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Dental Can’t Get Bonding Right

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I have seriously impressive (in the bad way) fluorosis stains. My dentist suggested that we do dental bonding to cover them. We tried that and you could still see the stains. He scheduled another appointment for me and made it thicker. That did cover the stains but they looked a bit thick and opaque. A few days later, the bonding fell off. We scheduled another appointment. He bonded it on again. A few days later, it again fell off. I’m not sure what to do at this point.

Patricia

Dear Patricia,

before and after dental bonding

While dental bonding can look very natural when done correctly, it is a very advanced procedure. Only the top 1% of cosmetic dentists can do it correctly. I don’t think your dentist is in that group. First, you don’t cover fluoride stains by making the bonding thicker. There are methods for doing that without causing the bonding to look fake.

This is not going to be the best dentist for your procedure. You are not going to get good results by having the same dentist repeat the same failed procedure. Instead, you are going to need a skilled cosmetic dentist. Unfortunately, cosmetic dentistry is not a recognized specialty. It is up to the dentist how much (if any) post-doctoral training they receive in cosmetic procedures. Because of that, any general dentist can claim to be a cosmetic dentist.

The American Academy of Cosmetic Dentistry (AACD) recognized the issue that patients, as well as dentists, faced and began an accreditation program to help both. The dentists get the training they need and patients have a way to know who is skilled and who isn’t. Any dentist who reaches AACD accreditation is among the top cosmetic dentists in the country. That would be the type of dentist I would go to in order to get your fluorosis stained covered.

Don’t be surprised if the dentist suggests porcelain veneers instead of dental bonding. They’re more durable, natural looking, and better to work with. In fact, you will spend a lot less time in the dental chair.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Can You Have a Beautiful Smile with Enamel Hypoplasia?

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I have enamel hypoplasia and am horribly embarrassed whenever I smile. In fact, I avoid smiling in public as much as possible. Is there a solution for someone in my position?

Deanna

Dear Deanna,

I am glad you wrote. There are great ways to get a beautiful smile, even if you have enamel hypoplasia. Which treatment you use will depend on the level of hypoplasia you are dealing with.

Mild and Severe Enamel Hypoplasia

For those who may not be aware of what Enamel Hypoplasia is, let me explain. Most of the enamel of your teeth is developed before birth and goes until about the age of twelve. Hypoplasia is a defect where the enamel on the tooth never fully develops. This can happen as a genetic defect or as a result of disease during the tooth formation stage of development.

If you have mild hypoplasia, this may manifest as white spots on your teeth. There are other causes for white spots on teeth, one of which is decalcification, which is a precursor to tooth decay. The solution, whether it be hypoplasia or decalcification would be to have composite dental bonding done.

Severe hypoplasia is characterized by thin, pitted enamel. In many cases, you can see the dentin of the tooth. In these cases, I only recommend porcelain veneers as the solution.

Either Procedure Requires an Expert Cosmetic Dentist

Whichever procedure you choose, it is important that you choose an expert cosmetic dentist. Many patients are not aware that cosmetic dentistry is not a recognized specialty. This means that any general dentist can do it regardless of the amount of training they have. Because it is not taught in dental schools, the additional training is a must.

In your position, because hypoplasia is such a challenging case for a smile makeover, I would only go to an dentist who has achieved accreditation with the American Academy of Cosmetic Dentistry. AACD Accredited Cosmetic Dentists are in the top 1% of their field. They’ll be able to give you a smile that is stunning.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

White Spots on Teeth

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I have had white spots on my front teeth since I was a kid. In images, it looks good, but in person it is embarrassing. Is there a way to get the rest of my teeth to match the white parts? Would using Zoom whitening work?

Callie

Dear Callie,

patient under the Zoom whitening light

While Zoom Whitening is a very powerful whitening procedure, it will not help in your particular case. Instead, it will whiten your teeth evenly, which will still mean you will have some spots on your teeth whiter than others. This is not what your goal is.

