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Hope Restorative & Cosmetic Dentistry

How Can I Whiten My Teeth After My Braces Are Off?

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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, but now they look spotty and yellow. Which whitening strips or toothpaste should I use? – Thanks. Aamir from MD

Aamir,

Thank you for your questions. Wearing braces can cause various kinds of teeth stains. Until a dentist identifies the source of the stains and recommends treatment, you should not 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 because it minimizes the risks of choosing the wrong treatment. Most dentists offer in-office and take-home whitening. The advantages of professional whitening include:

  • 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 may 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 professional 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
Before-and-after teeth whitening photos

Professional teeth whitening will give you brilliant results
Photos courtesy of KöR Whitening

Schedule an appointment with an advanced cosmetic dentist to examine your teeth and explain your options.

Dr. Jerome Cha, a Tulsa, Oklahoma, cosmetic dentist, sponsors this post.

 

My dental bonding is peeling off

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Man hiding his mouth in his sweater portraying dental bonding that is peeling offIn November, my dentist whitened my teeth and later placed bonding on them to hide fluorosis stains. After three tries, the color still isn’t right, so I let it go. I figured that I would keep the bonding because my dentist said it would last five years. After that, I planned to find another dentist to replace it. But within the past week, the bonding started peeling off like old paint. This is so embarrassing.

I called my dentist, and he said that bonding on fluorosis sometimes doesn’t stick to your teeth. He never mentioned that the bonding might peel before he placed it. Now I am concerned that I have to live with these stains. If my dentist cannot get this right, what are my options? Thank you. Karson from Santa Barbara, CA

 

Karson,

We are sorry to hear about your experience with dental bonding from your dentist. Fortunately, you have options for concealing fluorosis stains, but you cannot rely on your dentist for them.

Types of Fluorosis Stains

Fluorosis stains occur from consuming too much fluoride as a child while your teeth are still developing. Tooth stains are white in mild to moderate cases and brown in severe cases. The stains are usually confined to the tooth enamel.

Concealing Fluorosis Stains

Concealing fluorosis stains in teeth is one of the most challenging aspects of cosmetic dentistry. Depending on the stains and condition of your teeth, an advanced cosmetic dentist may recommend dental bonding or porcelain veneers.

Dental bonding

  • Applying dental bonding to tooth enamel requires these steps:
  • Etch the tooth enamel
  • Rinse and dry the enamel
  • Apply a liquid bonding agent to the tooth and use a curing light to cure it
  • Place composite over the cured bonding

At least your dentist bleached your teeth before applying the bonding, even though the color did not stay on. Bleaching teeth first is essential to matching bonding to your natural teeth. Whitening is an effective way to refresh your smile.

Porcelain veneers

After removing a conservative amount of tooth enamel, a cosmetic dentist will complete these steps:

  • Take impressions of your teeth
  • Provide a wax-up of your veneers
  • Make temporary veneers for you to wear
  • After you approve the temporary veneers, send pictures and instructions to a dental ceramist to make the final product
  • Try the veneers on your teeth to ensure you are delighted with them

Schedule a Cosmetic Dentistry Consultation

If your dentist is unable to apply your bonding and make it last, we recommend scheduling a consultation with an advanced cosmetic dentist to discuss your options.

 

Dr. Jerome Cha, a Tulsa, Oklahoma dentist, sponsors this post

Will a root canal lighten my gray tooth?

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Man with glasses smiling for info on whitening a gray tooth - from Tulsa, OK dentist Dr. Jerome ChaAbout five years ago, I fell while running a marathon and hit my face. My left front tooth is turning dark, and my dentist referred me to an endodontist for a root canal. The tooth does not hurt. I’m wondering why my dentist did the referral instead of bleaching my teeth. Will my tooth get lighter after a root canal? Thank you. Milton from Ohio

Milton,

Thank you for contacting our office.

When a Tooth Turns Gray

If a tooth turns gray, the nerve inside is likely dead. Unless the tooth is dead or infected, you do not need root canal treatment.

Will Root Canal Treatment Lighten a Tooth?

