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What Else is Necessary with Porcelain Veneers?

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I want to get porcelain veneers. My dentist is fine with that but said he wants me to get my teeth whitened first and my crooked front tooth straightened with Invisalign.  I thought that porcelain veneers made your teeth whiter and could make a crooked tooth look straight. What else is really necessary with porcelain veneers?

Kelly

Dear Kelly,

a porcelain veneer being placed on a tooth

I can give you some guidelines here, but bear in mind that I have not examined you so it would be irresponsible to give specifics. In principle, you are right, porcelain veneers can change the shape, size, and color of your teeth. If that is the case, why would you need anything else?

Let’s start with the teeth whitening. Most dentists will suggest you whiten at least your bottom arch of teeth. Patients generally only get veneers on their upper teeth, so if you want your two arches to blend, whitening the bottom teeth is an inexpensive way to do that. You would only need to whiten the upper arch of your teeth if you were not getting enough porcelain veneers to cover the teeth that are exposed when you smile. Most people have a smile that is 8-10 teeth wide. Let’s say you were getting just six porcelain veneers. Then, the adjacent teeth would not match when you smiled. Whitening them will help them to blend.

The Invisalign is a whole different story. It is rare for a patient to need orthodontics and porcelain veneers. You mentioned you had a crooked front tooth. An experienced cosmetic dentist can make crooked teeth look straight with porcelain veneers. The exception to that would be if you had a pretty complicated orthodontic case. That doesn’t sound like you at all.

This gives me a clue to your dentist. It is quite possible your dentist is using Invisalign like a crutch. He doesn’t feel comfortable shaping crooked teeth with porcelain veneers so he only wants to work with the ideal cases. If it isn’t ideal he suggests other procedures until it is. This is a waste of your money and time.

I suggest you get the teeth whitening with him. It is inexpensive and useful.  Then, get the porcelain veneers with an expert cosmetic dentist. I recommend looking on the mynewsmile.com website. The man who runs this site is a retired cosmetic dentist. He prescreens every dentist who wants to be listed there for their training, technical knowledge, and artistry. Any one of them can give you a stunning smile makeover, without having to do unnecessary procedures to get there.

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

Retouching up Teeth Whitening

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I need to get a dental crown on a front tooth. I know the color will be permanent so I want to retouch up my teeth whitening before settling on the color of the crown. Do you have any tips about how to go about this? Specifically, I am looking at how long I should whiten every day and for how many days.

Caroline

Dear Caroline,

Photo of teeth whitening trays in a blue case.

Teeth whitening trays

I’m glad you wrote. I am curious though if your dentist was unable to advise you of this. The reason I ask is because placing a dental crown on a front tooth is much trickier than other dental crowns. It takes some expertise in cosmetic dentistry to do a crown properly on a front tooth. If he wasn’t able to answer the questions about teeth whitening, which does not require expertise, I am going to advise you to find a different dentist at least for the crown.

If it turns out that you do need to switch dentists in order to get a beautiful porcelain crown to match your other front teeth, I recommend you see someone who is recommended on the mynewsmile.com website. These dentists have all been prescreened and are among the top cosmetic dentists in the country.

Touching Up Teeth Whitening

In practice, it is up to you how long each day you leave on your teeth whitening trays. The longer you can leave them on each day, the faster they will whiten. But, if your teeth are sensitive and you can only do them a little bit each day, that is okay too. You will just have to do more days. The fastest would be to sleep in the trays if you can.

While there is no cut and dried rule for how many hours per day or days in general to whiten, there is a standard for how long to wait between the time you stop whitening and you go in for your dental crown. I would recommend giving it one week for the color to settle on your teeth before having the dentist create your dental crown.

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

Bleaching Teeth with Clorox

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I have a friend who has pretty white teeth. I asked her which teeth whitening she uses and she told me she just rinses with Clorox Bleach every day. Is that safe?

Penny

Dear Penny,

custom-fitted teeth whitening trays

I am always amazed at the creative questions we sometimes get here. I think this one is a first for me. So there are a couple of things to consider here. First, Clorox (chemically speaking) is a strong base. Think of Lye and that might give you an idea of what I mean. Because of its base strength, it is highly corrosive to organic tissue.

As an example, many dentists use a household bleach curing root canal treatments. It is a method we learned in dental school to help dissolve any organic debris left inside a cleaned out root. It also disinfects the tooth. Notice we’re using it to dissolve something.

A second consideration is when bleach comes into contact with certain other types of chemicals, it will release chlorine gas, which is toxic.

