Archive for the ‘Porcelain Veneers’ Category

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Lumineers to get rid of my stains?

Thursday, November 10th, 2011

I have had Invisalign to correct mild crowding of my front lower teeth and am happy with the position of my teeth,I have no caries or fillings and no gum disease. I am however unhappy with the mild discoloration/yellowing which has occured over time and am not satisfied with the result of conventional whitening methods, so I am exploring lumineers or composite veneers to attain a permanently brighter and whiter smile. How will my orthodontic treatment be affected by veneers? Which of these two methods would you consider more favourable?? I appreciate your time and look forward to hearing from you.
Kindest Regards,
Ivy from Brisbane, Australia

Ivy,
I’m not sure what you mean by “conventional whitening methods.” Maybe what you need then are unconventional whitening methods because it’s whitening that would be the correct treatment for your situation.

Here’s how I analyze your situation.

You are happy with the alignment of your teeth. You didn’t say anything about their shapes, so I’ll assume you’re happy with that. What you’re unhappy with is the color, and you speak of the color as “mild discoloration/yellowing which has occured over time.” Effective professional bleaching techniques are excellent at removing acquired stains and they even go beyond that and whiten the natural color of your tooth beyond their original whiteness, similar to what happens when someone bleaches their hair. The only stain they have trouble with is tetracycline stain, which is extremely dark and is structurally embedded in the dentin of the teeth. But there are new bleaching methods that even work very well for tetracycline stains now.

I would strongly caution you about doing direct dental bonding or Lumineers if the only problem you have is with these acquired stains. Lumineers is a brand of porcelain veneers that is typically done without any tooth preparation, meaning that they will tend to make your teeth bulky and they will add about 2 millimeters of length to your teeth. Also, the laboratory that fabricates the Lumineers is not the best esthetic dentistry laboratory and the teeth tend to come out looking pasty and fake.

Bonding requires a true artist to do it correctly, and I’m not sure, even if you were to travel to Brisbane, if you could find a dentist artistic enough to do a good job for you with this. And even if it is done well, it is quite expensive and is fairly susceptible to scratching, dulling, and staining. There are some excellent cosmetic dentists in Melbourne. But again, if you like the alignment and the shape of the teeth, bleaching is the treatment of choice.

Neither of these treatments should affect the alignment of your teeth if they are done only on the upper teeth, but they could if they are done on the lower if they aren’t done correctly.

My recommendation would be to find a dentist with more expertise in cosmetic dentistry who is more familiar with some of the stronger teeth bleaching techniques. Any acquired stain should be able to be removed by bleaching that is properly done.

This blog is sponsored by Colorado Springs cosmetic dentist Dr. Joseph Rota.

Read a follow-up question from Ivy, and the answer about teeth sensitivity while bleaching.

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What toothpaste to use for porcelain veneers?

Saturday, October 8th, 2011

I’m planning on getting porcelain veneers, and had some questions about taking care of them afterwards, specifically about the toothpaste. My dentist told me to get a toothpaste with baking soda in it, but I read that baking soda is abrasive and not good for porcelain veneers.
- Monica from Maryland

Monica,
The reason you may be getting conflicting information about baking soda and how abrasive it is is that it comes in different forms. There is straight baking soda, out of the box, which is in a powder form. Yes, that is rather abrasive. But when it’s dissolved in toothpaste, it has low abrasivity. And it is a popular ingredient in toothpastes, because it has a buffering action that neutralizes plaque acids.

You do want a toothpaste that has low abrasivity, not so much to protect the porcelain, which is harder than tooth enamel, but to protect the resin bond between the porcelain and your tooth. This fine line which is at the margin between your porcelain veneer and the tooth is the weak spot that can most easily wear down and become stained. An excellent toothpaste recommended by many cosmetic dentists is Supersmile, which can be purchased on the Internet. It has a very low abrasion yet it is excellent at removing stains. It is a little expensive, but could be worth it to protect your investment in your porcelain veneers. Yes, it does have baking soda in it, but it is in a low abrasivity form.

Another thing to watch when you have porcelain veneers. Don’t let your dental hygienist use any power polishing equipment like the Prophy Jet. This delivers a power spray of sodium bicarbonate (i.e. baking soda, and a very abrasive form of baking soda) that does clean your teeth very well but it removes the glaze on the porcelain and makes them very susceptible to staining. One cleaning with a Prophy Jet can ruin your porcelain veneers.

This blog is sponsored by Colorado Springs cosmetic dentist Dr. Joseph Rota

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What to do about a dark porcelain veneer?