Root canal treatment will not lighten a tooth. Unless a dentist cleans out root canal filling material and cement from the portion of a tooth above the gumline, the tooth will darken. Some endodontists use the GentleWave system for root canals. The system uses sodium hypochlorite to dissolve soft tissue inside a tooth. Although sodium hypochlorite can whiten a tooth somewhat, it does not stay inside the tooth long enough to bleach it.

Your dentist can internally bleach your tooth after verifying that root canal treatment was successful. Sealing bleaching gel inside the tooth can correct the color. If bleaching is successful, a cosmetic dentist can insert a flexible fiberglass post in the tooth and fill it with dental composite. Otherwise, a dentist can restore the shade with a porcelain veneer, which requires removing less tooth structure than a dental crown.

We recommend scheduling an appointment with an advanced cosmetic dentist to examine your gray tooth and discuss your options for whitening it.

Dr. Jerome Cha, a Tulsa, OK accredited cosmetic dentist, sponsors this post.

I Hate My Porcelain Veneers

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I had a full set of porcelain veneers done (six in total). The whole thing feels like a disaster. I wish I’d have got my teeth whitened ahead of time because you can still see teeth that don’t have veneers on them when I smile and they are much more yellow than my new veneers. Even if I had though, this smile looks ridiculous. There are gaps on top between the veneers and the gum as well as between some of the teeth. They also aren’t as white as I asked for. When he first did the wax model, I mentioned all these issues and he told me it was because it was the wax. Once the real ones were made, none of that would be an issue. Then, when he did the try-in of the real ones, everything seemed exactly like the wax ones. I mentioned that and he said we should bond them on and we’d see what I thought then. I agreed, but I’m not sure why. He did appear frustrated with me so I felt a bit like I was being a “problem patient”. I didn’t like them after they were bonded on. He told me to give it some time and see if I’m just not used to the new look. I did, and still didn’t like them. Now he is saying I agreed to bond them on. Is there anything I can do?

Miriam

Dear Miriam,

Porcelain veneer being placed on a tooth

Thank you for writing. You have been through quite a bit with this dentist. You are facing one of the big problems with cosmetic dentistry these days. It isn’t a recognized specialty. That means any general dentist can do cosmetic dentistry. There are cosmetic dentists who have invested their time and money in training to do smile makeover, which is not taught in dental school. Then, there are general dentists who just call themselves cosmetic dentists.

It sounds like your dentist was going through some motions he’s heard about without understanding what they were for. Both the wax mock-up and the try-in are for YOU to decide what you think of them. If you don’t like them in either step, they should go back to the lab to be re-done until they are done to your satisfaction.

Under normal circumstances, because you had given approval for him to bond them on, you would have no recourse. You aren’t able to get a refund simply because you don’t like how they look. However, there is something you mentioned that could work in your favor. You said there are gaps between the top of your porcelain veneers and your gumline. This isn’t an issue of them being unattractive. It is a functional issue. Those gaps will trap food and other bacteria. This will cause you both gum disease and decay. So…yay you! Now you can get a refund.

My suggestion is that you have a dentist with real expertise look at your case. If they agree about that gap, they can help you secure your refund. Just make sure you don’t tell them who did your porcelain veneers until after they give their opinion. The dental world is a small one. It is better for you if they do not feel conflicted because it would mean saying something negative about a friend.

The best cosmetic dentists are AACD accredited. This is different from membership. It means they have proven their cosmetic skill and are capable of creating beautiful smiles. This is who you should get to give your second opinion and to re-do your porcelain veneers.

As to the teeth whitening, go ahead and get that done. It won’t hurt your porcelain veneers and it will even up your smile somewhat.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Save Yourself from a Cosmetic Dentistry Disaster

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I had four porcelain fused to metal crowns done on my front teeth years ago. I wanted to update my smile. I went to see one cosmetic dentist who was voted as one of the best cosmetic dentists in our area, but he was out of my budget. Plus, he wanted to do four crowns and four porcelain veneers covering eight teeth and I really only need the four crowns done. I went to my family dentist who assured me I’d get a smile I’d love. This hasn’t turned out to be the case. The crowns he made are too short and you can’t even see my teeth, which makes me look ancient. I also think the color looks greenish, which he said, “Is the color I picked.” I’ve been back several times trying to get this right. The last time they actually said to me, “You’re expecting perfect teeth, which is unrealistic.” Well… duh. That is why someone does cosmetic dentistry. I don’t know what to do at this point.