Finally, there is the label on the back of the bottle that says it is a violation of federal law to use it in any way other than what it was manufactured for. If you’ve already pulled the tag off your mattress, that is two strikes and you could end up in “the pen” for a long time.

Healthy Teeth Whitening

The most effective and safest way to whiten your teeth is with a dentist. Generally, they offer two options for you. The first is take-home whitening. This lets you have more control over how white your teeth get. Once you reach the level of whitening you want, you can simply stop using the whitening gel.

A second option is Zoom Whitening. This is done in the dentist’s office and will get your teeth their whitest in just one appointment. This has the advantage of being the fastest, but if you just want a mild whitening, this will whiten beyond that.

Plus, you won’t have to worry about the bleach or mattress police.

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

Tanda Pearl Ionic Teeth Whitening System Review

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I have TMJ Disorder and wearing my teeth whitening trays for an hour tends to aggravate my jaw.  I recently read about the Tanda Pearl system which allows you to whiten your teeth in just five minutes a day. That is very appealing to me. Do you know if it actually works? They say their light makes it work that fast.

Kathy

Dear Kathy,

custom-fitted teeth whitening trays

What I’d like to do is go over some of the differences between the Tanda Pearl System and the type of whitening you get with a dentist, which should help you make a decision.

The Trays

The teeth whitening trays you have from your dentist, should have been custom fit to your bite. The fact that it seems to be aggravating your TMJ Disorder makes me wonder though.

They also have separate trays for each arch of your teeth. This allows you to go about your day more easily. You could even wear them while shopping if you wanted to and no one would notice (whether or not you’re wearing a mask). Many people simply sleep in them to get the most teeth whitening for their time.

The Tanda Pearl trays you create at home by biting onto impression material. This is a single tray that you have to clench onto in order to keep it in. In truth, this will do way more to harm your TMJ issues than help them. Clenching is one of the worst things you can do, even for just 5 minutes.

The Light

This system claims to have a patented ionic technology. I’m skeptical about this. There doesn’t seem to be any information given about the light. If it were really such a breakthrough, they would make a ton of money selling it to dental offices. They’ve never even tried, which makes me think the light is more for psychological effect than any real use.

One thing I recommend is you talk to your dentist about the pain you are experiencing in your jaw. In the meantime, you can cut down on the amount of time you are wearing your trays each day. If a shorter time appeals to you, wear them a shorter time, at least until your dentist figures out why they are causing strain on your jaw. Really, in as little as 15 minutes, the gel has time to soak into your teeth adequately enough to make a difference.

One Appointment Whitening

Another option for you is to get Zoom Whitening. Not every dentist has this option so you may have to call around, but it allows you to get your teeth completely whitened in just one appointment.

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

Damage After Crest Whitestrips

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I had a damaged tooth from years ago that has always been a bit darker than my other teeth. It’s always embarrassed me about my smile. I recently talked to my dentist about it and asked if tooth whitening would be a good idea. He doesn’t offer that service but said that Crest Whitestrips work.  After about a week my teeth became sensitive. I went back and he said he thinks I need a root canal treatment. I don’t know why it would. Do you think I need a second opinion? Also, if Crest Whitestrips won’t work for me should I try another dentist who does do teeth whitening?

Calli

Dear Calli,

 

Photo of teeth whitening trays in a blue case.

Teeth whitening trays

Your dentist showed a fundamental lack of understanding about teeth whitening. I’m glad to hear he doesn’t offer the procedure because he’d do one of the simplest cosmetic procedures ever wrong. No matter what type of teeth whitening you do, it will whiten the teeth evenly. So even if this darker tooth got whiter, so would all the other teeth around it. Therefore, the tooth would still be darker than the rest of them.

In this situation, you would need dental bonding or a porcelain veneer. Either one of these procedures would require an expert cosmetic dentist. Your dentist doesn’t qualify.  Before we go onto finding an expert cosmetic dentist I want to address your immediate issue.

I would get a second opinion before getting a root canal treatment. Crest Whitestrips aren’t very strong. They do whiten, but it would take a significant number of boxes to match what you would get with a dentist. Even then, you would only have your first six teeth get whitened because that is all the strips will reach. I would be surprised if it caused you to need a root canal treatment. That doesn’t mean you didn’t have something else going on.

Bottom line. Get a second opinion. After that is dealt with, if you decide you want to get that tooth fixed cosmetically, I suggest you go to the mynewsmile.com website. They recommend expert cosmetic dentists by zip code. So you should be able to find one in your area.

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

Pain with teeth whitening

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I had dental bonding done about seven years ago. Since then I’ve been whitening my teeth, the dental bonding isn’t whitening, but that isn’t why I am writing. Recently, I’ve started having pain for about 30 seconds right where the bonding connects to the chipped teeth. Do you think the teeth whitening is damaging the bond?

