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Dental Bonding Versus Porcelain Veneers

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My daughter has two lateral incisor peg teeth that we are ready to repair. Our dentist wants to do four porcelain veneers on her teeth to have them match. It was quite pricier than we expected, so he suggested he could do dental bonding for 1/5 of the price. This sounds like a great solution but I heard they don’t last as long. Should we do the cheaper one and just plan on re-doing it more often?

Millie

Dear Millie,

before and after dental bonding to repair a chipped tooth

I have some concerns here. First, the fact that he has to do four teeth instead of the two peg teeth tells me he is not comfortable with his skill level. He does not feel like he can match the lateral incisors to the front teeth so he wants to do all four which will make it easier for him. However, that doubles your cost and is totally unnecessary. A second thing that worries me is the cost he quoted you.

In reality dental bonding is best used for small repairs such as the one above for a chipped tooth. If a dentist tries to do it over the entire surface area of the tooth it would actually be more work than doing veneers. This is because composite bonding has to be done free hand. It would actually cost close to the same amount or possibly even more than the porcelain veneers.

My suggestion is that you want to get her teeth done you do it right. I would go to an expert cosmetic dentist and let him or her do just two porcelain veneers. Look for someone who are accredited by the American Academy of Cosmetic Dentistry. The accreditation process requires true technical expertise and artistry to pass. They are in the top 3% of dentists.

You didn’t mention how old your daughter is. If she is young, her teeth probably are not very stained. However, if she’s an adult, she will have developed some surface stains on her teeth which is a natural result of living. If that is the case, I would suggest you get her teeth whitened before you have the veneers done on her teeth.

Porcelain veneers can be made to any color, but once they are made the color is permanent. If she decides to whiten her teeth a few years later, her natural teeth will whiten but not her veneers. It is more financially responsible to whiten ahead of time. If you don’t the veneers will have to be replaced.

This blog is brought to by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Can I Get a Better Smile without Bonding?

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I have slightly discolored teeth, due to aging. A few years back, I also fell and chipped my front tooth. My dentist did composite bonding on that and I’ve never been happy with it. It doesn’t match the rest of my teeth and never has. Plus, there is a gap that wasn’t there before. I went to him about the discoloration for all my teeth to see what he’d recommend and he wants to do composite bonding on the top eight teeth. I am a little leary of this given how the gap turned out. Is there another way to handle this?

Kevin

Dear Kevin,

before and after dental bonding

You bet there are other ways to handle this. My first suggestion would be to simply have professional teeth whitening done. This will take care of the discoloration you are talking about.

The next step would be to replace the badly done dental bonding. The problem you faced with the bonding was not the procedure as much as it is the dentist who did the procedure. He could have matched your teeth perfectly and not had any gaps. The fact that he was not able to accomplish that tells me he is not a skilled cosmetic dentist.

If the only things you want to change about your smile are the color and this bonding, then I would simply find a better cosmetic dentist. Look for an AACD accredited dentist to do your work. These are the best cosmetic dentists in the country.

If, however, there are other things about your smile you are hoping to change, then I would look into getting porcelain veneers. These can give you a complete smile makeover. They’re able to change anything about your smile, including the color, shape, size, and character.

Like the dental bonding, it will require an expert cosmetic dentist, but when well cared for they will last for many years. Whatever you do, don’t go back to the same dentist who could not get your chip repaired properly.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dentist Won’t Do Bonding

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I have black triangles that developed after some orthodontics.  I read online that this can be fixed with dental bonding but my dentist is insisting this is a bad idea. I don’t want to leave these holes so what can I say to convince him? I’ve tried showing him an article about it and he really still doesn’t think it is a good idea.

Brenda

Dear Brenda,

example of black triangles

While you are correct that dental bonding will be a good solution for this, I would not push him into this. When a dentist tries to steer a patient away from a procedure, it is usually because they are not qualified to do it but do not want their patient to lose confidence in them.