There are two types of white spots on teeth. I”m going to talk about the kind yours are NOT first so that people who are dealing with it will not think what I am going to explain to you is the right solution for them.

White Spots After Braces

When white spots appear after braces are removed, they are almost always decalcification spots. It is hard to get the teeth cleaned thoroughly with all those wires and brackets. When you don’t the teeth become decalcified. These are pre-cavities so it is important to treat this.

The proper treatment, in this case, is to have some microabrasion done in order to remove the decalcification and then have dental bonding done to repair the breach. This is not something that your average dentist can do. You would need an expert cosmetic dentist. We’ll talk more about how to find those in a moment.

Now, back to what you are dealing with, Callie. Your white spots are not from decalcification because you’ve had them your entire life. The best way for you to get uniform color on your teeth for this is with porcelain veneers. Again, like the dental bonding, this will require an expert cosmetic dentist.

Finding an Expert Cosmetic Dentist

Doing smile makeovers, along with other cosmetic procedures are not taught in dental school. Unfortunately, there is not a recognized cosmetic dentistry specialty either. This makes it challenging for the patient to know who has invested in the post-doctoral training necessary to do a good job.

The American Academy of Cosmetic Dentistry (AACD) recognized this issue and started an accreditation program to both help train dentists and give patients a guide as to who has done the work. If I were having cosmetic work done, I would use an AACD accredited dentist. Bear in mind this is different than just being a member of the AACD. When you go to their site to find a dentist, make certain you checkmark that you are looking for an accredited dentist.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

A Full-Mouth Reconstruction to Whiten Teeth? No Way

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I have a chipped tooth and my teeth are pretty stained because of my coffee habit. My dentist suggested I get all of my teeth crowned. It’s pretty expensive to do that. Is there a better solution that will make my teeth look just as good?

Audrey

Dear Audrey,

A brunette with a beautiful smile

Getting a gorgeous smile makeover requires a skilled cosmetic dentist

I want to make sure I understand you correctly. The only thing you are concerned about fixing is the color of your teeth and a chip to repair. Is that right? In that case, what your dentist is suggesting is a major overtreatment. Crowning every tooth is known as a full-mouth reconstruction. This is a very advanced procedure and is really only necessary for the most serious TMJ cases or if your teeth have been ground down to nubs from bruxism.

The solution for whitening your teeth, surprisingly enough, is just teeth whitening. Once that is done, then you can have dental bonding done to repair the chipped tooth. These two procedures together would be thousands of dollars cheaper than what your dentist is suggesting.

Now, let’s say your teeth are ground down and that is why he is suggesting something so drastic. That would be appropriate. However, you need to ensure this dentist has the type of training that will lead to a healthy and attractive result. If it isn’t done correctly, it could cause significant bite problems leading to painful TMJ issues.

You will need a dentist who has done significant post-doctoral training in these type of procedures. For instance, Dr. Rothwell has done post-doctoral training at the Seattle Institute for Advanced Dental Education, as well as the famed L.D. Pankey Institute. Some additional reputable schools for this type of training would be the Las Vegas Institute for Advanced Dental Studies and the Dawson Academy.

You don’t want to have to choose between the correct function and beautiful form. It is possible to get both. So, in addition to the training mentioned above, look for an AACD accredited dentist. These are the top cosmetic dentists in the country and can provide you with a stunning smile.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Tetracycline Stains and No Money

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I’ve had tetracycline stains since my adult teeth came in. I don’t have money for porcelain veneers and wondered if getting dental bonding done would be more affordable. I know it won’t last as long, but maybe by then I’ll have the money for veneers.

Cassie

Dear Cassie,

teeth whiteninging trays

I am glad you wrote. In this case, though dental bonding is generally less expensive, it will end up more expensive. Bonding has to be done by hand. In order to do it correctly, they’d have to spend much longer in the chair with you which will cost more. While porcelain veneers are the better treatment, they have to be done by an expert cosmetic dentist. Another price increase. However, there is an alternative treatment that will help significantly, if you are persistent enough.