Fanny

Dear Fanny,

Photo of teeth whitening trays in a blue case.
Teeth whitening trays

You didn’t mention whether or not you are under the supervision of a dentist during your teeth whitening or if you are doing an over-the-counter teeth whitening. There are a couple of ways in which the method you chose won’t matter.

First, neither form of teeth whitening will weaken the bond. Second, neither method will whiten your dental bonding. Even professional teeth whitening will only whiten natural tooth structure. The only way to whiten your dental bonding would be to re-do it.

Here’s where their differences in the methods lie. The strength of over the counter teeth whitening is only a fraction of what you get through a dentist. You have to do countless kits to get the same value in teeth whitening. The second difference is the care you get.

A dentist would be monitoring any complications which would come up during the process, including pain and gum issues.

The pain you are experiencing is likely because of a sensitive spot on that tooth where the bonding agent has worn down. With the age of your bonding, that doesn’t surprise me.

Here’s what I recommend. See your dentist and let him or her know what is going on. There is a way they can cover the sensitive part while your teeth whitening is going on. That should cover the pain.

Then, you can continue the whitening until you get to the level of brightness you want. From there, you can get your dental bonding replaced to match the newer color.

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

matching teeth to eyeballs?

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I wanted to know if it is possible to use teeth whitening to match my teeth to my eyeballs?

Luke

Dear Luke,

custom-fitted teeth whitening trays

I want to give you points for the most unique question I have received. There are two factors in answering this question.

First, a lot of the answers will depend on one how white your eyeballs are. While teeth can be bleached exceptionally white, there are limits to its whitening ability.

The second factor is that teeth whitening results vary quite a bit. This is why when someone is getting a complete smile makeover we have them bleach their teeth first. You get much more accurate results when you are matching porcelain veneers to a color, than when you are using teeth whitening.

If it is just a color you are going for, then you can attempt to do it with teeth whitening and see if it gives you the color you want. It is the least expensive way to give yourself a mini makeover.

However, if there was more you wanted to change about your teeth, such as their shape or size, in addition to the color, then the way to go is with porcelain veneers.

As I mentioned above, they can be made to any color you desire. But that isn’t all. A great cosmetic dentist can lengthen and widen your teeth, completely changing the character of your smile. Depending on how the dentist shapes your teeth, he can change the appearance of your smile to look youthful, sporty, authoritative…whatever you want.

However, it does require some expertise and will be more expensive. Unlike teeth whitening, which any dentist can do equally well, to do truly beautiful smile makeovers takes advanced technical and artistic ability.

This is only developed after extensive post-doctoral training. Doing smile makeovers isn’t taught in dental school. In your place, I’d look for an AACD accredited dentist. They are in the top 1% of cosmetic dentists in the country. Any smile they create for you will be absolutely stunning.

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

fixing this dental bonding

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I had dental bonding done by my dentist in the previous state I lived in. It was getting old and picking up stains so my new dentist tried to spruce it up with teeth whitening. That seemed to just make it darker. Is there some way to whiten this bonding?

Kathy

Dear Kathy,

Photo of teeth whitening trays in a blue case.
Teeth whitening trays

Unfortunately, teeth whitening will not work on your dental bonding. It isn’t just bonding. It won’t work on any dental work. The reason your dental bonding looks darker is the teeth whitening did work on your natural teeth while your bonding stayed the same color.

There is not a way to whiten old bonding. Instead, you’re going to need to have it re-done. I don’t think your current dentist will be the one to do it. He or she didn’t understand how teeth whitening works, which is the bare basics of cosmetic dentistry. Dental bonding takes an expert level of cosmetic skill to get right.

In your place, I’d look for a dentist recommended on the mynewsmile.com website. They pre-screen dentists who wish to be listed for both their technical training and their artistic skill.

One thing you might want to consider is upgrading to porcelain veneers. Your bonding will have to be re-done every few years, When porcelain veneers are well cared for, they can last for two decades. Again, you would need to have this done by a cosmetic dentist.

You can stay with your current dentist for all your general work. However, when you go in for cleanings, make sure they know not to use anything like a prophy jet or acidulated fluoride. Both of those will take the glazing right off your cosmetic work. This will ruin them and cause them to pick up stains.

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

whitening tetracycline teeth

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I’ve had tetracycline-stained teeth since I was a child. It has always been a source of horrible embarrassment for me. My dentist said teeth whitening wouldn’t do much good for me and not to waste my money. He didn’t have a solution for me either. Is there anything I can do or am I just going to have to learn to live with a smile I’d rather hide?