This is an advanced, tricky procedure to do. In your place, I am going to suggest you see a dentist with the training necessary to do it. The dentists with proven skills and training are AACD accredited. There are other excellent cosmetic dentists as well, but these have already been tested so you know what you are getting into. If I were in your position. That would be the dentist I’d use.

If you are interested in whitening your teeth. Make certain you do it before you have any bonding done. The color can’t be changed on the bonding after it is done, so you want any color matching to be done with the color you are going to keep.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

 

Splotchy Teeth After Braces

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My daughter had braces. Before the braces, her teeth looked uniform in color. Now they are splotchy. Is there something we can do to repair this?

Pauline

Dear Pauline,

Smile with braces

When teeth are splotched after braces, it is generally white spots. These are decalcification spots. It means the enamel in that area is weakened because they didn’t get thoroughly clean during her braces treatment. This happens quite a bit. It is rather difficult getting between all those metal wires and brackets. Plus, they trap things there. Hopefully, her dentist or orthodontist had the foresight to instruct her to keep a toothbrush and toothpaste with her at all times so that she can brush after each meal.

Decalcification spots are pre-cavities, so you do want to treat them. The best treatment is to have the spots gently ground off and then use dental bonding to protect the area.

One word of caution. This isn’t a procedure I would recommend your average family dentist do. You want someone who can blend the composite perfectly to her teeth so that it looks natural. This takes advanced cosmetic dentistry training. Make sure your dentist has that before moving forward.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss. Click here to learn about AACD accredited dentists.

Dental Bonding Turning Yellow in a Week

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I don’t know what is happening. I had dental bonding done on six of my front teeth. It’s been only a week and they’re turning yellow. I really loved them when I first got them and expected them to last a few years. What do I do? Can I whiten them?

Pauline

Dear Pauline,

before and after dental bonding

I am sorry this has happened to you. There are a couple of possibilities here. One is that your dentist used subpar materials. The second is that you did something to damage the polish on them. Either way, the fault will likely lie with your dentist because it is his responsibility to instruct you on your post-operative care.

Is it possible you brushed your dental bonding with something abrasive such as an over the counter whitening toothpaste or some baking soda? This will scratch the polish on the bonding allowing them to pick up stains much more quickly than they would otherwise. Many people aren’t aware that whitening toothpastes that you purchase at the store “whiten” your teeth by using abrasives. This creates a wicked cycle of making your teeth look whiter by scraping off stains, but it also creates micro-scratches on the surface of your teeth that causes them to pick up stains more quickly.

The only type of whitening toothpaste I would ever recommend is Supersmile Toothpaste, which uses a natural enzyme to whiten your teeth without any damage.

Unfortunately, teeth whitening won’t get them any brighter or whiter. It will only work on natural tooth structure. Because it has been such a short time since they provided your dental bonding for you, I am going to suggest you call and ask them to repolish them for you.

Caring For Your Dental Bonding

  • The best toothpaste for any type of cosmetic work is Supersmile Toothpaste. It’s specifically designed to remove stains without doing anything that will damage the work.
  • Like with anything related to your teeth, brushing and flossing is an important part of keeping the bonding healthy and shiny.
  • Make certain your dental hygienist knows how to care for your dental bonding. For instance, during your cleanings it is important she doesn’t use anything like a power prophy jet or acidulated fluoride, which will damage the polish on them.
  • If you use a mouthwash, make sure it is alcohol-free. Alcohol can loosen the bonding.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

 

Cosmetic Solution for Fluorosis Stains

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I have fluorosis stains on my teeth and wondered if teeth whitening is a good cosmetic fix for someone in my position? I want to have a smile I am proud of.

Diego

Dear Diego,

I will say right off that teeth whitening will not be the solution. It whitens teeth evenly and is only more likely to make your fluorosis stains more obvious. For the benefit of those who are unfamiliar with what fluorosis stains are, it happens when someone ingests too much fluoride while the teeth are still forming. The fluoride in the water in the United States is optimized for the right consumption so we don’t see much of it here.

There is good news, though. Your teeth can be attractive again. Which solution depends on the amount of fluorosis you are dealing with. For either repair, you will need an expert cosmetic dentist. My suggestion would be to find an AACD accredited dentist.