You can use at-home teeth whitening trays provided to you by your dentist, which are custom fit to your bite. You’ll have to wear them every day for months, but eventually, your teeth will get white enough for you to feel comfortable with your smile.

Under normal circumstances, in order to whiten thoroughly, I’d suggest Zoom Whitening, which works in one appointment. However, these treatments are much more expensive than the trays I’m recommending. With tetracycline stains, you’d have to do this many times over. It would end up costing you more money than is worth it.

When You Can Get Porcelain Veneers

If circumstances change and you end up where you can get porcelain veneers, you will have to be quite careful who you allow to do them. Because of the depth of the stains, the veneers need to be made opaque enough to cover the dark stains, yet still be translucent enough to look natural.

Accomplishing this takes advanced training. You’ll need someone with proven technique and artistry. I’d recommend an AACD accredited dentist. These are the top 1% of cosmetic dentists in the country.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Fast Fix for My Teeth

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I’m so sick of not liking my smile. They’re stained from years of coffee drinking and my teeth are chipped from some grinding. Now that I finally have some money, I want to do something about it. My dentist is suggesting Lumineers. I’ve been looking online and they have mixed reviews. How do I know if that is the right treatment or if I should do something else? It’s important to me it gets done rather quickly.

Caroline

Dear Caroline,

Woman Covering her mouth

You don’t have to spend your life hiding your smile.

I am quite glad you wrote. My hope is to save you some grief. First, let’s talk about what you’re wanting to fix. If you only have one or two chips and stained teeth, you can save a lot of money just dealing with those issues. For instance, your teeth can be whitened in one dental appointment with an in-office procedure such as Zoom Whitening. Then, when the whitening is completed, you could have dental bonding done to repair the chipped teeth. That will be significantly less expensive than a procedure like Lumineers, which is just one brand of porcelain veneers.

When are Porcelain Veneers the Right Treatment

Porcelain Veneers are the go-to procedure if you are looking for a total smile makeover. They can change the shape, size, and color of your teeth. One word of warning. I’m not sure your dentist is the one to do it if that is the way you decide to go. The Lumineers brand is often marketed to inexperienced cosmetic dentists as being easy to place.

Unfortunately, while it may be “easy-ish” to bond them on, that has nothing to do with the artistry involved in how to create beautiful smiles. Unfortunately, doing smile makeovers isn’t taught in dental school. This means your dentist has to invest in post-doctoral training. It takes a significant amount of additional schooling and practice to develop the skills and artistry needed to do this well. Unfortunately, there isn’t a recognized specialty in cosmetic dentistry for patients to know which dentists invested in that training and which didn’t. Any general dentist can call themselves a cosmetic dentist.

If you decide you want to get a total smile makeover, there is a good resource for you. The American Academy of Cosmetic Dentistry recognized the pickle patients found themselves in. Because of that, they began an accreditation program where dentists can prove they have what it takes to create beautiful smiles. After they’ve passed stringent exams, they then have to provide visual evidence for a large number of cases they’ve personally done to show they can put into practice what they have in their head. If you want a smile makeover, the safest way to get a stunning smile is with an AACD accredited dentist.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Zoom Whitening and White Spots

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I’ve had some white spots on my front teeth ever since getting my braces off. It’s been a while. My dentist insists my teeth are healthy and everything is fine. But, the way they look makes me really self-conscious. I’m just starting my career out. I want to feel confident when I smile. I wondered if something like Zoom Whitening would work? My dentist doesn’t do it but I could find one who did and just use them for this one procedure. What do you think?

Tina

Dear Tina,

South Carolina Zoom whitening step 3 While Zoom Whitening is a fantastic way to get your teeth beautifully white in just one appointment, it will not work for your white spots.

