Tag Archives: Dental Bonding

Dealing with Enamel Hypoplasia

I am have enamel hypoplasia on my teeth and it is very embarrassing. I try my best not to smile, but sometimes you just have to. I want to have a smile that I am not ashamed of. Do you know what are the best ways to treat this? I suspect with today’s cosmetic dentistry, there are solutions.

Pamela


Dear Pamela,

You are correct that there are some good solutions for this situation. An image with two examples of enamel hypoplasia

If you are reading this and wondering what in the world enamel hypoplasia is, it is when the enamel on teeth does not fully develop. This can happen because of a genetic defect, or because of an illness contracted during the formation of the the adult teeth. This is generally before age twelve.

Mild Enamel Hypoplasia

before and after dental bonding

Some cases of hypoplasia is mild, such as on the case on the left image, which gives a mottled appearance to the teeth. If this is your situation, dental bonding would be a good solution. This is done using a composite that is bonded directly to the tooth. It is often used to repair tooth gaps or chips in teeth, such as in the example above.

Severe Enamel Hypoplasia

porcelain veneer being placed

Some cases of hypoplasia are much more severe, such as with the image on the right. As you can see, the teeth are pitted and there is significant discoloration. Dental bonding will not work in this situation. Instead, I would look into having porcelain veneers done.

Both of these procedures are quite advanced and will require you go to an experienced and artistic cosmetic dentist. You may even want to look for an office that has an AACD accredited dentist. They are the top cosmetic dentists in the country.

Once you have this work done, you will no longer be ashamed to smile. In fact, a beautifully done smile makeover can completely change your life because of the confidence that comes with it.

I hope this helps. Enjoy your new smile!

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

My Crowns Hurt

I had some dental bonding done years ago on my two front teeth because of an accident. Now, about ten years later the bonding is looking pretty rough so I decided to bite the bullet and get the work redone. My dentist thought doing crowns would be better and did four of them so that my teeth would match. The four teeth do match each other, but not quite the other teeth. That’s not why I’m writing, though. The dental crowns feel really weird and heavy. They hit my other teeth in a way that makes it hurt when I chew. Is it possible that I have a cavity or infection under one of them? Is it a dental emergency?

Emma

Dear Emma,

Porcelain crown being placed on a tooth

A simple x-ray will tell you if there is an infection under one of those crowns, However, you said it hurts when you bite down but did not mention it hurting any other time. This make me think that the problem is the fit of the crowns and not what is underneath them.

I’d like you to get a second opinion on the fit of these crowns. I would not consider it a dental emergency, but I would try to get in as soon as possible simply because you are uncomfortable.

The fact that your dentist gave you four dental crowns to replace dental bonding on just two teeth makes me wonder about his ethics. This was a massive overtreatment.

On top of that, he told you that you needed four dental crowns in order to make them match. That is not true. A skilled cosmetic dentist can even match a single crown to the rest of teeth. Even then, he couldn’t match the four crowns to the remainder of your teeth.

I don’t know if you went back to have your dentist look at these, but the pain could be solved by a simple adjustment. If he doesn’t solve the problem or tries to tell you everything is fine, then I would definitely get that second opinion.

Don’t tell them who provided your dental crowns, just that they hurt when you bite down. Dentists know each other and you don’t want them worried about critisizing a friend’s work. If he or she asks, just explain you want an unbiased opinon. They should respect that.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Dental Bonding for Children

My eleven-year-old broke her two front teeth quite badly. Most of the structure is gone. She only has the top and sides left. Everything else is gone. We went to our pediatric dentist and he suggested removing the teeth. I wasn’t keen on that idea so I took her to my dentist. He said that dental bonding was the solution. I was so glad to hear that she could keep her teeth, I didn’t even look into the procedure. When the results were done, her bonding was so awful. It was lumpy and uneven and in places the color didn’t even make sense. She’s horrified and I don’t blame her. I don’t know what to do. Is there any way to fix this? I’m devastated for her.

Carolyn

Dear Carolyn,

before and after dental bonding

I’m shocked that your pediatric dentist suggested you extract her teeth. That was quite extreme. I expected he would have suggested dental crowns, but that would be a bad idea as well. The pulp of our teeth shrink as we age. In an 11 year old, that pulp is still quite large. Doing a crown on their teeth can kill the pulp.

Your other dentist was on the right track in recommending dental bonding for the repair. The problem lie in he did not have the skills to do such a massive repair. Dental bonding has to be done freehand and takes a great deal of training and artistry. When done well, it will blend in perfectly with the remainder of the tooth structure, as evidenced by the image above.