Pam

Dear Pam,

Woman giving a thumbs up in a dental chair

You are running up against a philosophy taught in dental school but corrected in post-doctoral institutions that teach cosmetic dentistry. In dental school, we’re taught the dentist always knows best and you don’t want cosmetic work to look perfect. Those dentists who invest in serious cosmetic dental studies know it is about how the patient wants their smile to look.

Another problem you are running up against is that doing smile makeovers isn’t taught in dental school. A dentist has to invest in that post-doctoral training in order to know how to do it well. My guess is your family dentist hasn’t done that. I also don’t think you’re going to get anywhere with him on making this the way you want it. That isn’t just because of the attitude. It’s also an issue of his ability.

You can ask him for a refund. He did assure you that you’d get a smile you love and he hasn’t been able to provide that. What you’ll need to do from there is find a true cosmetic dentist. It isn’t a recognized specialty so it is hard for patients to know who has invested in the training and who hasn’t. The best cosmetic dentists are accredited by the American Academy of Cosmetic Dentistry. That is different than just being a member. To get AACD accredited, the dentists have to not only pass stringent exams, but demonstrate their artistry with visual evidence of a large number of cases they’ve done.

As to the other dentist who is suggesting you also get four porcelain veneers, he is probably doing that so your smile will match. Most smiles are much wider than just four teeth. One other way to accomplish that is to whiten your teeth, which is recommended anyway so your bottom arch will blend well. See if he’ll let you do that instead of getting veneers and crowns.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Cracked Porcelain Veneer

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I received a substantial amount of money (at least to me) in an inheritance. I decided to spend it to finally get a smile I am not ashamed of. I decided to do it right and found the best cosmetic dentist I could, even though they were more expensive. I LOVE the porcelain veneers. Not only are they gorgeous, but they lengthened my teeth, which are normally pretty short. Now you can see much more of my teeth when I smile, which I’ve been doing all the time since getting this smile makeover seven months ago. My only problem is one of the veneers has developed a horizontal crack. I want to fix it but can’t keep going back to this dentist. I’ve not even picked up the phone when they call to schedule my cleaning and checkup because I can’t afford them. Do you think they will try to blame me for the crack? I’ve been so careful with these veneers because I’ve been so proud of them. I’m really worried this will fall off, otherwise I’d just ignore the crack.

Stephanie

Dear Stephanie,

porcelain veneer being placed on a tooth

I don’t think you have to be worried about them blaming you for the crack. When someone abuses their teeth, it usually results in chips, not cracks. In most cases, a cracked porcelain veneer will stay on just fine because of the bonding. However, you expressed they lengthened your teeth I am worried there isn’t much bonding there. Of course, that depends on the location of the crack, which I don’t know.

I would call them and tell them what’s going on. Don’t worry about the fact that you can’t afford them regularly. Most top cosmetic dentists are used to patients coming to them just for their cosmetic work. Some even have patients fly in from other countries to have their work done. If you tell them your financial situation they won’t continue to pester you for your regular cleanings.

The repair for this is to replace the porcelain veneer. I’m sure they didn’t give you any guarantees about how long they would last. That being said, seven months is definitely not long. I think they will repair it for you free of charge.

Tips For Follow Up Care with Porcelain Veneers

When you have to stay with your family dentist for cleanings instead of the cosmetic dentist there are some things you may need to make them aware of, especially if they’re not used to dealing with veneers. First, make sure the hygienist doesn’t use either a Power Prophy Jet or acidulated fluoride during your appointments. Both of these tools, while fine on natural tooth structure, will damage the glazing on your porcelain veneers. This will cause you veneers to pick up stains, essentially ruining them.

Second, while by no means required, I always suggest using Supersmile toothpaste when you have porcelain dental work. This safely removes stains using a special formula that collects and rinses the stains while keeping the glazing perfectly intact.

Some patients use traditional whitening toothpaste without realizing these use abrasives. While it will scrape and scratch off stains, it will also scratch the surface of your veneers causing them to pick up stains. So you are aware, teeth whitening will not fix stained veneers. It only works on natural tooth structure. Maintenance is the key to their longevity.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Crowns for Teeth Whitening? NO!

