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dentistry

Will Tooth Mousse Get Rid of My White Spots?

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I have some white spot lesions. My dentist provided me with some tooth mousse. When it is done, we’ll start teeth whitening. What type of results should I expect from this?

Casey

Dear Casey,

teeth whitening trays

Your dentist is way off here. Tooth Mousse can help some by remineralizing your teeth, but the company that made it has never suggested it be used on its own. There is normally some microabrasion that needs to be used with it.

His suggestion of teeth whitening is even worse. Any type of teeth whitening will whiten your teeth evenly. That means that you will still have the white spots. In fact, they will be even more noticeable.

Your best option to get rid of these spots is to have dental bonding done on the affected teeth. However, this will require an expert cosmetic dentist and I don’t feel your current dentist is up to the task. I am going to suggest that you look for an AACD accredited dentist to advise you on this. They will get a good look at your teeth and give you the best course of action.

The good news is, because they are in the top 3% of cosmetic dentists worldwide, you will get a beautiful result. My recommendation would be to go that route. Have your teeth thoroughly examined by the right dentist. Then let him or her suggest the best course of action for it. You will love the results.

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

 

New Lumineers Over Old Ones

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When I first got my Lumineers my dentist knew that I wanted them to be whiter than they were made, but his lab guy said that it wasn’t quite possible to do them that white. They could only do what he called “natural” looking styles.  These days I see people with very white teeth and figure they are now able to do them whiter. Is it possible for me to have new Lumineers placed over my old ones so I can have the smile I really wanted?

Kelly

Dear Kelly,

a porcelain veneer being placed on a tooth

Should you place new veneers over old ones?

While it is possible for you to place new Lumineers over old ones, I am not going to recommend it. First, it is just as much work for the dentist to do that than to just provide you with a totally new smile makeover. to begin with. Second, it will be less secure. Porcelain bonds much better to natural tooth structure than it does to porcelain. That puts you at a greater risk of bonding failure for your new Lumineers, not to mention that you have double the risk because at some point your old Lumineers bonding could give out. I am going to recommend something completely different.

The first thing you should be aware of is that Lumineers is simply one brand of porcelain veneers. That particular brand is heavily marketed to inexperienced cosmetic dentists and I believe your dentist falls into that category. One reason I think that is he just agreed with the lab when they said your Lumineers could not be as white as you wanted. That was not true. Even then, you could get veneers of any brand as white as you wanted. The lab was wrong about that. That brings me to a second issue with Lumineers, which is their lab. The DenMat company, which owns this brand, insists you use their lab. They are not known for their artistic, quality work.

What I would like you to do is look for an expert cosmetic dentist and have them just re-do your smile makeover altogether. Do not be surprised if they suggest a completely different brand of porcelain veneers than the one you currently have. There are many brands that are far superior and will give more artistic results. The best cosmetic dentists are AACD accredited dentists. You can find them listed on aacd.com. They have extensive training and have passed stringent exams as well as proven their artistry before a board of examiners on a large number of their cases.

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

 

Dental Bonding Disaster

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A couple of years ago, I had dental bonding done for a chipped tooth with a dentist from another city. This year, I relocated. A few months into the move, the bonding started to have some discoloration. So, I asked my new dentist to fix it. She said she’d need to bond both teeth for it to look right. I thought that was odd because my last dentist did not have to do that, but decided to give her a chance. I wish I hadn’t. The color doesn’t match my teeth at all, there is now a gap between my teeth that wasn’t there before, and now one tooth is longer than the other! I asked her about the gap and she said that is a common issue with bonding. Then I asked her to file down the long tooth, so it could be the same size as its partner. Finally, when I asked about the color, she said natural teeth aren’t all the same color. Her suggestion is that I wait a week and see if I change my mind about its appearance. Then we are supposed to meet again and determine if there is anything I still want her to change. Should I wait and give her a chance to fix this or just ask for a refund. She is nice, but honestly, my smile is worse than it was before.

Cadance

Dear Cadance,

before and after dental bonding

I think you need to ask for the refund and then find another dentist to do the work. Here’s the problem you are facing with this dentist. Cosmetic dentistry is not taught in dental school. She may have learned how to repair teeth, but learning to make them look beautiful and natural is a skill set they have to invest in during a post-doctoral course of study.

Dental bonding in particular is one of the most challenging of the procedures because it has to be done free hand. Additionally, they have to understand all the materials, such as colors, textures, and translucencies, and which ones go together in order to sculpt a true replica of the tooth. I don’t think this skillset is going to magically appear in a week.  In fact, I would not even wait the week. Call the office, tell them you want the refund and start your search for the dentist who can do this right.