My suggestion is you look for a practice that has a dentist who is accredited with the American Academy of Cosmetic Dentistry on their staff. Ideally, they should also be a practice that enjoys working with children. But, if you had to choose, go with the AACD accredited dentist. Your current dentist should be willing to give you a refund.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Tooth Mousse & Zoom Whitening

I have some white spot lesions on my teeth. My dentist prescribed tooth mousse for me. It is a nine week treatment. After that, if the white spots are not gone, then we will finish it up with Zoom Whitening because it is fast. However, we are hoping the mousse will take care of it on its own. Is there a chance that both those things together won’t work and I’ll need a third treatment?

Eve

Dear Eve,

someone getting zoom whitening
Zoom Whitening

I’m glad you wrote. Your dentist is sort of close on this, but not close enough for me to not give you some warnings. First, tooth mousse is a decent treatment option. However, I’m concerned he doesn’t understand the point of the treatment. It is designed to treat white spots, but mostly to remineralize the area.

White spots are precursors to decay. Using the tooth mousse will repair the demineralization that occurred to cause the spots in the first place. The company makes no claim that it will change the aesthetics of the tooth.

As for the Zoom Whitening finishing that up, it will actually make things worse. Teeth whitening, no matter what method you choose, will whiten your teeth evenly. This means the white spots will get whiter along with the rest of your teeth.

While the remineralization is a great idea. The thing that will make the teeth even in color is dental bonding. However, I would not ask your dentist to do the bonding himself. This is an advanced cosmetic procedure. If he did not understand how teeth whitening works, he will not be able to do the bonding well.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Closing a Tooth Gap

I asked my dentist about how I can close my tooth gap on my front teeth. It has always bothered me. He said we could do it with porcelain veneers. The price was a bit higher than I was expecting. Is that the typical way to solve this problem or do I have other options?

Melanie

Dear Melanie,

Invisalign aligners

You have a few options here. If the only thing you were wanting to change about your teeth is the gap, then I would consider porcelain veneers a major overtreatment. Veneers are designed for people who want a complete smile makeover. They can change anything and everything about your teeth, including the shape, size, and color. It is the procedure people use to get that Hollywood Smile.

That did not sound to me like what you needed. In that case, you have two much more affordable options. Your first is to simply use dental bonding. This uses a composite resin that the dentist will place and sculpt between the two teeth to fill in and close the gap. It does take an expert cosmetic dentist to do this well because it has to be done freehand, so I would not just let any dentist do that.

Another option is Invisalign (pictured above). This is the modern way of straightening teeth. Instead of metal wires and brackets that traditional braces use, this uses clear aligners, allowing you to straighten your teeth without anyone even knowing. It also has a hidden benefit where the aligners can double as teeth whitening trays. This means you can straighten and whiten your teeth at the same time for a fraction of the cost of what you’d pay with the procedure your dentist suggested.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Zoom for White Spots

I have had white spots on my two front teeth since childhood. I would like to have a more evenly colored smile. My dentist suggested Lumineers but that is very expensive. I was thinking something closer to Zoom whitening or something. Would that work?

Ada

Dear Ada,

Can Zoom Whitening fix white spots?

I am very glad you wrote. What your dentist suggested is a bit of an overtreatment, unless you were looking for a complete smile makeover. Even then, Lumineers would not be my first choice in the brand of porcelain veneers to use. They’re often marketed to inexperienced cosmetic dentists. If you didn’t suggest a desire for a smile makeover, I worry that your dentist may have been using you for practice.

That being said, while Zoom whitening is a very effective means of whitening your teeth, it will not be the solution you are looking for in this situation. Any type of teeth whitening will whiten all the tooth structure evenly. That means as your teeth get whiter, so will the white spots. This is probably not the look you were going for.

The simplest solution would be to see an expert cosmetic dentist who can do microabrasion and then dental bonding. Or, if you do desire to get a complete smile makeover, you could see that expert cosmetic dentist, but for porcelain veneers instead.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Daughter Broke Her Front Tooth

My daughter fell and broke a chunk off her front tooth. I immediately called our pediatric dentist and he said the soonest he could see her is six months from now. I told him we are pretty anxious to get it fixed and asked him to recommend somewhere. His response was that everyone will tell us that the nerves need time to calm down and then they can see us. For some reason that felt like an excuse to me. If not, why not say that upfront instead of originally saying he’s booked for six weeks? Is there really a necessary time to wait?

Belinda

Dear Belinda,

Your instincts are good. There isn’t really a reason you should have to wait. I’m guessing your pediatric dentist just didn’t want to lose any business. This can be treated right away.

If you have the piece that broke off, a good cosmetic dentist can reattach it. If not, the solution would be to have dental bonding done. This will also need to be done by a good cosmetic dentist. It doesn’t necessarily need to also be a pediatric dentist. There are general dentists who work well with children.

As she ages, the pulp of her tooth will get smaller. At that point, it may be necessary to do a dental crown. Until then, bonding or reattachement are your best options for her.

