Miranda R.- Tallahassee

Miranda,

If I were you I’d switch dentists. It will be a little more of an expense for you because some of the work will have to be re-done, but you’ll be glad you did. Once you said that your dentist is trying to convince you they are better than you think they are, I lost confidence in your current dentist as an expert cosmetic dentist.

In dental school we’re taught that the dentist knows what is best with regards to treatment. However, with cosmetic issues we know the patient knows what is best. We’re creating the smile YOU want. If he’s trying to talk you into something you don’t like, it may be he or she is not confident they can even create the smile you want. Porcelain veneers are too large of an investment for you not to be thrilled with the results.

The American Dental Association requires that dentists cooperate and make the transition smooth if you want to change dentists mid-treatment. Your dentist is ethically bound to provide any x-rays and notes that may be helpful to the dentist you choose.

To locate an expert cosmetic dentist in your area, I’d go to the mynewsmile.com website. Here they evaluate dentists based on their cosmetic training and artistic skill. Anyone recommended on that site would be a safe choice for you to get the smile you desire.

This blog is brought to you by Phoenix cosmetic dentist Dr. Arthur Chal.

Jennie D.- Cabot, AR

Jennie,

How great that you are getting on a healthy path. The last time we treated a recovering bulimic she mentioned how much it helped to feel good about her smile again. Before her smile makeover, she was always was reminded of her past struggles. But, with her new smile she felt like a brand new “normal” person.

With bulimia, most of the damage is to the back of your teeth. Porcelain veneers will only treat the front of your teeth. What you need is to get porcelain crowns, which will treat the front and the back of your teeth.

It will be important that you go to an expert cosmetic dentist who can make your smile look both natural and beautiful. Don’t just go to any dentist who calls himself a cosmetic dentist, because you may end up with a smile you’re disappointed in, which will negatively affect your self esteem during your recovery.

I’d suggest going to the mynewsmile.com website. They recommend expert cosmetic dentists by state. I’m sure you’ll be able to find one close to your town.

If the cost is too much, you could just start with your two front teeth. Those usually have the most damage and they’re the ones that are the most noticeable.

This blog is brought to you by Phoenix cosmetic dentist Dr. Arthur Chal.

Fran D.- Alabama

Fran,

If you have dental insurance, you won’t have to pay the entire fee. How much you pay will depend on where you need the filling. If you need it on a front tooth, then your insurance will probably cover it. They consider white fillings on a visible front tooth a legitimate expense. However, if it is on a back tooth, then they may only cover the amount it would have cost to get an amalgam filling and you would pay the difference.

This blog is brought to you by Phoenix cosmetic dentist Dr. Arthur Chal.

Rodney- San Bernadino, CA

Rodney,

Teeth whitening won’t hurt your Lumineers, but it won’t whiten them either. Are you talking about just whitening your bottom teeth that don’t have Lumineers? If that is the case then there is no problem, as long as you already have your Lumineers the level of whiteness you desire. If you didn’t get them made as white as you want your teeth, then your only option is to get new Lumineers or another brand of porcelain veneers. I hope your dentist warned you about that.

This blog is brought to you by Phoenix Cosmetic Dentist Dr. Chal.

Kathy L.- Chicago

Kathy,

Sjogren’s syndrome attacks your moisture-producing glands. That will affect your saliva production. Because of that, you’ll have to be very careful how often you eat, and to clean your teeth as soon as possible afterward. Many people are unaware that their saliva helps them fight tooth decay. It both kills bacteria, but also has minerals that help repair early decay.  Without that, your teeth are at a great disadvantage. If I were in your place, I would avoid snacking at all costs.

This condition will also determine what type of treatment to use for your chips.  You’ll always want to do the least aggressive treatments, in order to prevent creating places vulnerable to decay. In this case, that would mean doing tooth bonding instead of porcelain veneers. Dental bonding only replaces the missing tooth structure, while veneers affect the entire surface of the tooth.

This blog is brought to you by Phoenix Cosmetic Dentist Dr. Arthur Chal.

Catherine C.- Little Rock, AR

Catherine,

Unfortunately, tooth whitening, does not fix uneven tooth color.  Bleaching tends to accentuate the differences in color, which is very likely to make your smile look worse. My recommendation to you is to get porcelain veneers. If you’re totally happy with your smile, minus the one tooth, you could just get one porcelain veneer placed on the opaque tooth. But, if there are other things you were dreaming of changing, veneers can take care of all of it simultaneously.

One word of caution. Putting a veneer on an opaque tooth requires expert technique. The veneer needs to mimic the natural translucency of the tooth adjacent to it, while not actually being translucent, allowing the opaqueness to show through. It can be done, but not by your average general dentist. You’ll want to find an expert cosmetic dentist.

