teeth whitening Archives - Dr. Duane Delaune's Blog

An Unhealed Sinus Perforation Is Delaying My Treatment Plan

Posted on August 31, 2023 by AllSmiles.

I’ve waited for an upper left sinus perforation after tooth extraction to heal since late May, but I still have symptoms. My next step was to get teeth whitening and four dental implants. I’m concerned that it will be 2025 before my dental work is complete. I don’t think my dentist can control the infection because he keeps prescribing antibiotics, but the infection flares again as soon as I finish the medicine. Should I request a referral to an oral surgeon, or is it too late? – Caleb from NM

Caleb

When a sinus perforation does not heal, it may be delayed by a root tip or bone fragment in your sinus. If your dentist took an X-ray of your sinus, he should be able to see if any foreign objects are lodged, preventing the area from healing.

What Can You Do If a Sinus Perforation Doesn’t Heal?

If a sinus perforation does not heal after tooth extraction, you can ask your dentist to refer you to an otolaryngologist (ENT) doctor. The specialist will examine your X-ray to determine whether a bone fragment or root tip remains in the sinus, interfering with healing.

Dental implant with crown, abutment, and implant screw identified

Dental implants need the support of healthy gums and bone

If you have a foreign object lodged in your sinus, the ENT will take these steps:

Remove the fragment, root tip, or other object
Suture the perforation
Prescribe antibiotics to clear the infection

After treatment from the ENT and confirmation that the area has healed, you can resume your dentist’s treatment plan for teeth whitening and dental implants. We recommend getting a second opinion from an advanced implant dentist to determine whether you need bone grafting or sinus augmentation before dental implant surgery.

Although you are understandably anxious to complete your smile makeover, please patiently wait for healing. Dental implants require healthy jawbone and surrounding tissues to ensure the implants and bone integrate. Otherwise, you may experience dental implant failure, which can further delay treatment, sometimes requiring alternative forms of tooth replacement.

Metairie, Louisiana, dentist Dr. Duane Delaune sponsors this post.

How Can I Whiten My Teeth After Braces?

Posted on June 29, 2023 by AllSmiles.

I should be finished with braces in October. How can I whiten my teeth after the braces are off? My teeth were yellow before the braces, and now they look spotty and yellow. Which whitening strips or toothpaste should I use? – Thanks, Ahmed from VA

Ahmed,

Upper and lower teeth whitening trays with bleaching gel syringe tips on either side

Teeth whitening trays and bleaching gel syringes. Only whiten your teeth with a dentist’s supervision.

Thank you for your questions. Wearing braces can cause various teeth stains. Only when a dentist identifies the source of the stains and recommends treatment should you whiten your teeth at home. Your efforts can make the stains more noticeable. Also, whitening strips and whitening toothpaste will have limited results.

How Can You Whiten Your Teeth After Braces?

Professional whitening from a dentist is the best way to whiten your teeth after braces. Most dentists offer in-office and take-home whitening. The advantages of professional whitening include the following:

Source of the stains – A dentist will examine your teeth to identify the causes of the stains. If your teeth are yellow and spotty, you have experienced decalcification beneath your braces and yellowing over time. A cosmetic dentist may recommend more than one cosmetic treatment for your teeth.
Anticipate the results – Without training, you cannot predict the effects of bleaching gel on your teeth, but a dentist can. Bleaching can make some stains more noticeable.
Targeted whitening – If you are a candidate for teeth whitening, a dentist will take impressions of your teeth for custom bleaching trays. Either you will you the trays for take-home whitening or touch-ups after in-office whitening.
In-office whitening – You can get rapid results with an hour of dental whitening in the office. You can continue whitening at home if you want your teeth brighter.
Treatment options other than bleaching gel – As the next section explains, bleaching gel may not be enough to remove teeth stains after braces.

Cosmetic Dentistry for Teeth Stains After Braces

Improving teeth stains after braces may include more than one cosmetic treatment, such as the following:

Teeth whitening – Removes surface and embedded stains
Remineralization – Stops demineralization and loss of tooth enamel
Composite restoration – Tooth-colored resin repairs damage to your tooth enamel
Microabrasion – Improves appearance by sanding and polishing tooth enamel

Dr. Duane Delaune of Metairie, Louisiana, sponsors this post. Read why Dr. Delaune’s patients consider him one of the best dentists in town.

