Tag Archives: Dental Bonding

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Can I get all this work done in one setting?

I’ve got a lot of dental work to get done. I have to get at least four root canal treatments, and I need to have a couple of teeth ground down as TMJ treatment. I also may need to have a dental bridge placed, though my dentist is still considering the best course of action in that case. I also need some dental bonding done on a chip on my front tooth. The problem is that I seriously freak out in the dentist’s chair.

I’d like to get this all done at once. I don’t have much time off of work, and I just want to get it over with. My question is, how much can be done in one sitting?

Frank from Escanaba

Dear Frank,

Time of treatment is determined by the patient’s ability to tolerate treatment. The placement of the teeth that need root canal treatments will affect the amount of time necessary for treatment.

The amount of treatment you need will probably require the services of a sedation dentist. This would have the added benefit of easing your anxiety. If you can’t locate a sedation dentist, or don’t want to go to one, then the length of treatment is largely decided on your ability to tolerate treatment. Your anxiety will probably lessen your ability to spend long hours in the chair, so consider this when you are deciding whether or not to go with a sedation dentist.

If you can’t locate a sedation dentist, you may want to consider going to an endodontist. A specialist will reduce the amount of time you need to spend in treatment.

This blog post created for Lafayette Louisiana cosmetic dentist Dr. Mike Malone.

T

Porcelain Veneers

Questions about porcelain veneers

I used to brush my teeth too vigorously, and as a result I have quite a bit of erosion and abrasions along the line where my teeth and gums meet. I’ve changed my brushing habits, but the damage has been done. I am thinking about getting porcelain veneers to cover the damage, but I have some questions first.

If I decide to go with porcelain veneers, will the abrasions make the treated teeth prone to cavities and stains along the gumline?

Are your teeth underneath the veneers extra vulnerable to decay, because the enamel layer has been shaved off to place them?

How long do porcelain veneers go before they start to stain and discolor?

How much does it cost annually to maintain porcelain veneers, and are there any special procedures that are necessary?

Are there any foods or beverages that I won’t be able to have anymore if I get porcelain veneers?

I know these are a lot of questions, but I want to make sure I am making a smart choice.

Thanks,

Chloe in Elverta, CA

Dear Chloe,

The first thing we should discuss is what really may have caused the damage to your teeth along the gumline. For many years, many dental professionals thought it was overly aggressive brushing, but recent research has shown that the type of damage you describe is caused by biting stress (also known as bruxism). The teeth flex at the neck (where the tooth meets the gum) because of the pressure of the clenching and grinding, and that is what causes the “notches”.

Porcelain veneers would cover the damage, but your dentist should address any bruxism issue before placing them, or the lifespan of the veneers will be reduced. If the damage is not too severe, a really skilled cosmetic dentist may also be able to cover the damage with dental bonding.

Porcelain veneers are more stain resistant than your natural teeth, so you should not have to restrict your diet. If the porcelain veneers are well made, they should also serve to protect the underlying tooth from further decay or erosion. There are no special annual procedures necessary to maintain porcelain veneers, but you must always make sure your hygienist is aware that you have veneers so she does not use any abrasive toothpaste.

This blog post sponsored by the dental office of Lafayette Louisiana cosmetic dentist Dr. Mike Malone.

Porcelain Veneers

Do I really need to see a cosmetic dentist? What is the difference?

I was recently in an accident that fractured my one of my front teeth and the tooth next to it. They did not break off, but both were very noticeably cracked. I was out of town and had to go to an emergency dentist for a repair, and the bonding is not the right color at all. I had to have a root canal on the front tooth, and the dentist said that too will likely darken over time, and become brittle.

So I need to have some cosmetic work done. Before this accident, my smile was a real source of pride for me. My teeth have always been great, and most of them still are white and straight and beautiful. I’ve consulted my regular dentist, who says that I can get just the damaged teeth done with porcelain crowns. I’ve been reading, and it seems like to make the repair look right, I should get six or even eight crowns or porcelain veneers. I am also reading that I should consult with an accredited cosmetic dentist to do this work. Is that really necessary? I like my regular dentist, and he seems confident in doing the work, but he is not an accredited cosmetic dentist, and does not really advertise much as doing cosmetic work. I don’t want to have him stick a couple of crowns on my front teeth that look out of place. I would rather have them all done, even with the expense, than spend the rest of my life dealing with a mismatched smile.

What do you think? I want my smile back! It is one of my few claims to beauty, and I am willing to invest to get it back again. What should I do?

Thanks for your help,

Tracy in Cedar Rapids, Iowa

Dear Tracy,

First, consulting with a cosmetic dentist in this case is essential. You sound like you really just want to get your smile back to what it was before the accident, and a really skilled cosmetic dentist should be able to help you do that. The brief statement you made about the reading you have done indicates that you are eager to be educated about this and want to make the best decision. Experience has shown that the most important decision you make for this kind of dental care is in choosing the right dentist.

Nearly all dentists are what we call “technician” dentists. When things break, they are very good at fixing them, but may not be overly concerned with nuances of appearance. You had a beautiful smile, and you want it back again. The key to reclaiming your smile is in finding the right professional to help you do so.

Porcelain crowns and porcelain veneers may be possibly treatments, but it is also possible that a skilled cosmetic dentist could do dental bonding on the cracked tooth that is still viable. A great cosmetic dentist will get you beautiful results while leaving as much of your natural tooth structure intact as possible.

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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!