Tuesday, August 30th, 2011

I have had one veneer done on my front tooth about 7 years ago, My dentist did such a fabulous job, you cant even tell one of my front teeth was fake. This past year however, there is darkening up at the gumline. When a picture is taken of me the one front tooth looks smaller than the other. What can i do rewhitten the top of the venner by my gum line in the front? is there an alternative without getting the veneer redone? i have read you can lighten your orginal tooth from the back which I am currently doing. Do you know by chance how long it takes to see results and will this lighten the fron by my gum line. Thanks in advance for your help.
- Donna from Boca Raton

Donna,
Yes, you can whiten the tooth behind a porcelain veneer a little bit, but I don’t think that will help your situation. First of all, what you’re telling me is that this veneered tooth is now uneven in color, because it is not darkening uniformly but is getting darker at the gumline. Teeth bleaching whitens a tooth uniformly, so it won’t correct a color discrepancy like this.

But more importantly, the reason a porcelain veneer will start to darken at the gumline is usually because it is leaking. The bond has maybe washed out there because it wasn’t very strong to begin with, and stain and possibly decay is getting up under the veneer. You need to have this checked by an expert cosmetic dentist, and then be prepared for possibly replacing this veneer. Ordinarily we would expect a porcelain veneer to last much longer than this, so maybe the dentist had some problem with the bonding procedure in this difficult area under the gumline.

But be careful. You don’t know how lucky you are that this looked so nice when you had this done 7 years ago. 95-98% of dentists could not do this that well. So if you aren’t going back to the dentist who first did it, don’t rely on the dentist’s self-proclaimed expertise in cosmetic dentistry. There’s a good way to find an excellent cosmetic dentist, and that is with the website mynewsmile.com. They examine the credentials of dentists who claim to be cosmetic dentists, plus they examine photographs of their work and recommend based on that information. Dr. Rota is their recommended cosmetic dentist in Colorado Springs, and they have several cosmetic dentists they recommend in the Miami area.

This blog sponsored by Colorado cosmetic dentist Dr. Joseph Rota.

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I’m a grinder, and I want a smile makeover. How about Snap-on Smile?

Tuesday, June 21st, 2011

I am looking for an excellent cosmetic dentist. I am considering crowns for my front teeth. Since I grind my teeth, I don’t think porcelain veneers are a good option. I have seen some people with crowns however that appear grey at the gumline. I don’t want that at all. How do you feel about Snap-on Smile?
- Gerard from Ohio

Gerard,
Snap-on-Smile will not give you a beautiful smile. It may give an acceptable smile, but your teeth will be a little bulky, and you won’t have that natural translucency of real teeth, plus some other drawbacks. The Snap-on Smile is a low-cost option for a smile makeover. You need to have low expectations for the Snap-on Smile or you’ll be disappointed.

You do have to be really careful if you grind your teeth. You don’t need to rule out porcelain veneers, as long as you are going to an excellent cosmetic dentist who has a lot of experience with smile makeovers. The dentist may have to make them so that they stay out of the way of your grinding patterns. That can be done. And you may need to wear a night guard to protect the veneers at night. We have often worked with grinders and clenchers and they have a hard time believing that wearing this protection at night helps, because they say things always break during the day. But the stress and microcracks that are created at night weaken the teeth and the porcelain, and so the night guard can be excellent protection. But again, it depends on the patient, and each case needs to be handled individually. And you really need an excellent cosmetic dentist with a great deal of experience.

As far as porcelain crowns, that would also be an option for you. The dark line that is associated with crowns is only associated with porcelain fused to metal crowns. An expert cosmetic dentist with many years of experience, again, will be able to place these in such a way as to keep them from breaking. One disadvantage of crowns if you are a grinder or a clencher is that the front teeth are weakened at the neck of the tooth, and, again depending on your grinding patterns, it may make it so that the tooth is more susceptible to breaking off entirely.

You want a dentist with expertise in cosmetic dentistry and in occlusion, and a dentist who is older, say in his late 40s at least, because they will have more long-term experience in doing total smile makeovers. A dentist who has done smile makeovers but not over that long a time period hasn’t yet seen how these makeovers in patients who grind their teeth hold up over time.

This blog sponsored by Colorado Springs TMJ dentist Dr. Joseph Rota.

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Porcelain Veneers and Dental Cleaning

Monday, January 3rd, 2011

I recently had veneers placed on my front teeth (in September) in New York State. We recently moved to Florida and am scheduled for my first cleaning since getting the veneers. I am concerned that my dentist here will not clean them properly, so what should I be prepared for. I certainly don’t want them to harm the finish on the veneers. Will using a scaler harm the finish?
- Martha from Florida

Martha,
There are two big no-no’s that a dental hygienist can do to ruin your porcelain veneers. The first way is by using a power spray to clean the teeth. The Prophy-Jet by Dentsply, that sprays sodium bicarbonate on the teeth to clean them, will destroy the glaze, and it will be expensive to fix that. Many hygienists are oblivious to this damage because when they’re through with the appointment, the veneers look beautiful and clean. But with the glaze gone, porcelain veneers will start to pick up stain after the patient leaves the office, and they’re never the same again.