If she gets nervous at the dentist, look for someone who offers dental sedation. They can give her something to relax her. It doesn’t have to be very strong, even just nitrous oxide will be enough.

This blog is brought to you by Lafayette, LA Dentist Drs. Foreman and Thimmesch.

Solution for White Spots

I had braces in my mid-twenties. Yes, that is late, but my parents were quite poor and I needed to wait until I had the money to do it myself. After they were off, I noticed these white spots on my two front teeth. I asked my dentist if there was anything we could do about that and her response was, “If it ain’t broke, don’t fix it.” While that might be fine for her to say, they aren’t her teeth. I just spent a small fortune getting my teeth straight, I would like to be proud of them when I smile and not have people staring at my white spots. So, do you think something strong like Zoom Whitening would help? I’d have to go to a different dentist for that because my dentist doesn’t offer teeth whitening, but I’d really like to fix their appearance.

Kelly

Dear Kelly,

Patient under a Zoom Whitening light.

I’m glad you wrote. It sounds like your dentist has what we call an engineering mindset. They got into dentistry because they like to fix things. As a result, they are not as interested in the cosmetic side of things.

I am glad to hear you are willing to go to another dentist to get this fixed because that is what it will require. Unfortunately, Zoom Whitening will not be the solution though. No matter what type of teeth whitening you use, it will whiten your teeth evenly. That means the white spots will get whiter along with the rest of your tooth structure.

You have two possible solutions here. Both of them will require that you see an expert cosmetic dentist. This is important because you want a beautiful result. Check out their smile galleries to see if you like their results.

Your first option is to have dental bonding done. Whatever dentist you go to will need to carefully remove the white spots (which are actually areas of decalcification) and then place composite dental bonding on top.

If your spots are very large, I suggest you have two porcelain veneers placed on your front teeth instead of the bonding. Especially for large areas, this will give a more aesthetic, longer-lasting result.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

Daughter has a Broken Tooth

I have a ten-year-old daughter. Today she fell and broke a front tooth. I am a bit frustrated with my dentist who said that he can fix it but he cannot see her for six weeks. When I told him I did not want to wait that long, he said it was necessary for the tooth to desensitize anyway. If that is the case, I’ll wait. However, I got the impression he was just saying that. If that is the case, I’d rather go somewhere else. What is the right thing for me to do?

Cassie

Dear Cassie,

No, there is not a medical reason to wait. I suggest you take her to another pediatric dentist to be evaluated and treated. If you tell them what happened, they may be able to schedule an emergency appointment for you. It would be ideal if it is a dental practice that also has a highly-trained cosmetic dentist on staff. It’s okay if they don’t, but you’ll want a skilled cosmetic dentist to do the repair.

If you have the piece that broke off they may be able to re-attach it. If that peice is missing, then dental bonding will be the right solution. Both require expert cosmetic dentists as I mentioned above.

As she gets older, the pulp of her teeth will shrink. At that point, she’ll need a single dental crown. Be aware that dental insurance only pays for the cheapest option. For children, that is usually a silver crown. I doubt you’ll want that on her front tooth, so call the office and find out what the price difference will be from what the insurance will cover and what you want for her. If you start saving now when the time comes it won’t be as much of a financial burden.

I hope this helps. This blog is brought to you by Lafayette, LA dentists Drs. Foreman and Thimmesch.

Pain With Teeth Whitening

I’ve been doing at home bleaching of my teeth with a kit I purchased over the counter. Everything was fine until today. While wearing the gel strip, I had a zing of pain that lasted for about 40 seconds. I noticed the area getting the zing is a tooth where I had a chip repaired. The dentist used dental bonding to repair it. Does this mean the whitening gel is weakening the bonding?

Karen

Dear Karen,

Teeth Whitening Trays

Dental bonding is a great solution for a chipped tooth. Fortunately, the teeth whitening gel will have no effect on the bonding. The problem, based on the type of pain you are describing, likely has to do with there being a sensitive spot on your tooth. Hopefully, you are doing this bleaching under the supervision of a dentist. This way he can treat the sensitive spot.

If you’re just doing this on your own, you’re going to need to see a dentist. Don’t whiten until that spot is treated.  Be careful about DIY kits. While many times they turn out just fine, there have been occasions where it led to a person needing a root canal treatment. Until your dentist treats the area, pause your bleaching.

One thing to be aware of is that teeth whitening gel only works on natural tooth structure. That means everywhere, except where the dental bonding is will whiten. The composite material that repaired your chipped tooth will stay the same color.  This means you will have to redo the bonding to get the tooth uniform. Wait until you reach the level of whitening you want though. Then, wait a week to give the color time to stabilize.

If you ever decide you want to whiten your teeth in just one appointment, ask your dentist about Zoom Whitening.

This blog is brought to you by Lafayette, LA Dentist Dr. Emily Foreman.