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Crowns Versus Veneers for Tetracycline Stains

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I have tetracycline stains and am finally in a position to get them fixed. I have a choice between two dentists. One is suggesting porcelain veneers and the other porcelain crowns. He said that added thickness is needed for the severity of the stains. He also wants to do top and bottom, while the other wants to just do the top and recommends whitening the bottom. I thought whitening didn’t work on tetracycline stains. Which of these treatments do you recommend?

Petra

Dear Petra,

teeth bleaching trays

Teeth Bleaching Trays

While teeth whitening will not make your teeth as beautiful as porcelain veneers, they can help a lot if you’re persistent. On the bottom arch, things don’t have to match the uppers perfectly, just get close to the color. I have found that KöR whitening does better with tetracycline stains than other brands. It’s pretty standard procedure to just whiten the teeth first and then just place veneers on the upper arch.

As for the porcelain veneers verses the crowns. I would definitely go with the dentist suggesting veneers. Those who suggest dental crowns often do so because they are uncomfortable with their cosmetic skill in porcelain veneers. His comment that you need the added thickness is incorrect and adds to my concern about his cosmetic skill.

Tetracycline stains are among the most difficult and advanced cosmetic procedures there are. Dentists have to manage the delicate balance of making the work opaque enough to cover the dark tetracycline stains, yet transparent enough to reflect light and look natural. In experienced cosmetic dentists think using crowns will help with this. It will not. All it serves to do is require removal of much more healthy tooth structure than is necessary. Porcelain veneers will do the best job for this in the hands of a skilled, artistic dentist.

It is worth it to you to find an expert cosmetic dentist, who has a lot of experience with tetracycline stains. In fact, I recommend that you ask to see before and after images of tetracycline stains that they’ve worked on.

I hope this helps you make a decision.
This blog is brought to you by Hoffman Estates Cosmetic Dentist Dr. William Becker.

Will I Save Money with Premium Home Whitening?

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I was thinking of getting my teeth whitened with my dentist but after looking at some things online, it looks like I can do the same thing much cheaper with the over the counter stuff. One that I’m looking into is the Premium Home Whitening Kit. Would this be a useful kit for me to use?

Audrey

Dear Audrey,

teeth bleaching trays

Teeth Bleaching Trays

I’m glad you wrote. First, the good news. They do use a valid whitening ingredient, which is 35% carbamide peroxide. It will whiten your teeth. There are two other concerns to consider before making your final decision.

First, the trays are a problem. When you have professional teeth whitening done, your dentist will do it with custom-fitted teeth whitening trays. The trays for these are not going to be specifically fit to your bite. That means that it will allow your whitening gel to leak out of the tray, which lessens the amount of whitening you will get. It will also allow your saliva to get in, which will weaken the gel that does get on their teeth.

This means you will need to purchase quite a few kits to do the same amount of whitening that just one treatment with your dentist will do for you. This is not likely to save you a lot of money.

A second factor is that when you are not under the care of a dentist during your teeth whitening treatment, you risk additional problems. There is a post on another blog about a woman who ended up needing a root canal treatment because of over the counter whitening. This was because she had a tooth that was having problems that was undiagnosed.

You will also want to have your teeth cleaned before you get your teeth whitening done. Otherwise the results will be splotchy.

My recommendation is to do it through your dentist. I’m saying this as someone who will not be the one treating you so I do not get anything out of it. I just want you to get the best care possible.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Is Using Tanda Pearl Whitening Better for TMJ Patients?

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I’ve read that the Tanda Pearl system only has to be worn for 5 minutes a day to whiten your teeth. My dentist is having me wear my trays for three hours a day and it is aggravating my TMJ. Would switching to the Tanda Pearl kit be better for me?

Mia

Dear Mia,

teeth bleaching trays

Teeth Bleaching Trays

I’m glad you wrote. If your dentist is using professional strength teeth whitening, there is nothing magic about you wearing the trays for three hours. Because that is aggravating your TMJ Disorder, I would reduce the time you wear them. Really, you want a minimum of fifteen minutes for it to penetrate the enamel efficiently. The only thing wearing it longer than that does is whiten your teeth faster. Don’t torture yourself.