Professional teeth whitening, whether using at-home whitening trays or Zoom Whitening will whiten your teeth evenly. So, if you have white spots, it won’t make your teeth match.

I’m sorry your dentist dismissed your concerns. There are generally two types of dentists. The first are dentists with an engineering mindset. They like to fix things, but aren’t that interested in the aesthetics of your smile. The second are dentists interested in the cosmetic side of things. They like creating beauty.

Your dentist is obviously from the first group. There isn’t anything structurally wrong with your teeth so she sees no need to mess with them. It’s the “if it ain’t broke, don’t fix it” mindset.

Dentists interested in cosmetic dentistry understand the desire to have an attractive smile and the confidence that comes with that. This is the kind of dentist you need to fix your white spots.

Two Ways to Fix Your White Spots

Option One: Dental Bonding

A good cosmetic dentist can use dental bonding to remove the white spots and make your teeth look uniform in color. This uses a composite resin. It should last for several years but will need to be replaced more often than the second option, but it is also less expensive.

Option Two: Porcelain Veneers

These use small wafers of porcelain that are bonded to your teeth. In the hands of a skilled cosmetic dentist, they will give you a stunning smile. You can get them on just the teeth with the white spots, or you can use porcelain veneers to have a complete smile makeover done.

This important thing, no matter which procedure you choose is that you make sure you use a highly-skilled cosmetic dentist. The easiest way to do this would be to find an AACD accredited dentist.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Zoom Whitening for White Spots??

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I want to get a quick second opinion. My daughter recently got her braces off and there are white spots on her teeth. Our dentist is suggesting teeth whitening. I want to get this done quickly so she isn’t self-conscious. Would Zoom Whitening be the best way? I heard this can be done in one day.

Laurie

Dear Laurie,

close up of the smile of a girl wearing braces

I’m glad you wrote. Your dentist has given you very bad advice. The white spots on your daughter’s teeth aren’t a teeth whitening issue. These spots mean there is decalcification on your daughter’s teeth. While fairly common on people after braces, it does need to be treated. Decalcification weakens the tooth and puts it at serious risk for decay.

Unfortunately, teeth whitening is the wrong solution. I’m not sure why your dentist recommended it. Teeth whitening works evenly on the tooth. The entire tooth will whiten but the spots will still be there and different from the remainder of the tooth. Even worse, you still haven’t dealt with the decalcification.

There are a couple of ways to deal with this. The first is by trying Tooth Mousse. This is a product designed for the recalcification of teeth. It is an inexpensive way to try to heal the teeth. However, it’s not likely to be fast.

The fastest way to treat this would be to cover the spots with dental bonding. However, you should be aware this needs to be done by an expert cosmetic dentist. I wouldn’t use your dentist. He currently doesn’t even have a rudimentary understanding of even the easiest cosmetic procedure— teeth whitening. Dental bonding has to be done freehand, so it will require an artist. I’d suggest an AACD accredited dentist if you can find one in your area.

What Zoom Whitening Will Do

I don’t want to ignore your question on Zoom Whitening, though. Zoom whitening does work in one appointment. Like traditional teeth whitening, though, it will whiten your daughter’s teeth evenly. If your daughter is currently unhappy with her natural tooth color, it will benefit her by making her teeth whiter.

However, it won’t get rid of the spots. That will still require dental bonding. My suggestion, in that case, is to use Zoom to get her teeth the color she wants, then have the dental bonding done. The color of bonding is permanent so doing the whitening first will enable her to get her bonding done the correct color up front.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Dental Bonding Yellowed After Three Days

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I think I did something to mess up my dental bonding. I’m heart broken about it. I really loved them. I brushed with baking soda. Did I ruin them? They’re turning yellow and I’ve only had them three days. Can they be fixed?

Amanda

Dear Amanda,

Woman Covering her mouth
A great cosmetic dentist can give you a smile you’re proud to share

Baking soda is quite abrassive and would have etched your dental implants allowing them to pick up stains. That’s where the yellowing is coming from. Your bonding is unprotected.

