are more prominent. In this case, simple dental bonding will not be enough. Instead, I suggest you have porcelain veneers placed. This is actually the go-to procedure for a smile makeover. It is what gives people that “Hollywood Smile.”

This procedure can last for a lifetime. However, don’t try to cut corners by going to an inexperienced cosmetic dentist for this. It’s not an easy procedure to do under the best of circumstances. With severe stains like these, it will take someone highly skilled. This is why I recommended an AACD accredited dentist earlier, these are the best cosmetic dentists.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Discolored Dental Bonding

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I’ve got dental bonding that is seeing the end of its lifespan. It is picking up stains and isn’t nearly as bright as it once used to be. I honestly don’t know if I should whiten them or replace them. If whitening would work then I’d like to do that. I’ve moved since then and don’t feel confident my new dentist can do the job. He said he’s willing to learn but I’d be his first case. Is there a specific type of teeth whitening that would work better with dental bonding?

Eliza

Dear Eliza,

before and after dental bonding to repair a chipped tooth

There isn’t a teeth whitening that will remove the stains from your dental bonding, unfortunately. In fact, because it only works on natural tooth structure, your teeth would whiten but not the dental bonding, making the disparity even worse. That being said, I am glad you are not just going to let your new dentist try his hand at dental bonding on you.

This requires some expertise because it is a procedure that is done freehand. A dentist needs training as well as artistry. However, you do need to have the bonding replaced. If you are happy with your dentist in every other aspect, you don’t have to switch practitioners. Cosmetic dentists are used to patients coming to them just for specific advanced procedures and then returning to their regular family dentist for the bread and butter type of care.

With that in mind, how do you go about finding a dentist to replace your worn out work? The easiest way would be to find an AACD accredited dentist in your area. These are dentists who have proven their technical knowledge and artistry to an examination board. They are more than qualified.

Should You Whiten Anyway?

Because the bonding color is permanent during its healthy lifespan, if you have any plans to whiten your teeth, the time to do that would be before you have the bonding re-done. This way when they replace the bonding, it can be done to the color you will want to keep for some time.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dental Bonding Doesn’t Match

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I chipped a tooth and did some research on repairs. The consensus was dental bonding was the best repair. I did get that, but the bonded part doesn’t even come close to matching the tooth part. It is so obvious there is a repair there. Is that normal? If not, who do I get this fixed? Will I have to pay for it?

Casey

Dear Casey,

before and after dental bonding

As you can see from the image above, dental bonding can and should look completely natural blending in seamlessly with the natural tooth structure around it. The problem you are facing is the dentist who did the procedure, not the procedure itself. It can be fixed and should be done at the dentist’s expense.

Doing bonding well is challenging because it has to be done freehand. This means the dentist either needs some natural artistic ability or invest significant time and money in the practice and training necessary to do it well. Not many dentists do that.

The first thing I recommend is you give your dentist another chance to get the dental bonding to look natural with your other teeth, with the understanding that if he can’t do it to your satisfaction, he’ll provide you with a refund so you can get it done properly. There is a reasonable expectation that the bonding matches the tooth.

If it turns out he can’t do it or just prefers to give you a refund, you’ll want to find an expert cosmetic dentist to do your dental bonding.  I suggest looking for an AACD accredited dentist or a dentist recommended on the mynewsmile.com website. These are the dentists that have the skill and artistry to give you a natural-looking result.

One other thing to be aware of in case your dentist didn’t tell you before your original bonding. Once the bonding is completed, the color is permanent. If you want to whiten your teeth later on, your natural tooth structure will whiten but not the dental bonding. Then, the only way to get them the same color again is to re-do the bonding. Because of that, I generally recommend to patients that they have any teeth whitening done before the bonding. However, you also have the option of waiting until it is time to replace the bonding. I just didn’t want you unaware of the limitations and then having to spend unnecessary money replacing your bonding early.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Bonding Color is Wrong

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I have these exposed places at the top of my teeth that are very sensitive. Other than that, my teeth were attractive. They showed me their plan and I knew immediately the color would need to be whiter. I pointed that out and they agreed. Then, they put in the new “whiter” color. It still doesn’t match my teeth. Plus, it looks opaque and is rougher looking than my natural tooth structure. I feel like what was an attractive smile has been made less attractive in order to prevent the sensitivity I was feeling. Is there a fix for this?