What Causes Jaw Numbness After Wisdom Teeth Removal?

Posted on May 15, 2023 by AllSmiles.

Is it normal to have severe jaw numbness after wisdom teeth removal? I already contacted my oral surgeon and dentist. It will be two weeks since I got the surgery. The oral surgeon did sensation tests and asked me to return in two weeks. I notice the sensation most when I eat, chew, or brush my teeth. Because of this, I canceled my in-office teeth whitening and the beginning date for braces. Will I be stuck like this? – Thanks. Dakota

Hi, Dakota,

Thank you for contacting Dr. Delaune’s office in Metairie regarding jaw numbness after wisdom teeth removal.

What Causes Jaw Numbness After Wisdom Teeth Removal?

Nerve damage causing lingering jaw numbness after wisdom teeth removal. Most surgeons evaluate the risk of nerve damage during surgery. The nerve that travels to your lower teeth, chin, and lower lip is close to the roots of your lower wisdom teeth.

Is Jaw Numbness After Wisdom Teeth Removal Permanent?

How long jaw numbness lasts can depend on the type of nerve damage. Below are the classifications and what to expect:

Bruising – You will feel numbness for about a month, after which the feeling will return progressively.
Crushing – You will feel numbness for a year as the nerve grows new fibers.
Severing – A severed nerve will not regrow, and the damage is permanent.

What Can You Expect?

If you have nerve damage, expect it to last at least a month. You may not feel improvement before your follow-up appointment with the oral surgeon.

As the nerve recovers, you will feel lip tingling first and gradual improvement. Meanwhile, patiently wait for the nerve to heal.

Talk to your dentist about rescheduling your teeth whitening treatment. Your orthodontist will consult with the oral surgeon to assess your recovery and when it is safe to begin treatment.

Metairie, Louisiana, dentist Dr. Duane Delaune sponsors this post.

Could a Pulp Cap Work for My Tooth?

Posted on October 29, 2022 by AllSmiles.

Last month, my dentist filled two cavities. While removing the decay from the third tooth, he mistakenly exposed the pulp. He stopped trying to remove the decay and used a pulp cap to avoid root canal treatment. Before that visit, I had not heard of a pulp cap, but I had to decide rather quickly because the pulp was exposed. My dentist explained the procedure to me and e-mailed some material to me. I want another dentist’s opinion on this, though. How do I know that the pulp cap will work? Are there any symptoms I should watch that might signal cap failure and that I will need a root canal anyway? Also, how long does this take? I was supposed to begin teeth whitening in two weeks and have it completed before my wedding. Thank you. Cecelia from Springfield, MA

Cecelia,

Thank you for choosing our office for your question.

We will give you and our readers some background on a pulp cap.

What Is a Direct Pulp Cap?

A direct pulp cap is a procedure to protect entirely or partially exposed tooth pulp. The process allows the dentin (the layer beneath tooth enamel) to grow back and cover the pulp. It can save you time and money and help you avoid root canal treatment.

When Do You Need a Pulp Cap?

You might need a pulp cap if tooth pulp (living tissue and nerves) is exposed during decay removal. Your dentist may be able to prevent damage with a pulp cap if the pulp is not infected. Saving tooth pulp can help avoid the need for root canal treatment.

What Is the Pulp Cap Procedure?

During a pulp cap procedure, a dentist will take these steps::

Remove tooth decay
Apply a cotton pellet to the tooth to stop bleeding
Clean and dry the tooth
Ensure the pulp is healthy
Apply a biocompatible material over the pulp to seal out the infection
Apply and bond composite filling in the tooth

If a dentist leaves decay in the tooth, it can grow slowly and infect the tooth eventually. If you are not experiencing any symptoms, we recommend not doing anything to the tooth. And if you remain symptom-free, your dentist can x-ray the tooth to see if it is still healthy. A toothache, sensitivity, or swollen gums are symptoms and signs of an infection leading to root canal treatment. Otherwise, your tooth should be healthy. After your tooth begins to heal, your dentist can give you an estimate of when you can start whitening your teeth.

