Elizabeth,
No, this is not right. The teeth should line up evenly. I’m not following you as far as seeing exactly what is going on in your case about which side overbites which side, but I think I am understanding your first statement that when you bite, the right side lines up but the left side doesn’t. This could be a very fundamental problem with your treatment.

Dental implant treatment is tricky and completely unregulated by the profession. It is not officially recognized as a specialty, so anyone can claim to be an implant dentist with no extra training whatsoever. Or, their training may be very superficial.

It could be that the surgery placed the implants in the wrong position, or that they were restored incorrectly. Sometimes, if the surgery is done by one dentist and the implants are placed by another, there is a communication problem and they are placed in a position that makes it impossible to restore them correctly. If the surgery and the restoration are done by the same dentist, you won’t have that problem. This is what we do in our office – Dr. Rota does both the surgery and the restoration. When they are done by different dentists, the restorative dentist has to have enough knowledge of implant surgery and enough confidence to be able to tell the surgeon exactly where to place them. A guide should be made by the restorative dentist. This guide will snap into your mouth and give a clear indication to the surgeon exactly where to place the implant and at what angle. But a lot of dentists don’t do that.

We wish you the best.

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

Katrina,
Exposure to saliva doesn’t break down a white filling. White fillings, or any type of dental restoration, are designed to function in the presence of saliva.

However, the filling site, when the white composite is used, must be totally isolated from saliva at the time it is placed or it will not bond to the tooth and will fail. In this respect it is different from the silver amalgam filling, which can be successfully placed in the presence of saliva or other contaminates.

And you are also correct that the silver amalgam filling, besides looking unsightly, will make the tooth hypersensitive to cold for a few weeks, especially if the filling is deep or is down on the root.

If you have decay under the gums, your dentist may be concerned about being able to properly place a white filling, and I suspect that this is what your dentist is concerned about. His or her concerns are justified. But there are a couple of things more to be said about this.

First, there is always a way to place the filling in almost any situation, even if it is under the gumline, and keep it isolated while it is being placed.

Second, I would never push a dentist to place a filling that he or she is uncomfortable placing. Your dentist probably doesn’t know how to isolate the filling, or doesn’t know the variety of white materials that are available that could be placed in a situation like this, and the restoration will therefore will fail. If having a white filling here is important to you, you need to find a dentist who is more familiar with these techniques and who has the confidence to be able to do this correctly.

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

HUGEST thank you ever so much! This has been extremely helpful. I cannot begin to explain how appreciative I am.
Have a wonderful day.
- Ivy from Brisbane, Australia

Thank you so much for your time. You have truly provided me with the most valuable information thus far.

Yes,the shape of my teeth I am happy with. By conventional bleaching I mean take home trays from my dentist using Night White bleach.

However, I experience sensitivity, (I m only able to use this for 1-1.5 hrs at a time) and am not happy with the shade of white achievable.

Any recommendations as to how I can achieve a whiter smile?
- Ivy from Brisbane, Australia

Ivy,
There are two ways for you to get better results with your teeth bleaching.

One would be to find a dentist who knows how to deal with the sensitivity issue.
I checked websites of cosmetic dentists in Brisbane, to try to find someone who knows what they are doing, and of the first few I looked at, I was most impressed with Dr. —–. I don’t know about his artistic skill, and there are some procedures that he is advocating that give mediocre smile makeovers, but he seems to at least be knowledgeable, by the memberships he maintains and where he has trained. There are ways to deal with this sensitivity issue – different bleaching gels, pre-treating the teeth to make them less sensitive, etc. That is one route.

The other would be to just work around your sensitivity. If you can wear the tray with the gel for 1 to 1 1/2 hours at a time, that really isn’t that bad. And what you would do would be to just keep on going. The longer you go, the whiter your teeth will get. If you have the persistence to stay with it, I’d keep doing that for a month or two – whatever you need to do until your teeth are the whiteness you want. I’d suggest overshooting the mark by a little bit, because there is a little relapse that occurs in the first week after you stop bleaching.

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

Read Ivy’s appreciative response.

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.

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

Sam,
There isn’t a really good way for a lay person to screen for a good cosmetic dentist. Celebrities find them by reputation, because in celebrity circles, many of them have had smile makeovers, and they quickly discover who the good cosmetic dentists are. But for most of us who don’t circulate with those people, there isn’t a really good way. You can ask to see photographs of their work and you can screen out some of the bad ones that way, because they won’t have any photographs. But you still leave yourself open to being burned. I have seen that happen. We have many people walking into our office very disappointed with the cosmetic dentistry they have received.

There is an excellent website, however, that is run by an accredited cosmetic dentist where they list recommended cosmetic dentists by reputation, by examining photographs of their work, and by checking educational credentials, and I believe they list several excellent cosmetic dentists in the Dallas/Fort Worth area. The site is www.mynewsmile.com. You can check it out.

Dr. Rota is their recommended cosmetic dentist for Colorado Springs, and when he got listed, he had to document several cases and answer questions about them before they would accept him onto their list, so we know they aren’t like other referral websites where a dentist can just pay a fee to get listed.

This blog is sponsored by Colorado Springs cosmetic dentist Dr. Joseph Rota.
See pictures of his porcelain veneer work.

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.

Anthony,
Yes, I wish orthodontists would put up pictures of the smiles of people who didn’t brush conscientiously when they had braces on, so that there would be no chance that their patients would misunderstand how easy it is to get these lesions on your teeth. You cannot let food sit on those brackets or they will make ugly white or brown spot lesions on your teeth that you’ll see when the braces come off. Brush after any time you eat anything.

And yes, the way to fix those lesions is usually with dental bonding after the braces come off. Unless they are extensive, and in that case you would want porcelain veneers.

Some dentists may think that bleaching will take care of these spots, especially if they are brown. Stay away from any dentist who suggests that – they don’t know what they’re doing.

And yes, dental insurance should help pay for those. The dental bonding or porcelain veneers is done to repair damage to your teeth, so that would be within the scope of most dental insurance contracts. But understand that the dental insurance may well have a minimum amount they will cover. They may only cover the minimum treatment required to repair the damage to your teeth, which will be less than what would be required to get the teeth to look beautiful. And my recommendation would be to go to an expert cosmetic dentist for this work and not to a regular family dentist. A family dentist will not likely stock the necessary materials to make this repair look beautiful.

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