The second way is by administering a standard fluoride treatment. They usually give fluoride treatments only to children, but some hygienists like to give them to adults. The problem is that the standard fluoride used in these treatments is acidulated, meaning that it contains small amounts of hydrofluoric acid. While this greatly helps the teeth absorb the protective fluoride, it will etch porcelain, which again will break the glaze and cause it to stain more easily. It can also remove some tinting on the surface of the veneers, altering the color of the veneers. Dentists who know better will keep a supply of neutral fluoride on hand to avoid this problem.

Beyond that, it is always best, if you have porcelain veneers, to have them maintained by an office that does a lot of them. There are other smaller things that are important that will be carefully followed by offices where they are passionate about cosmetic dentistry. Scalers can be used, but ultrasonic scalers have the potential to chip the margins of the veneers. Coarse polishing pastes can cause extra wear on the bonding composite between the porcelain and the tooth. Those are finer points. The key thing is to stay away from any of the power sprays like Prophy-Jet or similar devices and the acidulated fluoride.

This is the blog of Colorado Springs dentist Dr. Joseph Rota.

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Laser porcelain veneer removal

Tuesday, December 7th, 2010

I have recently (few months ago) had two porcelain veneers placed on my lateral incisors as they had spaces on either side and were a bit too short compared to my front teeth. Since there was plenty of room to work with all around each tooth, I didn’t need to have any reduction of the enamel…it was just simply “roughed up” about a week before the procedure (the roughed up tooth looked the same as before it was roughed up). However, I am not too happy about the appearance and it does not feel like “my smile” and my mouth gets very dry quickly when I speak. So my question is, since my tooth still pretty much looks the same under the veneer and there was no actual reduction in size of the tooth, would it be possible to remove the veneers non-invasively and still have healthy teeth (my old smile)? I read somewhere online about a laser that non-invasively removes veneers…but would my tooth still look/feel the same with the veneer removed? Please let me know. Thanks.
- Tessa

Tessa,
That’s a shame that you had this work done and you actually like the appearance of your teeth better before these porcelain veneers were put on than after.

Yes, you can have the veneers removed and get down to the original enamel, but it has to be done very carefully, and there are going to be very few dentists who can do this without damaging your tooth.

There is a laser removal technique that uses a laser to soften the bonding resin so that the veneer can be popped off. I don’t know how many dentists are familiar with this technique and have the required equipment to do this. We have a laser in our office, but most dental offices don’t, and Dr. Rota has the experience to be able to do this. If I were the patient, I would test the dentist by calling the office and asking, “How would Dr. So-and-So remove two porcelain veneers that I have decided I don’t like?” If they volunteer that the dentist would do it with a laser, without you ever bringing up the idea of the laser, then that would be a good way to determine that they are truly familiar with this technique.

If the dentist doesn’t have a laser, there is a way that the veneer could be ground off without damage to the underlying tooth, but that has to be done very carefully and the dentist needs to be experienced in this. If it is done dry and under magnification, a skilled and experienced cosmetic dentist should be able to easily tell where the porcelain ends and the tooth begins, to know how much to grind off. But that term, “skilled and experienced cosmetic dentist” is going to limit you to about one to two percent of dentists, and they will tend to be in larger cities.

My view is that it is the responsibility of the dentist to make sure that you loved how the veneers looked before ever putting them on. If that had been done, you wouldn’t even think of ever taking them off. We never have that happen in our office, where a patient is unhappy with how the porcelain veneers look.

This blog brought to you by Colorado Springs cosmetic dentist Dr. Joseph Rota.

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What can I do about tetracycline stains?

Saturday, September 4th, 2010

I’ve heard about Supersmile toothpaste and that it’s good for stains on teeth. How does it work on tetracycline stains. If it helps, I want to buy some.
- Jeff from Arizona

Jeff,
Supersmile won’t have any effect on tetracycline stains, because those stains are embedded in the teeth. The tetracycline antibiotic, if it is taken while the permanent teeth are forming, will deposit in those teeth and cause a brown or gray stain that is deeply embedded in the teeth. Supersmile removes other surface stains by dissolving away the protein pellicle that the stains attach to. So it is great for tobacco stains, Peridex stains, and other similar stains.

Tetracyline stains are one discoloration, also, that doesn’t respond well to Zoom whitening or bleaching. Bleaching will lighten them a little, but not a lot. They are best treated by covering them with porcelain veneers. Even then you need to be careful to have this done by a highly experienced cosmetic dentist, or the results could be very disappointing. Dentists who try this without a lot of experience tend to make the porcelain veneers too translucent, and the dark brown or gray shows through.