Which Dentist Can Do Dental Bonding Well?

My first suggestion is that you look for a dentist who has reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country. They have the technical knowledge, skill, and artistry to create a beautiful result for you.  It is sometimes hard to find one, depending on where you live, but it will be worth it even if you have to travel to a nearby city or state.

If that proves impossible for you, your second option is to look on the mynewsmile.com website. They recommend excellent cosmetic dentists by zip code and the distance you are willing to travel.  The site is run by an AACD accredited dentist and he personally screens each dentist he recommends. A dentist cannot just pay to be listed on his site. Many are on their way to accreditation, which is a process that takes years.

One other thing I will mention. You may not even need this, but if you’ve been considering teeth whitening, I suggest you do it before having the bonding placed. The color of the bonding will mot respond to whitening agents, only your natural tooth structure will. If you try to do that after, you’ll end up with two different colored teeth.

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

 

 

Zoom Whitening and Uneven Teeth

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My daughter got her braces off not too long ago and there were a bunch of white spots around her teeth. The orthodontist said this was fairly common in teenagers and that our dentist could take care of it. When we went to see our dentist, she suggested we try Zoom Whitening. She had just gotten the equipment and would even give us a discount as her first patient using it. I liked the idea of getting a discount for the treatment that she would need anyway and agreed. When we were done, the teeth seemed worse, not better. Is it possible because this is a new thing for our dentist she did something wrong?

Sally

Dear Sally,

Patient under a zoom whitening light

 

I am very glad you wrote and believe I can be a great help to you and your daughter. Zoom Whitening is an effective teeth whitening procedure that can produce remarkable results in just one appointment.  The problem wasn’t with her not understanding how to do Zoom Whitening. The real problem was her not understanding the principles behind how teeth whitening works.

No matter what method of teeth whitening you do, it will always whiten the teeth evenly. That means the white spots will get whiter along with the remainder of her teeth. The good news is there is a solution.

The white spots your daughter is dealing with are actually decalcification spots. Decalcification is a precursor to decay. My guess is your daughter used traditional wire and bracket braces. Those can be very hard for patients, whether adults or teenagers, to really get in there and brush well around all the metal clutter. This leaves food and other bacteria trapped, which in turn leads to the decalcification which your daughter is dealing with now.

There are two possible ways to fix this. One only works sometimes but is less expensive, so I’ll make sure you know about it in case it works for her.

Repairing White Spots on Teeth

The first thing I would try is a product called Tooth Mousse. This is applied topically and can sometimes remineralize the teeth.  You can purchase it over the counter. It doesn’t always work so if you don’t start seeing results, I would move on to the next option before decay sets in.

The second solution is dental bonding. This needs to be done by an expert cosmetic dentist. I’ll tell you how to find one in a moment. With this repair, the dentist will gently remove the decalcified spots and then fill in the area with the composite bonding material. The dentist will use a variety of colors, textures, and translucencies to match her tooth structure and appearance perfectly.

As I mentioned, she will need an expert cosmetic dentist. This has to be done freehand and is one of the most difficult cosmetic procedures. I cannot stress enough that I do not think your current dentist is up to the task. In your place, I would look for an AACD accredited dentist or one who has been recommended on the mynewsmile.com website. Any of those dentists will be able to give your daughter a beautiful result.

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

Dental Bonding Versus Porcelain Veneers

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My daughter has two lateral incisor peg teeth that we are ready to repair. Our dentist wants to do four porcelain veneers on her teeth to have them match. It was quite pricier than we expected, so he suggested he could do dental bonding for 1/5 of the price. This sounds like a great solution but I heard they don’t last as long. Should we do the cheaper one and just plan on re-doing it more often?

Millie

Dear Millie,

before and after dental bonding to repair a chipped tooth

I have some concerns here. First, the fact that he has to do four teeth instead of the two peg teeth tells me he is not comfortable with his skill level. He does not feel like he can match the lateral incisors to the front teeth so he wants to do all four which will make it easier for him. However, that doubles your cost and is totally unnecessary. A second thing that worries me is the cost he quoted you.

In reality dental bonding is best used for small repairs such as the one above for a chipped tooth. If a dentist tries to do it over the entire surface area of the tooth it would actually be more work than doing veneers. This is because composite bonding has to be done free hand. It would actually cost close to the same amount or possibly even more than the porcelain veneers.

