Can I bleach my non-veneered teeth?

I had four porcelain veneers done several years ago. They look fine, but the teeth next to them have stained a bit and it looks weird having white teeth and not white teeth when I smile. I was thinking of getting Crest Whitestrips but don’t want to hurt the veneers. Would it be safe?

Mia

Dear Mia,

custom-fitted teeth whitening trays

Crest Whitestrips are safe for your teeth and they will whiten them some, but very slowly. They only cover a few teeth so to get the teeth you need whitened, you’ll need to cut them and try to fit them on those teeth.

I wouldn’t use other over-the-counter products. They’re not as safe. Some have citric acid and some have things which will etch the teeth to make the look whiter. Unfortunately, they also cause micro scratches on your teeth which will cause them to pick up stains.

Consider Professional Teeth Whitening

If you want to whiten them faster, you may want to consider professional teeth whitening with a dentist. They can get all the teeth you want without any damage to your porcelain veneers.

Another option would be to add porcelain veneers to the teeth which are exposed when you smile. This way you wouldn’t have to constantly worry about the discrepancy in color.

In fact, originally, your cosmetic dentist should have suggested to cover all your teeth visible when you smile. For most smiles, that would mean 6-8 veneers. Some wide smiles require up to ten.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

dentist said no to porcelain veneers

I had dental bonding done on my front four teeth. The bonding has since worn out. I decided I wanted to upgrade a bit and get porcelain veneers. My dentist said I’m not a candidate for that because of the bonding. Instead, he wants to do crowns. I’m not crazy about that option. Do you have a recommendation?

Laurie

Dear Laurie,

A woman getting a porcelain veneer placed on her teeth

My first recommendation is you see another dentist. Under no circumstances should you let your dentist put dental crowns on your front teeth. This will grind them down to nubs. If this were necessary that would be one thing, but it is completely unnecessary.

You can have porcelain veneers placed after dental bonding. The only reason your dentist is saying you can’t is likely because he doesn’t know how to place them.

In dental school, we’re taught to always be confident with patients. Without that confidence, patients will grow anxious. So, instead of saying, “i’m not comfortable doing porcelain veneers” or “I haven’t done many porcelain veneers”, which could make you (understandably) uncomfortable, he says you’re not a candidate and avoids the issue altogether by suggesting a procedure he does know.

Find a Great Cosmetic Dentist

Cosmetic dentistry isn’t taught in dental school. A dentist has to make an effort to invest in cosmetic training after they graduate.

Even if you needed crowns, I would suggest a different dentist. To get a beautiful smile, you need an expert cosmetic dentist. Otherwise, the results would be disappointing.

In your case, I’d go to the mynewsmile.com website. They have a “Find a Cosmetic Dentist” link. You’ll input your zipcode and how far you are willing to travel to see a cosmetic dentist.

The key to this site is they have pre-screened each dentist who wants to be listed. They can’t just pay to get on the site. Instead, they have to show their technical knowledge and skill, as well as demonstrate their artistry in their work.

Anyone they recommend can give you a beautiful smile.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.

help avoiding dental implant failure

I’m looking at dental implants. One dentist is insisting on a CT scan but he uses a brand of implants I’ve heard a lot of good things about called Straumann. The other dentist says the CT scan isn’t necessary, but he uses a brand I can’t find much about called Southern Venturi. I like the idea of saving money on the CT scan, but want to make sure the brand is okay first. Do you have an opinion on that brand?

Keith

Dear Keith,

dental implant diagram

CT Scans and Dental Implants

I’m glad you are asking these questions. Both have important implications for a successful dental implant case. Let’s start with the CT scan. I would spend the money on that. The big reason is getting dental implants is a 3-Dimentional procedure. In order to get the right placement, it helps to have 3-Dimentional scans.

A lot of dentists are willing to place the dental implants without the scan but here’s what concerns me about that. If you’re talking about a an implant for a front tooth, without the scan the dentist risks it perforating your sinuses. Some dentists try to circumvent that issue by using a small implant, but they aren’t always able to retain the tooth in the long-term.

Another important piece of information is the depth and thickness of the bone. You only get that with the CT. This one additional step can prevent a host of problems.

The Brand of Dental Implants

The first brand you mentioned, Straumann, is one of the brands the top implant dentists prefer. Other good ones are Nobel Biocare, BioHorizons, Zimmer, and Astrotech.

The second brand you mentioned has me a tad concerned. I don’t know any of the top dentists who use this brand. It may be a cheaper brand which saves the dentist money, but you have to be very careful with “cheap” implant fixtures.

Often, it goes fine at the procedure but fails later and the patient has no idea it’s because the dentist used a cheap implant fixture. You also have no real recourse if that happens. It’s much better to pay a little more and get a proven fixture.

The Importance of a Skilled Implant Dentist

Another huge factor in the prevention of dental implant failure is the skill of the dentist. You want a dentist with extensive dental implant training. You can look at some of Dr. Delaune’s credentials to get an idea of what you are looking for in a dentist.

Don’t hesitate to ask where they received their dental implant training. Dental school isn’t enough. They must have post-graduate training.

You also want to make sure they do a significant amount of cases and have a lot of experience. Additionally, ask about their success rate. I’d want someone with a 98% success rate.

I hope this helps you. This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Custom mouthpiece for grinding because of meds?

My dentist is trying to convince me to get this custom-fitted device to sleep with. He says I’m grinding my teeth because of the medicine I take. First, wouldn’t I know if I happened to be grinding my teeth and second, can medicines really make you do that? Does it even matter?

Clark

Dear Clark,

custom-fitted trays
Custome-fitted mouthpiece’s will protect your teeth.

I promise your dentist isn’t trying to pull one over on you. Everything he said is based in fact. Most patients doen’t realize they are grinding their teeth, because it happens at night while they’re sleeping.

The Consequences of Grinding and Clenching

Griding and clenching your teeth is known as bruxism. When you do that habitually, whether intentionally or not, your teeth begin to wear down. In some cases, I’ve seen them worn down to nubs and the patient had to have all their teeth crowned. This is known as a full-mouth reconstruction and is very costly.

In addition to wearing down the teeth, you can also end up chipping or even cracking them . Cracked teeth will also have to be crowned in order to save them.

A nightguard protects your teeth from the force of these motions. Even though you likely won’t be able to stop doing them, your teeth won’t bear the consequences.

Be on the Lookout for TMJ Disorder

With constant motion of your jaw in grinding, you’re in danger of another kind of problem. You could wear down your temporomandibular joint, leading to TMJ disorder.

Here are some symptoms to look out for:

  • Jaw Pain
  • Clicking in the Jaw
  • Migraines, especially in the morning

If any of these pick up, you’ll want to see a dentist who has some special training in TMJ.

This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.