Tag Archives: Dental Bonding

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Brown spots won’t respond to whitening products

I am in my early 20’s and just recently graduated from college. For almost as long as I can remember, my front teeth have been discolored. I have ALWAYS taken really good care of my teeth (no cavities!), but my mother told me the discoloration was caused by an illness I had as a small child. Now I am trying to get my professional career off the ground, and I feel like my teeth are making an awful first impression.

With the support of my dentist, I have tried almost every over-the-counter teeth whitening product available. If anything, my teeth look WORSE now. The spots did not change in color one bit, but the contrast with the surrounding tooth material (which whitened considerably) is even more noticeable and ugly. Now my dentist is suggesting a “trial” treatment, where he will grind away at the spots until they are gone. The problem is he doesn’t know how much he will have to grind, and I just cannot imagine how this will ever look good!

What about professional whitening? I just really need to get this issue addressed. My teeth are holding me back, and my self-confidence is really taking a beating. I don’t want potential employers to think that I am the type of person who doesn’t even properly care for their teeth!

Thanks so much for your help,

Leta in Albany

Dear Leta,

First and foremost, find a different dentist. Your current dentist obviously does not understand the principles of teeth whitening or he would not have had you wasting your time and money on repeated attempts of the same treatment. Professionally whitening is unlikely to yield the results you want, either. And the idea of grinding away the spots could go horribly wrong.

You need to seek the services of a talented, experienced, educated cosmetic dentist. Make sure you thoroughly check their credentials, and ask to see pictures of their work.

Depending on the severity of the spots, there is a very small chance that a technique called microabrasion might work. This is often used with white spots, but is only effective with brown spots when they are very superficial.

If the spots are small, dental bonding may work to cover them. This is one of the most difficult and artistically demanding skill sets in cosmetic dentistry, so make very sure the dentist you chose is not just competent, but exceptional. If bonding will not work, porcelain veneers may be a solution. Both of these treatments require a high degree of artistry and skill.

I hope you can find the right dentist to help you.

Porcelain Veneers

Teeth very sensitive after removal of braces

I had braces for two years, and have just recently had them removed. Ever since they were taken off, I have noticed that my teeth are incredibly sensitive to temperature. If I try to eat or drink anything hot or cold, it is really painful. I can also feel rough patches and dips on the front of my teeth, almost as if the enamel is gone. Could my orthodontist have damaged my teeth when she removed the brackets? I am also noticing that my teeth seem to be getting darker every day. I don’t drink coffee or cola very often, but my teeth seem to soak up every stain like never before.

What should I do? I did not go through two years of ortho to have ugly teeth!

Thanks for your time,

Savannah from Council Bluffs

Dear Savannah,

I don’t think your orthodontist caused this damage, though it is not unheard of that damage can happen during bracket removal. The patches you describe sound like areas of decalcification. These are areas where your teeth have lost some minerals, and those areas are porous, which is causing the staining you are seeing. Those spots may eventually turn brown, and even chip away, leaving pitted holes in your teeth. I am sure this is NOT what you envisioned as you went through orthodontic treatment, and that missing enamel is what is making your teeth so sensitive.

Teenagers are not always as diligent as they should be about brushing their teeth after eating, and when a teen has braces, the problem is magnified. The brackets allow food to sit against your tooth, and underneath the brackets, the acid in your saliva that helps digest food is busy working away at the surface of the tooth. The extent of the problem becomes really evident when the braces come off.

It is important to address the issue before it gets any worse. Bleaching will not help the stains. It will probably make them look worse, so I would not recommend going that route. If the damage is just to a few small spots, a treatment choice might be dental bonding. Freehand dental bonding is one of the most challenging cosmetic dentistry techniques from an artistic standpoint, and if it is not done well, you will not be happy. Make sure you chose a cosmetic dentist who is trained and experienced. Direct dental bonding requires a very high degree of artistry and technical skill that very few dentists possess.

If the damage is extensive and/or severe, you may be looking at porcelain veneers. That is a daunting prospect after two years of orthodontic work, but it is better to be prepared.

If you have friends that still have braces, you can be their cautionary tale. People with braces simply MUST brush after every single time they eat. At the very least, they must rinse thoroughly with water if brushing is impossible. It is very frustrating to go through all those years of ortho work, only to continue struggling with dental issues when you are done.

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Should I wait to fix my child’s broken tooth?

Last evening at t-ball practice my youngest daughter was hit in the mouth with a bat. One of her front teeth on the top broke right off, and the other one has a crack all the way across it. We took her to our family dentist first thing this morning, and he said he won’t have time to fix it for three weeks. Three weeks! That just seems crazy to me. Everything I’ve ever heard or read about damage to teeth says that you should “get to a dentist right away”. Well, what is the point of that if they aren’t going to fix it?

One of the reasons our dentist gave for the delay is that the root of the broken tooth needs time to “desensitize”. Is that customary? If it is, then I guess we will wait, but my instinct is to take her to a different dentist, one who will treat this with some urgency.

I hope you can answer this quickly. I don’t want to wait, but I’d like some expert advice about what to do.

Nora in Bar Harbor, Maine

Dear Nora,

Your instincts are correct – there is no reason to wait to address this.

If you have the piece of the tooth that broke off (and see this response promptly!), an expert cosmetic dentist might be able to reattach that portion of the tooth. If you don’t have the piece or it is too badly damaged, a likely procedure to repair both teeth is direct dental bonding.

For this reason, I strongly suggest you chose an expert cosmetic dentist for this procedure. Direct dental bonding requires more than excellent technical skills and training. It requires artistry. The bonding material must be color matched and placed with an eye to the gradients of color that comprise her natural teeth. Only truly gifted cosmetic dentists can do really beautiful direct bonding work.

You don’t say how old your daughter is, but because of your reference to t-ball I am guessing that she is under 10. Direct bonding is a great solution for younger patients. When she is older, she will probably need a single dental crown for the tooth that was broken, but your dentist will have to make that decision when the time comes. If the other tooth is severely damaged, both front teeth may need crowns.

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Bad bonding job to close gap – what can be done?

I need to know if dental bonding can be removed without doing any damage to my teeth. I asked my dentist to fix the gap in my front teeth (they were chipped, too, so there was a V-shaped gap). I have not had a lot of experience with this kind of dental repair, but I don’t think he did a good job at all! I’ve seen pictures on the web that look so much better than what my teeth look like right now. There is still a gap, and you can tell where the bonding material begins and my teeth end. In the pictures I’ve seen, the bonded teeth look completely natural. What should I do?

Marcus from San Antonio

Dear Marcus,

I am sorry to hear that you’ve had such a bad experience. You are right in expecting better results. Very few dentists really have the artistic skills to do beautiful bonding work. It is one of the most difficult cosmetic dentistry procedures to master, and requires a high level of training and aesthetic sense.

The good news is that dental bonding is reversible, and can be taken off with a special sandpaper that all dentists have. There should be no damage whatsoever to your teeth.

I hope you won’t let this experience discourage you from seeking a new dentist to complete the procedure to your satisfaction. Look for a cosmetic dentist that is accredited by the American Academy of Cosmetic Dentistry (AACD). ANY dentist can say they do cosmetic dentistry, but it requires many, many hours of specialized training and education to achieve accreditation. I encourage you to seek out someone who can show you pictures of dental bonding work, to reassure you that they have the skill set to do the kind of beautiful work you see in pictures on the web. Good luck!