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Fixing Splotchy Teeth

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My teenager has always had thin tooth enamel. We tried to be very careful when she had braces. We seemed to avoid the splotchiness in all but her front two teeth. I’m glad her teeth are straight but these need to be dealt with. I’ve heard there is a procedure to fix it. Do you know if dental insurance will cover it?

Caroline

Dear Caroline,

before and after dental bonding for a chipped tooth

These white spots, as you probably know are decalcification— precursors to tooth decay. There are two possible solutions to this. The first only works sometimes. There is a product called Tooth Mousse that can sometimes re-calcify teeth. It doesn’t work all the time, but is inexpensive and worth a shot in my opinion. You can get it online.

If that doesn’t work, a sure-fire solution is dental bonding. You will need an expert cosmetic dentist for this so don’t expect your average family dentist to be able to do it. Above, I’ve shown an image of dental bonding that is being used to fix a chipped tooth. What your daughter will need is for the decalcification spots to be gently sanded off and then the composite bonding can fill in the gaps.

As I mentioned earlier this procedure needs an expert cosmetic dentist. The whole thing is done freehand, plus you want them to know enough color theory to be able to match her teeth perfectly. I would look for a qualified dentist on the mynewsmile.com website. Every dentist on their is prescreened for their cosmetic training and artistic skill.

As for your dental insurance, it varies from policy to policy, but do not expect it to cover the whole procedure. At the most, they will contribute to it, but that is about all I would expect.

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

Dental Bonding Doesn’t Match and Falls Off

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I have tetracycline stains and my dentist said dental bonding would take care of it. It has not worked out at all like I wanted. First, the color doesn’t match and it is pretty obvious. Plus, you can still see some of the tetracycline stains through it. As if that weren’t bad enough, the bonding fell off after just three days. I went back for him to repair it. At the time, I told him about the color problem so he made them thicker, which looks weird in its own way. Now they have fallen off again just a few days later. I called him back and he said they’re not meant to be permanent so I should not have high expectations. However, I was told they’d last up to five years, this is like just a few days. What should I do?

Calorie

Dear Calorie,

before and after dental bonding for a chipped tooth

As you can see from the image above dental bonding can blend in quite naturally with your teeth. I think the biggest problem you are facing is the skill and technical knowledge of your dentist. Both dental bonding and tetracycline stains are some of the most advanced procedures in cosmetic dentistry. You should be aware that cosmetic dentistry is not a recognized specialty. Any general dentist can call themselves a cosmetic dentist regardless of the amount of training they have invested (or not invested) in.

I think your dentist is in way over his head. Dental bonding should not fall off, especially after just a few days. As for the color, if he is an inexperienced cosmetic dentist, he probably doesn’t even have the colors and other materials necessary to make things blend well. An additional problem in dealing with tetracycline stains is making the teeth opaque enough to cover the stains, while translucent enough to look natural. That is not an easy accomplishment, even for a skilled cosmetic dentist.

Honestly, the better treatment for you would be porcelain veneers and not bonding. It is more permanent, decades rather than years. Plus, it is more stain-resistant. I don’t think your dentist is the one to do it. Here is my advice. Do not let him “fix” this. instead, ask for a refund. Then, we’re going to get you to a highly skilled cosmetic dentist.

Finding an Expert Cosmetic Dentist

Because there is not a recognized specialty in cosmetic dentistry it is hard for patients to know who has the skills and who doesn’t. There is a website that strives to help patients in your position. A retired cosmetic dentist runs the mynewsmile.com website. He prescreens all dentists that want to be listed on his site. They cannot purchase their way on. Instead, they have to show their training credentials, in addition to proving their artistry and skill on cases they’ve completed. Any dentist he lists can provide you with a stunning smile.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.
Click here to learn about our free virtual smile makeover consult.

Dental Bonding Doesn’t Match

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I chipped a tooth after a fall. My dentist wanted to put a crown on the tooth, but I did some research and saw the best solution was dental bonding so I asked him to do that. He agreed, but the results aren’t that great. The colors don’t match so you can really tell it is a repair. Is it okay to have this dentist do it again? Should I have to pay for it to match?

Olivia

Dear Olivia,

before and after dental bonding for a chipped tooth

When dental bonding is done correctly, it can match perfectly with the rest of the natural tooth. However, it isn’t easy to do. Not only is it done freehand, but many dentists don’t carry enough of a selection of shades and textures to do this right. When a dentist suggests something like a dental crown for a chipped or gapped tooth, which is a massive overtreatment, it is an indication they are uncomfortable with cosmetic dentistry.

You have two options: The first is to give your dentist another chance to get this right. Explain to him that the repair is obvious and doesn’t match the rest of your tooth. If he cares about the quality of his work, he should be willing to do it again. And, no, you shouldn’t have to pay for it.

I would give your dentist another opportunity to get this right. You shouldn’t have to pay for the color to match. That is part of what you paid for in the beginning. Don’t be surprised if he still struggles, but it is fair to give him another chance.  If after the second go he still can’t get it to match, then I would suggest your next step is to ask for a refund, then find an experienced cosmetic dentist.

Who Should Do Your Cosmetic Bonding?

In your place, if it doesn’t work out with your original dentist, then I am going to suggest you look at the mynewsmile.com website. The man who runs this site has retired from cosmetic dentistry but wanted to offer patients a service to help them know who has the skills to do beautiful cosmetic work. Most patients don’t realize that there isn’t a recognized specialty in cosmetic dentistry. That means any general dentist can call themselves a cosmetic dentist regardless of the level of skill they have.