I would not recommend switching to Tanda Pearl, especially because you have TMJ Disorder. Their kit uses a single bite tray. You have to keep it in by clenching your teeth. Even for just five minutes, that will end up causing you significant problems. Though, I have serious doubts that their “ionic” technology makes their whitening work faster. They would make more money selling that technology to dentists than over-the-counter and they provide no documentation to back up their claims.

The other thing to be aware of with over-the-counter kits is that their trays will not be custom fitted to your bite the way professional teeth whitening will. That means that your saliva will leak into the trays, which weakens the whitening potency. Second, it also allows some of your whitening gel to leak out, which weakens its potency even further, as well as putting your gums at risk for sensitivity from the gel getting onto them. The reduced whitening also means you will have to purchase a LOT of kits to get the same level of whitening that you will with your dentist.

My advice is to stick with the professional kit you have already paid for but reduce the amount of time that you wear the trays to a time that does not aggravate your TMJ.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

I Hate the Way My Teeth Look

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I have never had much money to do anything. I have done nothing but work and pay my bills… barely. Now I am 52 and my smile is an embarrassment to me. I was recently gifted some money. I’m trying to figure out how to fix my smile. My teeth are very yellow and I have a lot of fillings. They are all those ugly silver fillings because I went to charity clinics. Is there a way to get my smile pretty?

Amanda

Dear Amanda,

Porcelain veneer being held up to a tooth

I am glad you wrote. I do not know how much you are wanting to spend, but you have a range of options. First, if you want a complete smile makeover, you could get porcelain veneers. This is what celebrities use in order to get that Hollywood smile. It can change everything about your smile, including the shape, size, and color. The only downside is it is pricey. It’s worth it if you can afford it, though.

teeth bleaching trays

Teeth Bleaching Trays

If that is out of your budget, do not despair. The only things you mentioned not liking about your smile are the fillings and the staining. There is an affordable way to improve both of these things. First, have teeth whitening done. Your dentist can provide you with custom fitted teeth whitening trays and professional strength gel. These can get your teeth as white as you would like. Simply whiten your teeth until you are pleased with the shade. Once that is done, give it a couple of weeks and then have any fillings replaced that you feel detract from your smile.

Your dentist can switch out your silver fillings with composite fillings. They are white and can be made to whiten your teeth. However, silver fillings are made mostly of mercury, a known toxin. You will want a dentist who knows how to remove them safely. I would look for a mercury-free dentist. They can perform what is known as a sanitary amalgam removal.

You will find whitening and replacing your fillings much lower in cost than veneers.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Re-Touching Teeth Before Crowns

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I need to get a couple of crowns placed on front teeth, and wanted to touch up my teeth beforehand in order to get them as white as they used to be. Would I be better of with Zoom Whitening or tray whitening? If I did tray whitening, how long would I need to whiten? Would it be days or weeks? How many hours a day should I whiten? Do I need to wait for any period of time between the whitening and the dental crowns?

Brianna

Dear Brianna,

Patient under the Zoom Whitening Light

There are few hard and fast rules for what you are asking, though there are general principles. A lot of what you do depends on how white your want your teeth. Zoom whitening is strong but will give you less control on how white they get. If you are wanting a high level of teeth whitening, Zoom would be fine and do the job quickly. If you want more control, then using tray whitening will be a better way to go.

As for how many days, that will depend on how long each day you can tolerate wearing the trays. The longer you wear the trays, the more whitening you get out of it. If you can wear them overnight, that is ideal and you’ll whiten faster. If you have sensitive teeth and can only wear them for under an hour a day, then you will have to keep whitening for more days.

The one rule that is a bit more fixed is the time between when you stop whitening and when you get your dental crown. Your teeth will continue whitening for between one to two weeks. I would wait two weeks if you want to be absolutely certain that the bleach is done. Then, you can match your dental crown with more confidence.

I am a bit concerned that your dentist was not able to give you this information. Placing crowns on front teeth is more challenging than back teeth because they are so exposed to the light. If your dentist couldn’t advise you on teeth whitening, then he will not have the cosmetic knowledge and skill needed to match your front teeth. You may be better served finding an expert cosmetic dentist to provide those. If you decide against that, just make sure your dentist tries them in with a temporary try-in paste first and you get to look at them and approve them before they are permanently bonded on. If you don’t feel they match, he or she should send them back to the lab to make the needed changes.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Fixing Tetracycline Stains Without Porcelain Veneers or Crowns

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I have had tetracycline stains for many years. I am tired of being embarrassed by my smile. Unfortunately, my dentist said that the only solutions he knows that works with tetracycline stains are Lumineers and porcelain crowns. I cannot afford to have either of those procedures done on all of my teeth. Is there anything else I can do that will improve the look of my smile?