Betsy

Dear Betsy,

While one particular brand of teeth whitening has had more success with these stains than others, most make hardly any difference at all. That doesn’t mean all is lost.

As you can see from this smile makeover that Dr. Deluane did on a patient, there is a way to obtain a beautiful smile after tetracycline stains. Here Dr. Delaune used porcelain veneers. This enabled him not only to cover her stains, but to reshape her teeth to add length.

I don’t want you to think you can just run to your family dentist and get porcelain veneers and all will be beautiful and shiny. These are among the most difficult cosmetic dentistry cases to do. It would take a dentist with advanced cosmetic training.

The difficulty comes in needing to make the porcelain veneers opaque enough to cover the dark tetracycline stains, yet translucent enough to have their natural shine.

Finding an Expert Cosmetic Dentist

I’m going to suggest you go to the mynewsmile.com website. A cosmetic dentist cannot just pay to be listed. They have to prove their cosmetic education as well as provide case samples to show they can get beautiful results.

However, while everyone listed on that site is an expert cosmetic dentist, tetracycline cases are a beast of their own. I’d like you to go one step further and ask to see specific before and after pictures of cases they’ve done dealing with tetracycline. You want to be certain they’re able to get the beautiful results you’re dreaming of. Then, you will have a smile you are delighted to share with the world.

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

For whiter teeth do i brush before or after tea?

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I had teeth whitening done about a month ago and am hoping to maintain the results as long as possible. However, I’m getting conflicting information as to whether I should be brushing before or after my tea. One person said that if I brush before, I’m opening up pores on my teeth and they’ll pick up stains quicker. Another person said that if I brush after tea, which is what I’ve been doing to get the tea off my teeth quickly, I’ll damage my teeth because the tea is acidic. Which is correct?

Thank you,

Maya

Dear Maya,

womean covering her mouth with her hand
When your teeth are stained it can be embarrassing to smile.

You’re asking good questions. Your teeth whitening results will last longer if you’re mindful with your tea habits. Ideally, you’d give up tea, but since that’s probably not realistic, let’s focus on what you can do when you indulge anyway.

Drink in One Session and Don’t Sip for a Prolonged Period of Time

It sounds like you’ve got this one nailed, but it’s worth mentioning. People who sip on tea and coffee all morning or all day pick up stains faster than those who finish their drinks in one go.

It’s Ok to Brush Before Tea

The concept of “pores” opening when you brush is an urban legend. While you do have tubules in your teeth, they have plugs in them. Very few things disrupt those plugs, but it’s generally restricted to things that happen in the dental chair, such as restorative work and professional teeth whitening.

The tubules develop new plugs within a day or two, so you’d want to avoid tea during that span so you don’t sabotage your efforts but otherwise, you’re good to go in that department.

Be Wary of Brushing After Tea

The problem with acidic foods and beverages is that they lower the pH of your mouth. Ideally, it should be closer to a 7.0, but a little variation in either direction isn’t too much cause for concern. When your mouth is more on the acidic side (anything below 7.0), your teeth demineralize. That means they lose calcium, phosphorus, and other minerals that make them strong and block decay. Your enamel and dentin will also soften for a period of time after consuming an acidic beverage.

However, as your pH returns to normal, they’ll pick up the minerals in your saliva (remineralize) and will harden again. Problems set in when you either don’t provide your teeth with an environment to remineralize or you brush while the enamel is still “soft.” In doing so, you can actually remove the softened layer and it doesn’t grow back. That’s referred to as acid erosion, though there are several alternate causes of it.

For the record, black tea is usually a 4.9-5.5 pH, making it one of the more acidic things you can introduce into your mouth, though it will vary depending on how you brew it and other factors. Coffee is usually around a 4.5- 6.0 pH, for comparison. Sodas and juices—especially citrus juice—can go as low as 2.0. Battery acid is a 0.0.

Rinse or Rebalance After Tea Instead of Brushing

One of the easiest ways to remove any residual tea is to give your mouth a quick rinse with water after you finish. If you have concerns about acid erosion or demineralization, you can also restore balance by using a pH neutral mouthwash after or by mixing one part baking soda to eight parts water and rinsing with that.

Fluoride may be an alternative to help create stronger teeth as well, though it obviously does nothing for staining. It doesn’t work in exactly the same way minerals will, but it also isn’t quite as sensitive to environmental factors, which is why it’s been trusted as a cavity-fighting tool for generations.

This blog is sponsored by New Orleans Dentist Dr. Duane Delaune.