Dr. Duane Delaune, a Metairie, Louisiana, accredited cosmetic dentist, sponsors this post.

How Much Teeth Whitening Is Too Much?

Posted on September 13, 2022 by AllSmiles.

Can I whiten my teeth too much? My dentist told me to wait six months before repeating zoom whitening. She said I could damage my teeth if I overdid it, but I wanted to see how white my teeth could get. I have been bleaching my teeth every two weeks for four months. I felt some sensitivity in my teeth and went to the dentist. After examining my teeth, my dentist asked me about whitening, and when I told her that I had been whitening every two weeks for four months, she asked me to stop. She also said that she would not complete another in-office whitening session unless it was necessary. I was hoping to get another in-office session in December for the holidays. Is my dentist correct? Do I need to stop whitening my teeth? Thank you. Torri

Torri,

Thank you for your question. Your dentist examined your teeth and asked questions to determine why your teeth are sensitive. Excessive teeth whitening is likely the culprit.

How Much Teeth Whitening Is Too Much?

Teeth whitening is too much when it creates lingering sensitivity and wears away the enamel. Over-bleached teeth can become brittle, thin, and discolored. According to the American Dental Association, factors that affect teeth sensitivity with whitening include:

Concentration of carbamide or hydrogen peroxide
How long the bleaching gel is in contact with your teeth
Intensity and duration of light use
Presence of adhesive restorations

If your dentist recommends that you pause at-home and in-office whitening, it may be time to give your teeth a break to avoid damaging them.

How Can You Prevent Teeth Stains?

Although you cannot prevent teeth stains altogether, you can minimize them. Limit or avoid the things that can increase staining, including:

Coffee
Cola
Dark berries
Smoking
Wine

Rinse your mouth with water immediately after consuming substances that stain teeth. It will dilute the ingredients and limit their staining effectiveness.

If you do not fully understand why your dentist recommends a pause in teeth whitening, contact her to request more information.

Metairie, Louisiana dentist Dr. Duane Delaune sponsors this post.

Why Do I Need Another Root Canal If I Take Care of My Teeth?

Posted on February 4, 2022 by AllSmiles.

I have two root canal teeth, and during my last visit, my dentist said I would soon need a third one. The first two root canals were completed after filling failed. I grind my teeth, and my dentist said I need another root canal on a cracked tooth that grinding may have caused. I have a night guard, but sometimes I forget to wear it at night. Other than that, I floss my teeth daily and brush them morning and night. Unfortunately, I must delay getting my teeth whitened until after the root canal. I don’t understand what I need to do to avoid root canals in the future. Are some people’s teeth more at risk for root canals? – Thanks. Monroe from Rhode Island

Monroe,

The problems you describe with your teeth are not uncommon. Preparing a tooth for filling requires removing some tooth structure, weakening the tooth. The tooth can become sensitive. And if you grind your teeth, they will experience even more stress. Try these suggestions.

How Can You Avoid Future Root Canal Treatment?

You can minimize the need for future root canal treatments through at-home care and finding a dentist knowledgeable about the latest techniques for preserving teeth.

Wear your night guard – In addition to practicing diligent oral hygiene at home, wear your night guard regularly. A night guard protects your teeth from the forces of grinding.
Avoid frequent snacking – Snacking throughout the day releases acid in your mouth that breaks down tooth enamel and weakens teeth. Although some people think brushing their teeth after snacking is the solution, it is not because brushing teeth while they are weak can further wear tooth enamel.
Look for high-quality dental care – A dentist with a commitment to continuing education and the latest techniques will provide work to improve your oral health and keep your teeth strong. If you do need fillings or restorative work, a skilled dentist will use techniques that minimize the impact on your tooth structure.

Although you need a third root canal treatment, if your dentist is not conservative in his treatment, we suggest that you get a second opinion. Root canal treatment weakens teeth, and if your tooth needs a crown afterward, conservatively preparing it will help preserve it. Also, talk to the dentist about your plans for teeth whitening and ask how you can minimize sensitivity during treatment.

Dr. Duane Delaune, a Metairie, Louisiana cosmetic dentist, sponsors this post.

Using Invisalign as a Retainer

Posted on May 30, 2021 by writeradmin.

