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How Much Is Needed for a Smile Makeover?

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I’m a little confused about smile makeovers. I was told that THE procedure for this was porcelain veneers, but when I went to see my dentist for this, he is suggesting I have teeth whitening, Invisalign, and porcelain veneers. Is all this REALLY necessary? I was under the impression that porcelain veneers can make teeth look straight. The only thing I have like that is one front tooth goes just slightly over the other. I would think you could shave that down, though I am not a cosmetic dentist. Am I misunderstanding something here?

Susan

Dear Susan,

porcelain veneer being placed on a tooth

There are a few things going on here. First, you are correct that porcelain veneers are the way to go if you are getting a smile makeover. You mentioned that you are not a cosmetic dentist so maybe you did not understand how they worked. The trouble is your dentist may not be a cosmetic dentist either. Believe it or not, cosmetic dentistry is not a recognized specialty. Any general dentist can do cosmetic dentistry regardless of the amount of training they’ve received. That leads me to answer your questions. Some of what he said could be necessary and one is not.

Let’s start with the teeth whitening. Unless you are placing porcelain veneers on every single visible tooth, then teeth whitening will be a good idea. You did not mention how many porcelain veneers you are getting. Most smiles are 8-10 teeth wide. Unless you are getting that many veneers, the whitening will help the adjacent teeth to blend in nicely and is less expensive than additional veneers. Just make certain that you do the teeth whitening before the veneers.

The Invisalign is a completely different story. Some cases are so complicated that it might be necessary, but from your description, it is NOT necessary in your case. An experienced cosmetic dentist could definitely make those teeth look straight. I don’t think your dentist is an expert cosmetic dentist. That is why he is suggesting Invisalign. It will help compensate for what he is not capable of doing on his own.

My suggestion is you find an expert cosmetic dentist to do your case. You will be much happier with the results. To find one with real expertise and proven artistry, I would look on the mynewsmile.com website. These are some of the best cosmetic dentists in the country.

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

Matching Dental Work to Really White Teeth

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I am new to my area due to getting transferred. I’ve always whitened my teeth once every two years and they are very white. With the transfer and the pandemic, I haven’t had time to find a new dentist and recently fell and chipped a tooth. I went to a dentist someone at work recommended. He told me I’d need to get a crown on the tooth to repair it. The problem I am having is getting the crown to match. I’ve asked him to send it back to make it whiter as it is obviously darker than my teeth, but he insists this is the whitest shade and showed me a shade guide to prove it. I’m having a hard time believing that people who whiten their teeth never need dental crowns. Is there no way to make my dental work match my whitened teeth?

Jennifer

Dear Jennifer,

Old Shade Guide

I think what you are up against is your bread and butter family dentist versus a true cosmetic dentist. While there is not a recognized specialty in cosmetic dentistry, there are dentists who have invested a significant amount of more time in cosmetic training than others. Dentists who invest in this training know things your average dentist doesn’t. One of those things is the tools available to match dental work. Your dentist is probably using the old color shade guide (pictured above).

That particular shade guide worked for many years. But, then teeth whitening gained in popularity this shade guide became outdated. Teeth were now whiter than the whitest shade on the guide. To respond to this need, I new shade guide was developed. This one had much whiter shades that dentists can use to match to the needed dental work. This shade guide (pictured directly below) has whiter options.

extended shade guide

You did not say where the tooth was, but my guess. is it is a front tooth. This is even more challenging. To be quite frank, I don’t think your dentist is up to the task. The front teeth are the most visible because the light hits them directly, exposing all the variations and subtleties of the teeth. Even expert cosmetic dentists will take one or two try-ins before getting it right. If he does not even have the right shade guide, then he will not be able to match a crown to a front tooth which will need specific additional instructions to the ceramist. In your place, I would look for a dentist recommended on the mynewsmile.com website. These are among the best cosmetic dentists in the country.

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

Click here to learn about our complimentary virtual smile makeover consultation.

Premium Home Whitening

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I received an advertisement for Premium Home Whitening. While the price is cheaper than what my dentist asks for teeth whitening, it is still higher than I want to risk on something I am not sure will work.  Do you know if this is a legitimate product or not?

Katherine

Dear Katherine,

 

Photo of teeth whitening trays in a blue case.

Teeth whitening trays

I am glad you wrote. I’ve looked into this. There are three main parts to this kit and I’ll go over each of them one at a time, then give my recommendation.

The Light:

This is the one part of this kit I would say it completely bogus. It doesn’t do anything. I think it is there simply as a sales gimmick, which bugs me.

The Whitening Ingredient:

This part is good, actually. It lists 35% carbamide peroxide. That is an effective whitening ingredient and will whiten your teeth. So, that is good news.

The Tray:

This will have some gaps because it is basically a DIY tray. If you look at the image above, I’ve posted a picture of professional bleaching trays. These are custom-fit to your specific bite. This will cause three specific issues:

  1. The tray will get saliva in it, which will weaken the strength of the gel.
  2. The gel itself can leak out, which does zero good toward any whitening benefit.
  3. Your gums are no longer protected which can lead to some irritation and other issues.

Getting Your Teeth Whitened

My suggestion, because the cost of this is close to what your dentist charges is to simply talk to your dentist about the advertisement and price and ask if he or she would be willing to do your teeth whitening for around the same price.  You will get more effective teeth whitening, all while being under the care and observation of a dentist.

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

 

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.