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I have two porcelain veneers on my front teeth. One of them chipped and needs replacing. My dentist says it is because I grind my teeth. The adjacent teeth are yellowing so my dentist wants to do dental crowns on eight of the upper teeth, which would pretty much be all of them when I smile. One of the things I’m wondering about is if I chipped my porcelain veneer would I also damage my dental crowns?

Marie

Dear Marie,

Woman covering her mouth with her hand

I’m appalled by what I’m hearing and am truly hoping there something else to this story. Putting dental crowns on all your upper teeth is a massive overtreatment unless there is something else going on. Based on what you’ve said he’s doing it because one of your porcelain veneers needs replacing and your natural teeth need to be whitened. That’s insane! When you need to whiten teeth, you do just that. You have teeth whitening done. I can see where it would benefit him to suggest otherwise. Teeth whitening will bring him in a few hundred dollars. What he’s suggesting, which is a full-mouth reconstruction, will bring in a minimum of $30,000. I hope that is not his motive.

Another concern I have is replacing your porcelain veneers with dental crowns. Whenever a dentist suggests that, it brings up massive warning bells. This tells me your dentist doesn’t know how to do porcelain veneers. Therefore, he’s telling you to do dental crowns. No dentist in his right mind would remove healthy tooth structure if he didn’t need to. Your dentist would rather do that than admit his lack of skill and send you to another cosmetic dentist with more expertise.

Now, there is a third thing that concerns me and gets to the heart of your question — your teeth grinding. I cannot believe your dentist would know you grind your teeth and not provide a way for you to protect them. A simple nightguard would have kept your porcelain veneer from chipping. As to whether you will damage your dental crowns, yes, if you don’t have the nightguard.

Bottom Line—You Need a Different Dentist

I don’t think you are being well served by your dentist. Here’s what I want you to do. Spend this time during the COVID-19 to research some dentists in your area. Ideally, you’ll want one who is AACD accredited. If you can’t find one, look on mynewsmile.com and go over the websites of their recommended dentists in your area. Check their reviews and pick one.

Once the quarantine is over, do the following. Get your teeth whitened. If you choose Zoom Whitening, give two weeks for the color to settle, then have that single chipped porcelain veneer replaced and have a nightguard made.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Figuring Out My Smile Makeover

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I want to get a smile makeover with porcelain veneers. My dentist said he wants me to get my teeth whitened first. I thought the porcelain veneers would change the color of my teeth. Why both procedures? I’m worried this dentist is doubling up procedures.

Cathy

Dear Cathy,

a porcelain veneer wafer being placed on a tooth

Believe it or not, your dentist is trying to save you money. Yes, porcelain veneers will change the color of your teeth, but unless you are willing to place porcelain veneers on every single tooth, teeth whitening is a better option for you. Of course, if you prefer to put a veneer on every tooth, I’m sure your dentist wouldn’t mind that.

The idea is to whiten your teeth to the color you’d want your porcelain veneers. It’s it is easier to match the porcelain veneers to the whitened tooth than it is to match whitened teeth to the color of veneers.

Additionally, unless there is something structurally wrong with your bottom arch of teeth, then teeth whitening is all you’d really want there. What shows when you are smiling is your upper teeth. Your bottom teeth are briefly visible while you talk, but as long as they match the color of your upper teeth, they look fine.

The Most Important Consideration with Porcelain Veneers

When you are considering getting a smile makeover, the most important factor is who does the smile makeover. You can have two dentists use the exact same materials and the smiles will turn out very differently. This is because cosmetic dentistry is actually an art form. One artist is bound to be better than another. So how are you to find the dentist with the right artistry who can give you a gorgeous smile?

If I were in your place, I’d look for someone who is proven. See if you can find an AACD accredited dentist in your area. They are among the top 1% of cosmetic dentists in the country. It is worth it even if you have to travel to see them.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Dental Bonding Done Wrong

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I’m a little annoyed. We got my granddaughter’s teeth whitened and then dental bonding done to build up . The lateral incisors don’t match at all. They’re darker than the rest of her teeth. The dentist blew us off and said he matched it to the canines. They don’t match those either so I don’t know what he’s talking about. When I brought that up he said it’s just the lighting. It’s not. Finally, he suggested we try a whitening toothpaste. Really? Is there anything we can do about this?