This blog is brought to you by Phoenix Cosmetic Dentist Dr. Arthur Chal.

Ben- Michigan

Ben,

Luster Premium Whitening is a separate brand and completely unrelated to Zoom Whitening, so it isn’t the take home version of the same thing.  In examining the kit you asked about, it appears the light is too weak to be effective, and is probably just there for psychological reasons, or maybe as a marketing tool. Their main whitening ingredient is zinc-oxide, in the super whitener. This is a pigment that will stick to your teeth and make them look whiter, but  the effects will wear off and you’ll have to continue to buy the kit to keep your teeth pigmented white.

This is completely different from how Zoom works, including the ingredients. With Zoom your teeth are whitened from the inside out, by the stains being oxidized permanently from your teeth using a strong peroxide gel. These stains will not return, though you can develop new stains. The light with Zoom is designed to activate the gel.

Hope this helps you make a decision.

This blog is brought to you by Phoenix Cosmetic Dentist Dr. Arthur Chal.

Gina,
I’m continually surprised at the number of dentists who don’t seem to know this. Maybe it’s because they don’t go to many continuing education classes or something. What you’re describing to me is a classic symptom of a bonding malfunction in placing this filling.

You didn’t say whether this is a white composite filling or an amalgam filling, but the symptom of the tooth being sensitive to chewing but not sensitive when you clench your teeth together almost always happens with a small to medium-sized white composite filling on the chewing surface of a back tooth. The exact mechanism of the pain isn’t well understood, but it could be related to over-drying the tooth before the bonding agent is put on. Some researchers believe that this causes incomplete wetting of the bonding surface resulting in tiny micro-bubbles at the interface where the filling is bonded to the dentin of your tooth. But the symptom is well known, and how to prevent it is also understood.

This does irritate the tooth and it can make the tooth more sensitive to various stimuli, and the treatment is to re-do the filling. I’d suggest showing this answer to your dentist and then asking him or her to re-do the filling. This time, to insure that the same thing doesn’t happen again, ask your dentist to place a glass ionomer base under the filling before doing any bonding steps, and then re-fill the filling with composite. That should take care of it.

Assuming this is a white filling, it isn’t because the filling is too thin. There is no minimum thickness for white composite fillings.

The pain in your gum may be something else. I wouldn’t know what to tell you about that without examining this myself.

She had an underlying TMJ disorder which she was able to live with. Then she was in an accident, and the pain became so great that she has been unable to sleep.

The resolution of her problems requires a careful analysis and a truly comprehensive dental examination. There is not one simple cause to her pain – there are underlying issues, and on top of that there is the trauma of the accident. But for complete healing, all her issues need to be resolved.

When we examined her, we discovered another serious problem that hadn’t been discovered during her years of dental care. In spite of the fact that she had recently been to her family dentist and had an examination and a dental crown placed, Dr. Chal’s examination uncovered underlying periodontal disease – she has moderate periodontitis, meaning that some of the soft tissue support of the teeth has been destroyed, and the disease has progressed to where the bony support of the teeth is beginning to be lost. It was our unpleasant duty to inform her of this neglect.

The  bottom line – nothing substitutes for careful diagnosis.

This blog is sponsored by Phoenix dentist Dr. Arthur Chal

My question is… what are my options? I would like some continuity in the color of all my teeth. I’m fresh out of graduate school and do not have a lot of extra money laying around to get more work done, and I’m not interested in getting more veneers. I would simply like them to not be so noticeably different, I’m talking 5 shades. Please let me know what you would recommend doing in my position, thanks for your time.
-Joe from Pennsylvania

Joe,
I feel bad for you. The brightness does not fade on porcelain veneers. It sounds like they just wanted to get these veneers on and didn’t want to send them back to the lab or reschedule your appointment.

You have a couple of options.

The fairest thing would be for this dental office that did this to you to either replace them themselves and get the color right this time, or pay you to have this re-done somewhere else. This could be a legal problem for them, because they lied to you to get you to let them put them on, and they violated your right to informed consent. You did not actually consent to having them put on the way they looked.

If the other teeth are natural teeth, another option would be to whiten the other teeth so that the color matches better. You can find dentists who do this teeth whitening for very reasonable fees. Some even do it for free as a come-on to get you to sign up as a new patient. If you are determined enough, you can just keep whitening and whitening for weeks until you get the color where you want it.

Or, you could pay another dentist to have the work redone. But I would go to a dentist who is more attuned to cosmetic dentistry.

This blog sponsored by Arizona TMJ dentist Dr. Arthur Chal.