Alice

Dear Alice,

teeth bleaching trays

Teeth Bleaching Trays

I am glad you wrote. While porcelain veneers are the ideal solution for tetracycline stains which produces the most beautiful result, there is a solution that will not cost you nearly as much as the procedures your dentist proposed. If you are persistent, you can make a big difference on the appearance of your teeth using teeth whitening. It will take some time, but it will work.

Don’t use Zoom Whitening or Laser Whitening, because it will require too many treatments. That won’t save you money at all. Instead, get the regular tray method of bleaching your teeth. The longer you can wear them each day, the faster you will get results. The ideal situation will be to wear them while you sleep, if you can tolerate that. Even then, it will likely require several months of bleaching. But, you will see a noticeable improvement.

A Word of Caution

Your dentist specifically recommended Lumineers. These are a brand of porcelain veneers that are highly marketed to inexperienced cosmetic dentists. Many skilled cosmetic dentists avoid this brand because they require the dentist to use their lab. The lab owned by the Lumineers’ company is not known for its beautiful results. This, combined with the fact that he also suggested porcelain crowns, makes me think that he is not a skilled cosmetic dentist. Often, when dentists are not confident in doing porcelain veneers they will suggest porcelain crowns instead thinking it will be easier because they are thicker. It is not.

My suggestion is to start with the teeth whitening. You can save up for the porcelain veneers. However, when you do get them, make certain that you use an expert cosmetic dentist. Doing smile makeovers is not adequately taught in dental school. It is an advanced cosmetic procedure which requires post-doctoral training.

Doing them for tetracycline stains are even more challenging because they require the dentist to make the veneers opaque enough to cover the dark stains, but still look translucent and natural. It will be worth the wait to save up and get it done by someone who truly can give you a beautiful result.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Can I Match My Natural Teeth to My Porcelain Veneers

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Can you help me even up my smile? I had four porcelain veneers done. They’re much nicer than my natural teeth. The only problem that I am having is that my regular teeth show when I smile. Next to the porcelain veneers, they look even worse. And, if I’m honest, it kind of gives it away that I’ve got something fake going on with those four teeth. Is there a way to bleach my natural teeth to match my porcelain veneers?  How will I know when to stop? Will the bleaching damage the porcelain veneers?

Millie

Dear Millie,

teeth bleaching trays

Teeth Bleaching Trays

I am puzzled why your dentist did not address this and keep you from all of this trouble. Standard operating procedure, when it comes to porcelain veneers, is to have the patient whiten their teeth first, before getting porcelain veneers. This is because most smiles are eight to ten teeth wide. You want to ensure that all the teeth which are visible when you smile blend in with the veneers.

It is much simpler to match your porcelain veneers to the white color you ended up with than it is to whiten after your porcelain veneers are done. This is because teeth continue whitening for at least a week after you stop using the bleach. Because of that you will not get an exact match.

While the teeth whitening will not have any whitening effect on your porcelain veneers, you can have your dentist build you a custom tray that will go around your veneers and only touch your natural tooth structure.

I’m glad you are pleased with the veneers that were crafted for you. Given, your dentist’s rookie mistake with the teeth whitening, you are fortunate to have not ended up with one of the cosmetic dentistry horror stories we sometimes hear about when a patient’s smile ends up worse than it was before they paid for their smile makeover.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Does Teeth Whitening Hurt?

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I have two friends who have gone through the tooth whitening procedure. Though their procedures were different, both of them had pain during the treatment. My first friend did Zoom and she said it hurt the whole time. She does have sensitive teeth, so I thought hers was more of a fluke. My second friend used home whitening and this is the one that has me the most worried. She said it was fine at first, but then she started having some pain near a spot that she had some dental bonding done. It was bad enough that she stopped the whitening process. I have some dental bonding myself. So, my question is how common is this? Is some amount of pain just something that has to be accepted and dealt with in order to get your teeth white?