I am finishing up my Invisalign treatment. I have two sets of aligners left. I have to move rather quickly to another state and will be quite busy once I arrive. My sister and her young son were just diagnosed with cancer, though they have two different cancers. I was coming to help anyway, but now her husband was in a car accident and he is in a wheelchair and will be for several months. I need to leave immediately. My boss has given me permission to work remotely. The only thing I don’t have worked out is how to do the Invisalign. I will have no time to find a new dentist. Do you have any recommendations?

Kathy

Dear Kathy,

Invisalign Aligner

First, let me express how sorry I am for all that you and your family are enduring at the moment, as well as how grateful I am that you are doing all you can to help them. I am sure it brings them some peace of mind. The first thing I would do is call your dentist and ask him to provide you with your last two sets of your Invisalign aligners. Assuming your case has had nothing unusual and everything is going according to plan, he should not have any problem with that at all.

That is the easy part. the tricky part comes after you are done with your treatment. You will need to wear a retainer, unless you want your teeth to go right back to the way they were before their treatment. The good news is, there is a way to do this without you having to take time out to see a dentist. Your final pair of aligners can double as a retainer if you follow these directions and take good care of them.

Using Invisalign as a Retainer

The first step will be to wear them all the time for a month. Once the month has passed, then start backing off. You can wear them nights only for a month or two. After that, try every other night. Directly after the first time you were without them for two days, I’d like you to do a little test. When you put the aligners back in, if they are a little harder to put on I suggest you go back to wearing them every night for a couple more weeks, then try again.

Once they remain in place, you can wear them every other night for a month then retest to see how that is going. If they are fine, you can go to wearing them once a week. Always repeat the test mentioned above before any change, backing off a little more after each stable pass. Eventually, you won’t need them at all.

I would still keep the aligners even after you are done with them for two reasons. First, you can periodically check to see that no shifting has happened. Second, they are great for doubling as teeth whitening trays. When you do get to a new dentist, he can provide you with whitening gel. This will allow you to keep your teeth youthful and bright at a fraction of the cost.

Best of everything to you and your family.
This blog is brought to you by New Orleans Dentist Dr. Duane Delaune.

Smile Makeover Disaster

Posted on May 15, 2021 by writeradmin.

I need some serious advice. I went to my dentist with the intent of having my cleaning done and then getting a recommendation for an orthodontist. My four upper front teeth are crooked. He said he could make them straight with cosmetic dentistry and I would not have to worry about the inconvenience of braces. That sounded great to me so I agreed. He told me that two porcelain veneers and dental bonding would make my smile look completely straight. I was excited about the possibility of having a beautiful smile. When the makeover was “completed”, it wasn’t anything like he promised. The teeth are still uneven, the porcelain veneer is too small and you can see a gap between the veneer and my gums. He also charged me for reshaping my lower teeth which was never even discussed. I was quite upset and told him this wasn’t the outcome I expected. Then, he proceeded to tell me the only way to get the outcome I want is with four dental crowns. Of course, that will be an additional fee. Is this allowed? Can he get away with it?

Fanny

Dear Fanny,

No. Your dentist cannot get away with this. I would go back to him and ask for a refund. If he says no, remind him that he was the one who told you what this outcome would be and he didn’t deliver on his promise. On top of that, the porcelain veneer he provided for you has an open margin (what dentists call that gap you described). Open margins put your teeth at risk because it allows food and other bacteria to get caught between your teeth and the veneers, leading to decay. A second issue that can get him in big trouble is reshaping your bottom teeth without your permission. It sounds like this dentist was using you for practice. Let him know you will be taking this issue to the dental board and I think he will provide your refund.

Once you have secured your refund, you will want to get the smile makeover you wanted. Believe it or not, it is probably still possible to do with porcelain veneers. You just need a skilled cosmetic dentist to do the work. I would look for a dentist who is recommended on the mynewsmile.com website. Dentists cannot pay to be listed on this site. Instead, they are screened for both their technical skill as well as their artistry. Any dentist recommended on there will give you a stunning smile.

I will say, if you are planning on just getting four porcelain veneers (and it is okay if you are) then I suggest you have teeth whitening done first. Most patients smiles are six to ten teeth wide. Getting your teeth whitened allows you to have your non-veneered teeth blend in better than if you left them their current tone.