To make matters worse, most of the skills they need for well done cosmetic work isn’t even taught in dental school. For a dentist to develop the necessary skills they will have to invest in post-doctoral training. It’s nearly impossible for patients to know which dentists have done that. The mynewsmile site, pre-screens dentists for their technical training as well as the artistry of their work. Only those who pass his rigorous standards can be listed. Any dentist on that site can give you a beautiful, natural-looking result.

Should You Whiten First

I don’t know if your dentist mentioned this, but the color that is created for your dental bonding is permanent. If you were to whiten your teeth at a later date, your natural tooth structure would whiten, but not the bonding. Therefore, most cosmetic dentists will warn their patients if they are even considering getting their teeth whitened, it will save them money to do it before they have the bonding done. This will save them money by not having to replace the bonding after they whiten.

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

Dental Bonding Disaster

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I had several teeth get have dental bonding done because of abfraction lesions. Before this (aside from the lesions) my smile was beautiful. Now, it looks darker, dull, and feels rough. Is it possible for this to be removed and re-done to where the teeth look natural or will it damage the underlying tooth to replace it? Also, one of them popped off. I’m guessing that is not normal.

Meagan

Dear Meagan,

An image of an abfraction lesion.It is a real shame you are dealing with this. And you are right that having your dental bonding pop off isn’t normal. Let’s start with abfraction lesions for the benefit o those who may not know what they are. As you can see from the picture to the left, the gum tissue has pulled away from the tooth.

We used to think this was from brushing too hard, but now we believe it has much more to do teeth grinding or clenching, which will cause the tooth to flex a little. This weakens your tooth which will lead to the tissue being worn away at the gumline. Your dentist can fill these areas with dental composite material and it shouldn’t be that hard.  Obviously, for your dentist it was.

This dental bonding can be re-done, possibly even resurfaced without having to re-do the whole thing. Your dentist should either be willing to re-do them or to give you a refund so you can get them done elsewhere by someone more qualified. If he re-does them, it is important that he uses a more flexible dental bonding material, such as Silux Plus and Renamel. Using this type of material that can flex a bit will ensure they stay put and not pop out on you anymore.

As for getting it to match, that shouldn’t be that hard, yet he is still struggling with it.  It can be made to mate to match perfectly. Don’t let your dentist tell you otherwise.

dental bonding before and after

Directly above is a case Dr. Delaune did on some gapped teeth which should give you some idea of how well direct dental bonding can blend into the natural tooth structure and still look beautiful.

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

Dental Bonding Turning Yellow

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I’ve had dental bonding for just a few days. I really liked how they looked, but they’ve started turning yellow. I can’t think of anything I’ve done to them except maybe the fact that I brush with baking soda.  Is that a problem with bonding? Is it possible for me to whiten them?

Karyn

Dear Karyn,

before and after dental bonding for broken teeth

 

As you can see from the picture above, as well as the results you had, dental bonding can look both beautiful and natural, when well done by a skilled cosmetic dentist. Unfortunately, your dentist neglected to instruct you on how to properly care for them. The likely damage culprit, in your case, is the baking soda. It is an abrasive. This will damage the polish on your dental bonding enabling them to pick up stains.

I think your dentist should be willing to re-do the polish on them without charge for a couple of reasons:

  • First, he should have told you how to care for your new dental work. His neglect to do so led to this problem.
  • Second, it hasn’t been that long since you had the bonding done. It shouldn’t be a problem for him to work with this.

Taking Care of your Dental Bonding

The first thing I want to recommend is you get some Supersmile Toothpaste. This is specifically designed to work with cosmetic dental work and will protect it while safely removing stains.

Unfortunately, teeth whitening won’t work. It will whiten your natural tooth structure but not your bonding. This is why I recommended instead you have your dentist re-polish them.

I would also like you to look at this link.  It is a fairly extensive article on dental bonding. If you scroll down, there is a section just devoted to how to properly care for your new bonding.

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

Finding a Cosmetic Dentist on Yelp!?

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I have chipped a few of my teeth due to teeth grinding. I’m going to get a smile makeover and am thinking of dental bonding because they’re likely less expensive than porcelain veneers. I am aware they take an expert cosmetic dentist. I’ve been going through Yelp! and found two in my area with very high ratings. Is there something else I should be looking for to help me choose between the two?

Jennifer

Dear Jennifer,

before and after dental bonding

It is great that you are trying to do research for you cosmetic dentist but I don’t think Yelp! is the way to go for this particular thing. It is a great resource for finding a decent dentist, but based on the research I’ve done, it doesn’t appear their algorithm judges based on the types of procedures. So they may have a lot of high ratings, but it has nothing to do with their ability to do beautiful cosmetic work. Those high rankings could be simply because they are a friendly office.

Before we go into a better way to find a great cosmetic dentist, though, I want to go over your procedure. You said you wanted a smile makeover which I’m assuming you mean to cover the tooth the way porcelain veneers would. Dental Bonding is much better for small amounts of work, like fixing a chipped tooth (as the images above show).

If you’re looking to cover the tooth the way porcelain veneers do, you will find that it will end up costing you more. Dental bonding is done freehand, which would take forever over larger surfaces. In fact, very few dentists will even do it. So depending on what you’re going for, you may want porcelain veneers.

Whichever procedure you choose, you will need to get a nightguard. This will protect your new dental work from the grinding you do at night. Without that, it will damage your veneers or bonding just like it did your natural teeth.

Choosing Your Cosmetic Dentist

There isn’t a recognized specialty in cosmetic dentistry. That makes it hard for patients to know who is good and who isn’t. One way to help with this is to go to the mynewsmile.com website. This is run by an expert cosmetic dentist who is retired from practice. He screens dentists who want to be listed for their training, technical skill, and artistry. A dentist can’t just pay to get listed on his site.

Any dentist recommended there can give you a gorgeous smile and are among the top cosmetic dentists in the country.

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