Don’t beat yourself up about this. The problem is your dentist didn’t actually prepare you for how to care for your newly bonded teeth. That’s on them. Because of how short a time span you’ve had them, your dentist shouldn’t object to redoing them for you.

My hope is that they didn’t use lower quality materials which makes it easier for them to wear down. After they’re redone, make sure you use Supersmile toothpaste to clean them. This is specifically designed to clean and protect cosmetic dental work.

If you use the right toothpaste and they still turn yellow, then you can know they’re using inferior materials. You’ll need to go to an expert cosmetic dentist in order to get your dental bonding done properly.

My suggestion, if that happens, is you see one of the recommended dentists on the mynewsmile.com website. They screen cosmetic dentists to make sure they have both technical skill and artistry to give you a gorgeous smile.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

Lumineers for a Gapped and Chipped Tooth?

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I just want to double check a treatment before I invest in. My dentist had recently developed an interest in cosmetic dentistry and just became certified to place Lumineers. He happened to ask if I’d like to fix the gap between my teeth as well as the chip on a tooth. In fact, I would like that repaired. He suggested I get four Lumineers. I wondered why four when it’s really just two teeth that need the treatment. He said so they’d match better. It’s going to be a tad pricey so I just wanted to double check. Is this the way for me to go?

Penny

Dear Penny,

A beautiful smile with a tooth gap

There are cosmetic solutions for a tooth gap

It’s great that your dentist is trying to improve his skills and broaden the services available to his patients. All cosmetic dentists have to start somewhere. All that being said, this isn’t the best treatment option for you. Here’s why.

Porcelain Veneers are for Complete Smile Makeovers

First, I should explain that Lumineers are simply a brand of porcelain veneers. If you wanted a complete smile makeover, then getting porcelain veneers would be a good option. As it is, you simply want to fix a gap and a chip. In that case, veneers are quite an overtreatment. I don’t necessarily think your dentist is trying to cheat you. He likely offered the only cosmetic treatment he knows.

The usual treatment for the things you want to fix is dental bonding. It uses a composite resin that a cosmetic dentist will hand sculpt onto the teeth to close the gap and to repair the chip. It takes a skilled cosmetic dentist because it has to be done freehand. I’m sure your dentist didn’t offer that because he doesn’t know how to do it yet.

Don’t Get Lumineers

If you were to decide to get a full smile makeover, I’m going to suggest you don’t get Lumineers. Let’s start with the “certification”. This is simply a seminar the dentist sits through. There’s not any significant training. It’s most often marketed to inexperienced cosmetic dentists as being easy to place.

However, the worst part about them is their lab. This brand is owned by the DenMat company and they require dentists to use their lab. Sadly, this lab is known for not being very good. Combine inexperienced dentist with bad lab and you’re likely to end up with a disappointing smile.

There is a very basic mistake your dentist is already suggesting. He’s saying you need four for them to match. First, an expert cosmetic can match a single porcelain veneer to the rest of your teeth. Second, most smiles are much wider than four teeth. If you’re wanting a smile makeover, you’d want a minimum of six to eight veneers (depending on the width of your smile).

However, if you’re happy with your smile, a single veneer is possible with a perfect match.

Who Should Do Your Porcelain Veneers

While every dentist has to start somewhere when it comes to cosmetic work, it is to your benefit to let him practice on someone else. You want someone with expertise and an artistic eye. Finding that dentist used to take a lot of research on the part of the patient. Fortunately, the American Academy of Cosmetic Dentistry started an accreditation program.

This program is designed to help patients know who are the best cosmetic dentists and who are still developing their craft. If you go the aacd.com, you can do a search for a cosmetic dentist in your area. Just make sure you check that you want one who’s been accredited.

This blog is brought to you by Hilton Head Cosmetic Dentist Dr. Bonnie Rothwell.

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