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

The Secret to Very White Teeth

Posted on March 31, 2021 by writeradmin.

I have been using whitening toothpastes for years and never seem to get very white teeth. I’ve about given up and am now looking at getting Lumineers at the suggestion of my dentist. It looks like it can give me very white teeth, but I wanted to make sure I am on the right track with this before investing that much money. Any advice?

Melissa

Dear Melissa,

You have a few good options. Before we get into that, I’d like to discuss why your whitening toothpaste hasn’t worked. These don’t actually whiten our teeth as much as scraping them clean. Whitening toothpaste uses an abrasive on your teeth, which removes the stains. However, it also will scratch the surface of your teeth. This has the unfortunate effect of damaging the surface of your teeth, in turn making them pick up stains more.

I’m a bit concerned that your dentist jumped from whitening toothpaste straight to Lumineers. It is massively more expensive than some of your other options. Lumineers are one brand of porcelain veneers. It’s a highly marketed brand. Unfortunately, it is mostly marketed to inexperienced cosmetic dentists. This rarely goes well for the patient. Plus, porcelain veneers are not intended for simply whitening your teeth. Instead, they are for total smile makeovers. If that is what you want, then great. Get porcelain veneers. They can be made as white as you’d like. They can also change the shape and size of your teeth. It’s important you choose an excellent cosmetic dentist to do that procedure. If you decide to go that route, I suggest you look for a dentist that is listed on the mynewsmile.com website. These dentists are pre-screened for their training, technical knowledge, and artistry. They cannot just pay to get listed.

If you are not looking for anything quite that expensive, then you can get your teeth very white by doing professional teeth whitening. Doing bleaching trays can get them very white and you can do it at your convenience. If you want them white super fast, then you can go with Zoom Whitneining which will whiten your teeth in just one appointment. Unlike with porcelain veneers, you won’t need an exceptional cosmetic dentist for either teeth whitening procedure. Pretty much any dentist who offers the services can do them without any problem.

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

Should She Finish This Full-Mouth Reconstruction?

Posted on January 27, 2021 by writeradmin.

I went for years grinding my teeth without any intervention or knowledge that it was happening. I moved to a new city, which meant a new dentist. He was the one who told me about the grinding. I would explain why my jaw always hurt. I am wearing a night guard now, but he also suggested a full-mouth reconstruction. I was a bit nervous about that because I have a very sensitive mouth. I once had Zoom Whitening done and it was absolute agony. I did (and do) trust this dentist so I went ahead with the reconstruction. He’s finished the first half, which is the bottom arch. While it does make that part of my smile look much better, it almost looks too perfect. I liked the quirky look of my old smile. Plus, like the Zoom, the procedure was agony for me. I’m no longer hurting, since he did the first half and I’m wondering now if it is necessary to finish. There is a color difference wtih my bottom teeth being whiter. If Zoom weren’t such a painful experience for me I’d just do that. Do you have an opinion?

Katherine

Dear Katherine,

You’ll need to bear in mind that I haven’t examined you, nor have I seen any x-rays. I can give you some generalities. I am not usually one to recommend half of a full-mouth reconstruction. In general, restorative material is harder on your teeth than natural tooth structure. That could cause a problem with your upper teeth, including increased sensitivity–something you definitely don’t need.

If not having the quirkiness bothers you, there is an easy solution for that. Most cosmetic patients want the perfect smile look. My feeling is your dentist and his ceramist would LOVE the opportunity to be more creative and add some quirkiness. You mentioned having some pain with the reconstruction. If the numbing medication isn’t working it is likely because with your sensitive teeth you have had enough bad experiences to give you dental anxiety. There is something about how the anxeity affects your body chemistry that causes it to interfere with the effectiveness of your medication. Oten, doing something as simple as using nitrous oxide before the procedure starts will relax you enough to enable the numbing medication to do its job.

All of that being said, if you feel the first half of your reconstruction has served the purpose you needed and all you truly want at this point is the whitening, you don’t have to use Zoom Whitening, which can be a tad strong for people with sensitive teeth. Instead, you can do home whitening trays. You will wear the gel at your convenience for as long as you can comfortably tolerate. You may find that a better solution for you. There are a variety of teeth whitening options.

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