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dentistry

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 Disaster- Help!

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I had my four front teeth bonded. One of my front teeth sticks out too far over the second one. One of the lateral teeth is too far back and the other one has a big chip. He said he could fix this, but it’s ended up a disaster. First, he ground down the front overlapping tooth, then he added bonding material to the lateral teeth to fill in the missing depth and fix the chip. However, he insisted on doing them yellowish, even though I wanted them white. Now I feel they look ugly, plus the one he ground down is sharp and painful. I know there is no going back, but can this be fixed? My dentist seems to think he did a great job.

Adabelle

Dear Adabelle,

woman giving a thumbs up from the dental chair

Getting a beautiful smile requires a skilled cosmetic dentist

Even though I don’t have a picture of your smile and can’t give you specifics of what was done incorrectly, I do know what the major problem is. Your dentist is likely a very good family dentist who did his absolute best for you, but he was in over his head. Maybe he could have pulled off a basic dental bonding case. Maybe. Those are difficult to begin with because they need to be done free-hand. Your case requires an even more advanced dentist because of the structural issues that need to be dealt with.

This would need a dentist in the top 1-2% of cosmetic dentists, which requires significant training outside of general dental school. They’d need training in color theory, polishing the bonding material, and shaping the teeth. Your dentist obviously didn’t have this. Plus, a true cosmetic dentist would never be satisfied if his patient wasn’t thrilled with the results.

What you need is an AACD accredited dentist. These are the top cosmetic dentists in the country. In order to become accredited, they have to pass stringent exams, as well as have a large number of specific cases they’ve personally done evaluated for technical proficiency, beauty, and artistry. You can locate them by going to the website of the American Academy of Cosmetic Dentistry. Make sure you check you want an accredited or accredited fellow. Being a member isn’t enough.

Once You Have an Accredited Dentist

Once you’ve located an excellent cosmetic dentist in your area, you have two choices to get the smile you want.

Option 1: Re-do the Dental Bonding

Dental bonding is less expensive than the next option I’m going to make you aware of. When done by an expert cosmetic dentist it can blend in perfectly with your teeth, comfortably, with a natural translucency. If you want your bonding whiter than your adjacent teeth currently are, it will be in your best interest to whiten all of your teeth first. This will enable the dentist to blend the bonding material to your beautiful new white color.

Option 2: Get Porcelain Veneers

While these are more expensive than bonding, porcelain veneers can change anything about your smile— the shape, the size, the color, even the character. The other big benefit is they last much longer. Well taken care of porcelain veneers can last a lifetime. The dental bonding will have to be re-done every five years or so. Either one can be made beautifully.

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

She’s Going to Need a Better Dentist

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I need to replace six crowns. They were done by another dentist but I’ve since moved. I really loved them, but they’re old and need to be replaced. I want to replace them all at the same time. I don’t like the temps my new dentist has provided. They’re much more yellow than my old crowns and are shaped differently. I liked my other smile. When I told him I didn’t like the temporaries, he raised his voice and said he’s the dentist and they’re perfect. What do I do?

Kelly

Dear Kelly,

woman giving a thumbs up from the dental chair

Your bumping up against the difference in philosophy between a standard dentist and a dentist who really invests in cosmetic dentistry. In dental school, we’re taught the dentist knows what is best. But, cosmetic work is different. You are creating a smile which the patient wants. The best cosmetic dentists are more interested in how the patients feel about their smile.

Your current dentist doesn’t understand this. He’s not going to work with you. If I were in your place, I’d go to a different dentist to get this finished. Your current dentist is ethically obligated to pass on all your diagnostics, etc. to the new dentist.

Finding the Best Cosmetic Dentist

Cosmetic dentistry isn’t a recognized specialty. It is up to the dentist how much training they get after they graduate dental school. When you are talking about a smile makeover, you want the best cosmetic dentist possible. These are the dentists who take their craft seriously.

They’ve done significant post-graduate training and have an artistic eye. In your place, I’d look for an AACD accredited dentist. These are the top cosmetic dentists in the country. Through the American Academy of Cosmetic Dentistry, they’ve passed stringent exams which test their technical knowledge. They also have to provide visual evidence of a large number of cases they’ve done in order to gauge their artistry.

I hope this helps you. This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dental Implant Doesn’t Match

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I’m devastated by how my dental implant turned out. I lost a front tooth due to a fall down the stairs. My dentist assured me that he’d be able to give me a new tooth that would help me smile again. The dental implant part is fine, but it doesn’t match my other teeth. It’s way more obvious because it’s a front tooth. I haven’t smiled since the fall. I just don’t know what to do. Can this be fixed or whitened? If not, I’m pretty sure I’ll never smile again.

Misty

Dear Misty,

A diagram of a dental implant

I have two pieces of good news for you. First, this can be fixed. Second, you won’t need to do the dental implant over. However, teeth whitening won’t be your solution for two reasons.

One, teeth whitening only works on natural tooth structure. What would happen is the teeth surrounding the implant crown would whiten but not the crown itself.

Second, even if it could whiten, you wouldn’t be able to get an exact match to your tooth that way. You might get close, but front teeth are very exposed. Any little difference is noticeable.

Matching a Single Implant Crown

Because of that, matching a single front tooth requires an expert cosmetic dentist. Only a small percentage of cosmetic dentists are able to do it well.

In your place, I’d look for a dentist who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists have passed stringent oral and written exams on technical skill and knowledge as well as submitted a large number of specific cases they’ve done in order to demonstrate their artistry.

If you don’t have one within a reasonable driving distance, a second option would be to look on mynewsmile.com to find one of their recommended dentists in your state.

Cosmetic dentists from either site can re-do your crown to match the adjacent teeth.

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