My suggestion is that you want to get her teeth done you do it right. I would go to an expert cosmetic dentist and let him or her do just two porcelain veneers. Look for someone who are accredited by the American Academy of Cosmetic Dentistry. The accreditation process requires true technical expertise and artistry to pass. They are in the top 3% of dentists.

You didn’t mention how old your daughter is. If she is young, her teeth probably are not very stained. However, if she’s an adult, she will have developed some surface stains on her teeth which is a natural result of living. If that is the case, I would suggest you get her teeth whitened before you have the veneers done on her teeth.

Porcelain veneers can be made to any color, but once they are made the color is permanent. If she decides to whiten her teeth a few years later, her natural teeth will whiten but not her veneers. It is more financially responsible to whiten ahead of time. If you don’t the veneers will have to be replaced.

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

Thoughts on Premium Home Teeth Whitening

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I’ve been wanting to do a smile makeover for a while. Recently, I received an offer in the mail for Premium Home Whitening. Then, I received a Groupon offer for the same thing. It is less than what my dentist charges. I was wondering if it will really work or if I will be wasting my money.

Katherine

Dear Katherine,

teeth whitening trays

I looked into this. There are some good and bad things about this. First the good. The whitening ingredient they use is 35% carbamide peroxide. This is a valid whitening ingredient and will whiten your teeth. That is great. Now for the less than good news. The light they advertise seems bogus. This makes me uncomfortable with the company. If they are willing to lie to patients to draw them in, how do we know their ingredients are what they say they are? I don’t like deception.

A second thing to consider is the whitening tray. When you get teeth whitening done with your dentist, he or she will prepare custom fitted trays. This both protects your gums for being irritated by the whitening gel as well as keeps the gel concentrated on your teeth by not leaking or by letting saliva in to dilute it.

The tray you get with this will not be not be custom fit. Instead, it will sort of fit. However, your saliva will weaken the gel meaning you won’t get as much whitening out of each kit as you would with your dentist.

You mentioned the price was more than your dentist, but did not say how much more. One thing I would do is tell your dentist how much the kit is and ask him if he can come close to that so you will be able to do the procedure with him under a professional’s care. My guess is if he is not willing to, some dentist will be.

If you are thinking about improving your smile, teeth whitening will make you and your teeth look younger. If you are looking for a complete smile makeover, the way to do that is with porcelain veneers. However, while teeth whitening can be done with any dentist, porcelain veneers require an expert cosmetic dentist. If you decide to go that route, my suggestion is you only do that with a dentist who is AACD accredited.

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

Can I Get a Better Smile without Bonding?

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I have slightly discolored teeth, due to aging. A few years back, I also fell and chipped my front tooth. My dentist did composite bonding on that and I’ve never been happy with it. It doesn’t match the rest of my teeth and never has. Plus, there is a gap that wasn’t there before. I went to him about the discoloration for all my teeth to see what he’d recommend and he wants to do composite bonding on the top eight teeth. I am a little leary of this given how the gap turned out. Is there another way to handle this?

Kevin

Dear Kevin,

before and after dental bonding

You bet there are other ways to handle this. My first suggestion would be to simply have professional teeth whitening done. This will take care of the discoloration you are talking about.

The next step would be to replace the badly done dental bonding. The problem you faced with the bonding was not the procedure as much as it is the dentist who did the procedure. He could have matched your teeth perfectly and not had any gaps. The fact that he was not able to accomplish that tells me he is not a skilled cosmetic dentist.

If the only things you want to change about your smile are the color and this bonding, then I would simply find a better cosmetic dentist. Look for an AACD accredited dentist to do your work. These are the best cosmetic dentists in the country.

If, however, there are other things about your smile you are hoping to change, then I would look into getting porcelain veneers. These can give you a complete smile makeover. They’re able to change anything about your smile, including the color, shape, size, and character.

Like the dental bonding, it will require an expert cosmetic dentist, but when well cared for they will last for many years. Whatever you do, don’t go back to the same dentist who could not get your chip repaired properly.

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

Can I Trust the Dental Tourism Adverstisement I received?

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I received this advertisement that describes the most delightful vacation I can take all while getting my dental care done at a fraction of the cost I would pay in the United States. I have my choice of Baja California or Cancun. I have to be honest, I am tempted. Is it safe?

Estelle

Dear Estelle,

Woman covering her mouth with hand.

I am very glad you wrote before taking part in this. Dental tourism is heavily marketed and when it works out, it can be okay. But, when it does not work out, and that is more often than people think, it can be a disaster.