Brenda

Dear Brenda,

before and after a chipped tooth is repaired with dental bonding

When dental bonding is done right, it blends in perfectly.

It doesn’t sound like your dentist is willing to take responsibility for his work. A true cosmetic dentist would never work this way. They know you paid for a beautiful smile and that is what you should get. He knows whitening toothpaste won’t work and is just saying that to get you off his back.

I’m going to suggest you see an expert cosmetic dentist to get a second opinion on his work. Sometimes having the opinion of a peer saying this was poorly done will help him take responsibility simply because he doesn’t want to look bad to a peer.

How to Find a True Cosmetic Dentist

There isn’t a recognized specialty in cosmetic dentistry. Any general dentist can call themselves a cosmetic dentist, regardless of their skill level or artistic ability. It’s hard for patients to know who is truly qualified. Fortunately, there are two great resources for patients.

The first one is the American Academy of Cosmetic Dentistry. They have an accreditation program. In order for a dentist to get accredited, they have to pass an oral and written exam which shows their technical knowledge. Then, they have to provide visual evidence for a large number of cases that demonstrates their artistic ability. It takes years and a great deal of time and skill to become accredited.

The second is mynewsmile.com. There are some great cosmetic dentists out there who are on their way to becoming accredited. This site screens dentists for their skill and artistry.

A dentist recommended on either one of these sites are the top cosmetic dentists in the country. They’ll do a great job for you, both in helping you get a refund and repairing the work.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

Dentist Stained my Lumineers

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I’m so upset. I spent a fortune on these Lumineers and they are an absolute disaster. First, I told him I wanted a very white smile. He said they could do that. When he bonded them on, though, they weren’t nearly as white as I asked for. When I mentioned that he said in order for them to look natural they have to add a slight stain. If I wanted my natural looking teeth, I wouldn’t have paid a fortune to have whiter ones made. I insisted that he make them whiter. He told me they couldn’t be whitened but he could remove the stain. I agreed to that not knowing he was going to essentially drill the top layer off. Now I’ve got misshapen, dull looking teeth. What do I do?

Caryn

Dear Caryn,

A porcelain veneer being placed on a tooth

The dentist is more important than the brand of porcelain veneers

The first thing you need to know if your dentist isn’t a true cosmetic dentist. Cosmetic dentistry isn’t a recognized specialty. Every cosmetic dentist is just a general dentist who enjoys doing cosmetic work. Unfortunately, skill and training vary. I don’t think your dentist truly sought expert training in cosmetic work.

A few things make me think this. First, he thought a stain was necessary. True cosmetic dentists understand patients want very white smiles. As you said, they’re not looking for natural color. They want clean and white. He didn’t understand that. Second, he thought he knew better than you. In general dental school we are taught dentists know best. However, when we study cosmetics, we know it’s what the patient wants that rules. It’s not repair we’re going for but beauty. That beauty is in the eye of the patient.

Finally, he didn’t understand what he was doing would ruin them. Or worse, he did and didn’t care.

You need a refund. Your dentist has ruined your smile makeover. Not that you were pleased with it anyway. In a small way, his drilling off the top layer is a blessing in disguise. Before he ruined them, it would have been hard to get a refund. The standard for dental work is functional, not beauty.

However, now, without their glazed layer, he’s ruined them and they are not functional. Tell him you want a refund. Your next step is to find a true cosmetic dentist.

Getting Gorgeous Porcelain Veneers

I’ll say one other thing first. If all you wanted was a whiter smile, your dentist would have better served you by offering you teeth whitening. Professional teeth whitening can get your teeth brilliantly white and is much less expensive than Lumineers. He didn’t, which makes me feel he was taking advantage of you.

I could be completely wrong about that. Maybe you wanted some other things changed about your teeth, such as their shape or size in addition to the color. In that case, a smile makeover with porcelain veneers would be the right course of action.

If you want a stunning smile, you should go the website of the American Academy of Cosmetic Dentistry. They have a link to find a cosmetic dentist. Make sure you check you’re looking for an accredited cosmetic dentist. These are the ones with the training and artistry to give you a smile you’ll be proud to share.

This blog is brought to you by Tulsa Cosmetic Dentist Dr. Jerome Cha.

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