Rebecca

Dear Rebecca,

teeth bleaching trays

Teeth Bleaching Trays

I’m glad you wrote. Most patients, though obviously not all, have no problems with teeth whitening whatsoever. Zoom whitening is pretty strong and those with sensitive teeth do sometimes experience pain. If you have sensitive teeth, there are a desensitizing agents that can help. You would also want to take some Tylenol or something similar ahead of time. At-home teeth whitening trays should have even less of a risk of sensitivity. One of the beauties of it is that you only wear the trays for the longest period of time that you are comfortable.

You will get the fastest amount of teeth whitening if you wear them all night. But, if that is too challenging for you, then you can wear them during the day for however long you are comfortable. I would try not to go less than 15 minutes, or you won’t really find it effective.

As for your friend with the dental bonding, it sounds like she had a piece of the repair that was not adequately covered. If she wants to continue her bleaching, she can see her dentist and have him cover that spot. This is just one of the reasons that you should always be under the care of a dentist when doing a teeth whitening procedure.

Because you have a dental bonding repair, it would not hurt to have your dentist look it over just to make sure everything is in good shape. This shouldn’t be a problem because you only want to do teeth whitening after having a cleaning and check up done anyway. If you don’t have a cleaning done, the results are likely to be splotchy.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

Tooth Mousse for White Spots

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I have some white spots on my teeth. My dentist suggested tooth mousse. I’ve been using it for about two months and now he is suggesting that I start teeth whitening. Will this finally take care of the white spots? I want to be proud of my smile.

Callie

Dear Callie,

Teeth Whitening Trays

 

I can tell that your dentist is trying to help, but in this case I think he is a bit in over his head. It sounds like he is a caring family dentist but just may not have invested much training in cosmetic dentistry.

Sometimes white spots are because of demineralization of teeth, which is a precursor to decay. In that case, tooth mousse is useful because it is meant to help remineralize teeth. However, it does not make any esthetic claims. So, the tooth mousse was a good idea from a tooth health standpoint, but is not likely to alleviate the spots themselves.

The teeth whitening, however, is going to make the white spots appear worse. When teeth are bleached, they are whitened uniformly. That means while the rest of your teeth get whiter, so will the white spots. This will actually end up making them more noticeable.

There are two successful ways to get rid of white spots. However, both of them require someone with expertise in cosmetic dentistry. I don’t think your current dentist will be able to do it. That doesn’t mean you have to switch dentists, just stay with your dentist for your general dental work and then for the more specialized cosmetic work go to a dentist with more training in cosmetic dentistry.

The first way is with a procedure called microabrasion. A dentist will rub an acid-pumice slurry onto the surface of the teeth. The white spots often disappear when that is used.

A second option is to have dental bonding done. With this procedure, your dentist can cover the white spots with a composite resin. This has to be done freehand so make sure they show you before and after pictures of cases they have done so that you have some evidence they can make it look beautiful and natural.

This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.

White Spots on Teeth

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Since my adult teeth came in, the bottom half of my two front teeth have been very white. I’ve kind of liked how they made me look in pictures, but when I am in person my teeth do not look like they match. Is there a way to get them all the same color that doesn’t require Lumineers? That is what my dentist is suggesting, but it is incredibly expensive. I was hoping there was a way to whiten the the rest of my teeth to match those two front teeth. Is that possible?

Erin

Dear Erin,

teeth bleaching trays

Teeth Bleaching Trays

Yes, it is possible to whiten the remainder of your teeth and leave these two alone. It will take an expert cosmetic dentist to supervise this, though. He or she will need to cut the area where your front teeth are away from the whitening trays. Your dentist’s suggestion of Lumineers makes me think they may not have the expertise. This is a brand of porcelain veneers that is highly marketed to inexperienced cosmetic dentists.

There are two types of white spots on teeth. The first, is just there from the time the teeth came in. This seems to be what you have and is not an issue. The second is decalcification of your teeth and is actually a precursor to tooth decay. We see this a lot with people who have their braces removed. It is often tricky to get the teeth adequately cleaned with all those metal wires and brackets, so we see this decalcification when people finish their orthodontics.

Those can be fixed with some dental bonding, but again, it would require an expert cosmetic dentist. It is an advanced procedure that has to be done freehand.

Your teeth whitening plan is a good one.
This blog is brought to you by Hoffman Estates Dentist Dr. William Becker.