I actually know about the dental group you are referring to here, but won’t give their name here, so as not to give them any more advertisement. Here are my concerns with this particular group, which believe it or not are better than most.

First, there are quite a few reports of them trying to upsell. That means they are proposing procedures that may not even be necessary. There are also reports of patients receiving the wrong treatment. In many of these dental tourism countries, when things go wrong there is not much recourse (if any at all) for the patients. The dentists themselves have zero risk.

Here is one review I saw on Yelp! where a patient experienced both of these issues at the same time. You should know they went to this dental clinic I believe you received this advertisement from.

“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.”

Doing a root canal treatment and putting a dental crown on a tooth that had the type bone loss described here shows a serious lack of integrity on the part of the dentist. He did two useless procedures on this woman simply to take her money, all while not giving her the treatment she actually needed.

You can probably guess by now that my advice will be NOT to go.  If you want to go to Baja or Cancun, go to enjoy the sites, but get your dental work done here by dentists you can trust. You didn’t mention if you were going for general dental work or if you had cosmetic work in mind. If you are looking for cosmetic procedures, the best cosmetic dentists are AACD accredited. I would suggest that is the dentist you seek for your smile makeover.

If you are looking for a general dentist, be sure to check their Yelp! reviews. This will give you some idea of the experiences other patients have had with them.

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

Fixing the Appearance of Protruding Teeth

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I have teeth that are slightly protruded and stained. What are my options for getting an attractive smile that doesn’t include braces? Seriously…NO Braces!

Alicea

Dear Alicea,

You have a couple of good options to get a beautiful smile. The first option is to get orthodontics. Now, I can hear you saying, “No braces!” I promise I am not talking about traditional braces. There have been some wonderful advances in dentistry. One of those is an invisible braces option, such as Invisalign. Instead of metal wires and brackets, these use clear aligners that straighten your teeth. For the discoloration, some simple teeth whitening will do the trick.

a porcelain veneer being placed on a tooth

A second option is to have a complete smile makeover done using porcelain veneers. This is the go-to for celebrities that want that Hollywood smile. It can change the shape, size, and color of your teeth simultaneously.

The important thing with porcelain veneers, though, is to make certain you go to an expert cosmetic dentist. Doing smile makeovers is not taught in dental school. Nor is cosmetic dentistry a recognized specialty. If a dentist wants to develop skills in cosmetic procedures, it is up to them how much and how skilled they become. There is no baseline.

Your safest option is to find an AACD accredited dentist. Dentists who seek accreditation through the American Academy of Cosmetic Dentistry have to prove not just their technical knowledge and understanding about cosmetic work, but also have to demonstrate they have artistry by submitting a large number of visual evidence of procedures they’ve done.

With the right dentist, porcelain veneers will give you a smile that lights up a room.

This blog is brought to you by Philadelphia cosmetic dentist Dr. Michael Weiss.

Teeth Under My Porcelain Veneers are Turning Dark

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I paid a small fortune for a smile makeover. For some reason, the teeth underneath it are turning dark. My dentist doesn’t seem to believe me. I don’t think I am imagining this. I wonder if it has something to do with the tops of the veneers don’t quite go flush with the gumline. There is a bit of a ledge there.

Portia

Dear Portia,

 

a porcelain veneer being placed on a tooth

Bear in mind I haven’t actually seen your porcelain veneers, Based on what you’ve described, though. you have got a big problem here. It sounds to me that you have some open margins which is leading to leaking. This means your porcelain veneers need to be replaced. There is more at stake here than just the appearance. You are also putting your teeth at risk.

What is going on is your porcelain veneers were not bonded on properly. As a result, there is food and other bacteria getting trapped between your teeth and your porcelain veneers. That bacteria will sit on your teeth and turn into decay.

It doesn’t sound like your dentist is willing to own up to his error without some encouragement. Most dentists want to look good in front of their peers. My suggestion is you get another dentist on your side. In this case, you will want to see an expert cosmetic dentist. I recommend you see if there is an AACD accredited dentist in your area.

Have them look at your smile makeover and see what they say about it. Make sure it is a blind second opinion. By that, I mean don’t tell your dentist who did your smile makeover. If they ask, tell them you want their unbiased opinion.

If it turns out I am right and you do need to have these replaced, the dentist can help you get a refund. Then, I would make sure you have the expert cosmetic dentist do the new veneers. You’ll have much more beautiful results that will last a long time.

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