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Tetracyline Stains are really tough to do right

Saturday, May 22nd, 2010

I have severe tetracycline staining from medication given to me as child. From the research I’ve done it’s my understanding that using porcelain veneers to treat tetracycline stains requires specific techniques and expertise. My problem is this: the local dentists I’ve consulted with regarding veneers have usually only worked with one or two tetracycline patients; some have never treated tetracycline stains. Are there any cosmetic dentists in Florida (or elsewhere) that you can recommend who have more experience with treating such staining?
- Brad from Florida

Brad,
You are smart to be cautious about what dentist you see for this. There is a high probability of seriously disappointing results unless you go to someone good. It would be worth a drive of a couple of hours to get this done right, if you’re not near any really good cosmetic dentists. You’d need maybe three trips to get this done – a small price to pay for a beautiful smile that you will enjoy for many years.

Tetracyline stains are very intense, and when a dentist doesn’t have much experience with them, they will make one of two mistakes. Either the porcelain veneers will be too translucent, and the ugly gray-brown color will show through, or they will be too opaque and your smile ends up looking chalky and fake. Getting that color blocked out while creating a translucent, natural, look, is very tricky and requires a careful technique of using opaquers directly over the stain and translucent porcelain over that opaquing. It takes experience to master that.

There is a great website that recommends expert cosmetic dentists all over the country. It’s mynewsmile.com. Check their list of Florida cosmetic dentists. I’m confident that any of the cosmetic dentists they list in Florida will do a great job with tetracycline stains. The owner of that website is a cosmetic dentist, and he personally screens every dentist they list. Drs. Rota and Smith are their recommended cosmetic dentists for Colorado Springs.

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What are the best porcelain veneers? And how do I pick a cosmetic dentist?

Thursday, April 15th, 2010

What are the most strongest but yet natural looking porcelain veneers that you would recommend. We have empress right now but are cracking. What questions do we ask the dentist to determine their expertise?
- Yvonne in New York

Yvonne,

Empress is an excellent, beautiful, long-lasting material for porcelain veneers. If your Empress veneers are cracking, I would guess that it’s not because of the material but because of the way it was bonded – that’s usually what makes veneers crack. But even then, the beauty and functionality only start with the material and come much more from how it is used. Would you commission a work of art based on the brand name of paint that the artist uses? Or on the type of clay he or she uses in their sculpture? Or would you tell your artist, once you have chosen them, that you want them to only use a certain brand? No – you pick the artist based on the quality of the work that you see, and you let them use the brand of materials that they are most comfortable with. And what brand of baseball glove catches balls the best? Isn’t that a lot more dependent on the player using the glove than the brand of the glove? Cosmetic dentistry is the same. The quality of the work depends on the technical ability of the dentist and on his or her artistic talent. Leave the choice of the material up to the dentist – that’s my advice. They know what works best in their hands, and every excellent cosmetic dentist has a passion for creating beautiful work that will still be beautiful five, ten, twenty years from now. They will take photos of it and show those photos to their colleagues.

And cosmetic dentistry is art. It includes expertise, but knowledge alone isn’t enough. The dentist has to be artistic in order to create a beautiful smile. You might be interested in reading an excellent post about what is a cosmetic dentist. That may get you a little more perspective on this issue.

That post comes from the website of a referral service that recommends excellent cosmetic dentists all over the country. They pick dentists based on the quality of their work and their credentials. The reason this referral service is so helpful is that there really aren’t any foolproof questions people could ask or things they could look for. In order for Dr. Rota to get listed by them, he had to disclose all his credentials and then submit a CD of detailed photographs of his cosmetic dentistry. These were examined by the trained eye of an experienced cosmetic dentist, and then they were willing to recommend him for Colorado Springs. I’d suggest checking this website for who they recommend in your part of New York.

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How do I fix my smile after gum surgery?

Thursday, March 18th, 2010

Wonderful website! I recently had gum surgery due to bone loss in both my upper & lower jaws. Now I’m concerned about the look of my teeth since my gums have been minimized by about 4 mm. The surgeon told me I could get veneers to make my smile look more natural. I also have a small gap between my two front teeth. Do you foresee any problems with this? What do you recommend?
Kara from Indiana

Kara,
Yes, porcelain veneers could help you get a beautiful smile back. But you really need to be careful. Your teeth are longer now, and for a situation like this you especially need a real artist. I would recommend that you check the cosmetic dentists recommended by mynewsmile.com. That’s a website that screens cosmetic dentists based on their training, and then they examine photographs of their work.

This is a problem with people who have serious gum disease. Even when there is no gingival surgery, the gums have often receded considerably making for longer teeth. It’s tricky to get the result to look right, but an expert cosmetic dentist will have experience in dealing with this problem and will know how to make your smile look beautiful again.

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