If You Have Mild Fluorosis

 

mild fluorosis stains

The picture above is an example of mild fluorosis. If this is what you are facing, then dental bonding can be a sufficient repair. Your dentist will gently shave about 0.5 millimeters of your tooth enamel. Then, he or she will replace it with direct composite bonding. It doesn’t last as long as the next repair I will talk about, but it does cost less.

If You Have Darker Fluorosis

heavier fluorosis stains

In some cases, as in the picture directly above, the stains are more prominent. In this case, simple dental bonding will not be enough. Instead, I suggest you have porcelain veneers placed. This is actually the go-to procedure for a smile makeover. It is what gives people that “Hollywood Smile.”

This procedure can last for a lifetime. However, don’t try to cut corners by going to an inexperienced cosmetic dentist for this. It’s not an easy procedure to do under the best of circumstances. With severe stains like these, it will take someone highly skilled. This is why I recommended an AACD accredited dentist earlier, these are the best cosmetic dentists.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Discolored Dental Bonding

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I’ve got dental bonding that is seeing the end of its lifespan. It is picking up stains and isn’t nearly as bright as it once used to be. I honestly don’t know if I should whiten them or replace them. If whitening would work then I’d like to do that. I’ve moved since then and don’t feel confident my new dentist can do the job. He said he’s willing to learn but I’d be his first case. Is there a specific type of teeth whitening that would work better with dental bonding?

Eliza

Dear Eliza,

before and after dental bonding to repair a chipped tooth

There isn’t a teeth whitening that will remove the stains from your dental bonding, unfortunately. In fact, because it only works on natural tooth structure, your teeth would whiten but not the dental bonding, making the disparity even worse. That being said, I am glad you are not just going to let your new dentist try his hand at dental bonding on you.

This requires some expertise because it is a procedure that is done freehand. A dentist needs training as well as artistry. However, you do need to have the bonding replaced. If you are happy with your dentist in every other aspect, you don’t have to switch practitioners. Cosmetic dentists are used to patients coming to them just for specific advanced procedures and then returning to their regular family dentist for the bread and butter type of care.

With that in mind, how do you go about finding a dentist to replace your worn out work? The easiest way would be to find an AACD accredited dentist in your area. These are dentists who have proven their technical knowledge and artistry to an examination board. They are more than qualified.

Should You Whiten Anyway?

Because the bonding color is permanent during its healthy lifespan, if you have any plans to whiten your teeth, the time to do that would be before you have the bonding re-done. This way when they replace the bonding, it can be done to the color you will want to keep for some time.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Help! I Look Like Jim Carrey!

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This quarantine has almost destroyed me. First, I tried to cut my own bangs which were almost down to the tip of my nose. Then, the other night I had WAY too much to drink and tripped, which resulted in chipping my front tooth. I seriously look like Jim Carrey in Dumb and Dumber. Help! My dentist still isn’t open but tell me there is a solution for this once he is. For now, I’m just going to hide indoors and ignore the doorbell. No one can see me like this.

Stephanie

Dear Stephanie,

Jim Carrey in Dumb and Dumber

Jim Carry in Dumb and Dumber

For the benefit of those who may not know Jim Carrey or the role he played in Dumb and Dumber, I’ve posted a picture above. Don’t feel too bad. This quarantine has been hard on us all. There are more than a few bad haircuts in the grocery stores these days. You’re also not the only one to hit the wine bottle either.

While a dentist can’t do anything about the cereal bowl haircut, you can certainly get that tooth repaired. The first thing the dentist will want to do is make sure there is no underlying damage to the pulp of the tooth from the trauma. If everything is okay there, the standard repair for a chipped tooth is dental bonding. This uses a composite resin that the dentist will sculpt on your tooth to make the tooth whole again. This is done freehand, so you don’t want your average dentist to do it. Dental bonding takes experience and artistry to make it look natural.