Callie

Dear Callie,

abfraction lesionWhen done well, dental bonding should blend seamlessly with the remainder of the tooth. I’m especially sorry for what you are going through because what your dentist is trying to do is even easier than when you have to repair a chip. If I understand your description correctly, you are dealing with what is known as an abfraction lesion (pictured left).

We used to think these were caused by brushing too hard. We now think it has more to do with clenching and grinding of your teeth. This flexes the tooth right at your gumline, adding stress. That repeated movement wears away the gumline. One thing you will want to do after this is repaired is to have a night guard made. This is a custom fit mouthpiece, similar to a sports mouthguard that you will wear while you are sleeping. Nighttime is when most grinding and clenching takes place. Usually, until their teeth are worn down, the patient has no idea it is taking place. Over time, this can lead to TMJ Disorder as well as wearing your teeth down to numbs.

Repairing Your Dental Bonding

before and after dental bonding to repair a chipped tooth

Pictured directly above, you will see a case of dental bonding done well. You can’t tell where the bonding ends and the natural tooth structure begins. Your teeth can look this way too. Unfortunately, the only way to fix this is to have it done over again.

Being blunt, I think this is beyond the scope of your dentist’s abilities. You will need to have a dentist with more cosmetic training step in and repair this. Ask your current dentist for a refund. Then, look for an AACD accredited dentist in your area. They can give you the results you are looking for.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Help! I Look Like Jim Carrey!

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This quarantine has almost destroyed me. First, I tried to cut my own bangs which were almost down to the tip of my nose. Then, the other night I had WAY too much to drink and tripped, which resulted in chipping my front tooth. I seriously look like Jim Carrey in Dumb and Dumber. Help! My dentist still isn’t open but tell me there is a solution for this once he is. For now, I’m just going to hide indoors and ignore the doorbell. No one can see me like this.

Stephanie

Dear Stephanie,

Jim Carrey in Dumb and Dumber

Jim Carry in Dumb and Dumber

For the benefit of those who may not know Jim Carrey or the role he played in Dumb and Dumber, I’ve posted a picture above. Don’t feel too bad. This quarantine has been hard on us all. There are more than a few bad haircuts in the grocery stores these days. You’re also not the only one to hit the wine bottle either.

While a dentist can’t do anything about the cereal bowl haircut, you can certainly get that tooth repaired. The first thing the dentist will want to do is make sure there is no underlying damage to the pulp of the tooth from the trauma. If everything is okay there, the standard repair for a chipped tooth is dental bonding. This uses a composite resin that the dentist will sculpt on your tooth to make the tooth whole again. This is done freehand, so you don’t want your average dentist to do it. Dental bonding takes experience and artistry to make it look natural.

Finding an Expert Cosmetic Dentist

before and after dental bonding to repair a chipped tooth

Your family dentist may also be an expert dentist. Just make sure before having him work on your tooth. The top cosmetic dentists are AACD accredited. This means they have passed stringent exams on the technical knowledge and procedural process in cosmetic work. In addition to that, they also had to submit visual evidence of a substantial number of cases they’ve personally done to be examined by a board of experts for the quality and beauty of their work. Any dentist who reaches accreditation is in the top 1% of cosmetic dentists in the country.

What if Your Dentist Isn’t Accredited?

Just because your dentist isn’t accredited, doesn’t mean he can’t do beautiful work. This is a process which takes many years and there are some artistic dentists out there who are still in that process. I would first look to see if he is listed on the mynewsmile.com website. If not, then your next step would be to ask for before and after images of dental bonding cases he’s personally done. Don’t settle for stock photos. If you are not absolutely thrilled with the results, don’ t let him near your smile.

Expert cosmetic dentists are used to having patients come to them just for the one procedure and then staying with their family dentist when that is through. There is no shame in that. He’ll understand and your dentist should understand as well.

I hope this helps. Try to keep away from the booze for a while, you don’t want to end up needing dental implants. Hopefully, this whole Coronavirus mess will be over with soon. I know dentists are ready to get back to work!

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

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