Finding an Expert Cosmetic Dentist

before and after dental bonding to repair a chipped tooth

Your family dentist may also be an expert dentist. Just make sure before having him work on your tooth. The top cosmetic dentists are AACD accredited. This means they have passed stringent exams on the technical knowledge and procedural process in cosmetic work. In addition to that, they also had to submit visual evidence of a substantial number of cases they’ve personally done to be examined by a board of experts for the quality and beauty of their work. Any dentist who reaches accreditation is in the top 1% of cosmetic dentists in the country.

What if Your Dentist Isn’t Accredited?

Just because your dentist isn’t accredited, doesn’t mean he can’t do beautiful work. This is a process which takes many years and there are some artistic dentists out there who are still in that process. I would first look to see if he is listed on the mynewsmile.com website. If not, then your next step would be to ask for before and after images of dental bonding cases he’s personally done. Don’t settle for stock photos. If you are not absolutely thrilled with the results, don’ t let him near your smile.

Expert cosmetic dentists are used to having patients come to them just for the one procedure and then staying with their family dentist when that is through. There is no shame in that. He’ll understand and your dentist should understand as well.

I hope this helps. Try to keep away from the booze for a while, you don’t want to end up needing dental implants. Hopefully, this whole Coronavirus mess will be over with soon. I know dentists are ready to get back to work!

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Dental Bonding Staining

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I have dental composite bonding on all my front teeth. I have them re-done every three or four years. This latest set is only six months old and is starting to look yellow. Can this be polished to look right again or do I have to re-do them early? What would cause this to happen so quickly?

Priscilla

Dear Priscilla

Whether or not these can be polished to get rid of the stains depends on the nature of the staining itself. Unlike porcelain, which is hard and very stain resistant, composite dental bonding is fairly soft and is susceptible to two different types of staining.

Dental Bonding Staining One

an image of dental bonding on teeth stained by scratches

This first type of staining is surface stains. It happens because of tiny scratches on the bonding which allow it to pick up stains that are trapped there. You can tell these front teeth have been scratched because they’ve lost their glossy finish, instead they look matte. If you look at the adjacent natural teeth, they still have a gloss to them.

The good news is this type of staining can be fixed. If your dentist thoroughly polishes them, it will remove the scratches and stains, all while bringing the gloss back.

Dental Bonding Staining Two

Teeth with the two front teeth having stained dental bonding

Composite bonding is made from a solution of inorganic filler particles such as quartz or glass bound together in a plastic matrix. Because of that, it will absorb stains into its actual material. For instance, if you drink a lot of staining beverages, such as coffee or tea, it will penetrate the plastic and become a part of the bonding structure.

The picture above is a good example of this. Notice the two front teeth are much more stained than the surrounding teeth. This is absorbed staining. You can tell that (as opposed to scratch staining) because the teeth still have their shiny gloss. Notice the adjacent teeth, though stained, aren’t as stained as the bonded teeth. This is because your natural teeth are less susceptible to staining than composite bonding.

Unfortunately, this has to be re-done. There is no way to polish this out. Teeth whitening won’t work either. It will only whiten natural tooth structure. If that is the case, I’m going to highly suggest you switch to porcelain veneers on your teeth. Yes, veneers are more expensive initially. However, you are re-doing these every few years. Great porcelain veneers can last upwards of twenty plus years. They’re much more stain-resistant than bonding. In fact, they’re even more stain-resistant than your natural teeth.

Keeping Dental Bonding Stain-Free

1. Start with the right materials. You want to go to a skilled cosmetic dentist. They are more likely to stock microfill composite. This is possible to get polished completely giving it a high gloss and helping it resist stains.

Most general dentists just keep a generic composite which will never completely polish up to the gloss you need.

2. Avoid abrasive materials. I recommend anyone who has cosmetic work use Supersmile toothpaste. It’s specifically designed to chemically remove stains, instead of doing it with abrasives the way most toothpaste works.

3. Avoid staining beverages. If you must drink them, try not to let it sit on your teeth. Swallow immediately.

4. Make sure your hygienist doesn’t use anything like a prophy jet or pumice on your bonded teeth. It will destroy the glazing.

I hope this helps. Seriously consider switching to porcelain veneers.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.