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Pain with Teeth Whitening

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For the last three weeks I have been using an over the counter teeth whitening kit. I had not had any problems until today. Out of the blue, I had this zing of pain that lasted half a minute. It was on a tooth that had some dental bonding done a few years ago. Could that be the problem? Will the teeth whitening damage the bonding or is it just a matter of the bonding nearing the time it needs to be replaced?

Avery

Dear Avery,

teeth whitening trays

Professional Teeth Whitening Trays

I do not believe that the teeth whitening is damaging the bond. If it did, the repair would just fall off. It would not cause pain the way you are experiencing. The pain tells me you have a sensitive part of the tooth. It may be that the dental bonding is not completely covering the area that it should be, either from age or from the beginning.

Hopefully, you are doing this under the supervision of a dentist. Either way, you need to be seen. Your dentist can put something over the sensitive area that will enable you to begin your whitening again without pain.

You should be aware that over the counter whitening will work, depending on which brand you purchased, but it will take significantly longer than professional teeth whitening done through your dentist. No matter which method you choose, however, the dental bonding itself will not whiten. Teeth whitening only bleaches natural tooth structure. If you are going significantly whiter than what your bonding is, you will want to replace it to match your teeth once you have reached the color you want.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.
Click here to learn about how to get a complete smile makeover.

Can I Bleach My Non-Veneered Teeth?

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I have four porcelain veneers placed on my teeth. I asked for them to be really white, which they are, but wasn’t thinking about how dark the teeth next to them would look. Is there a way for me to whiten them with something like Crest Whitestrips?

Evie

Dear Evie,

teeth whitening trays

Professional Teeth Whitening Trays

I have a solution for you but I want to address your smile makeover first. Most smiles are eight to ten teeth wide, so four porcelain veneers will make your non-veneered teeth quite obvious. Because of the difference in color, it can even make the veneered teeth look fake. Don’t beat yourself up about not knowing this. It was your dentist’s job to point this out. When a patient cannot get enough teeth to cover their smile, teeth whitening is recommended before the veneers are placed. That is too late for you now, but that doesn’t mean this can be worked around.

Though, Crest Whitestrips will whiten teeth, I do not recommend them in this situation. First, the gel that they use are much weaker because they are over-the-counter. Second, they are only designed to cover your front four to six teeth, depending on the size of your teeth. Those are the veneered teeth and not what you want to whiten. It won’t damage them, but it is pretty useless.

My suggestion is that you go to your dentist and have him custom design teeth whitening trays to fit around your porcelain veneers. This will allow you to whiten your teeth much more quickly while protecting your gums and avoiding your veneers.

I hope this helps.
This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.

Luster Premium Teeth Whitening System

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I saw an advertisement for Luster Premium At Home Teeth Whitening System. There seem to be some positive reviews that said they saw an almost immediate difference. Do you know if this is safe for my teeth?

Drew

Dear Drew,

teeth whitening trays

After looking into this product, I have come to the conclusion that they are swindling people. Starting with the light, it doesn’t have any real power to do anything so I believe they have put it there as a psychological trigger to make patients think the light is the reason their teeth look whiter. It’s not.

You may be wondering why I say it is a swindle if their teeth are whiter. Good question! The whitening results are coming from a pigment in their “Super Whitener”. The pigment, zinc oxide, sticks to your teeth and makes them look whiter, but fades away. My guess is the positive reviews were written when the pigment was first placed on the teeth. I would not waste your money on this because you will have to keep buying it often in order to keep the pigment on your teeth. That isn’t whitening your teeth; it is painting them.

The Best Way to Whiten Your Teeth at Home

If you want to truly whiten your teeth, the best way to do that is with bleaching trays from your dentist. He can custom fit trays to your specific bite. Then he or she will give you some whitening gel to wear in the trays. You can wear it at a time that is convenient for you from about 20 minutes up to overnight.

This gives you complete control over how fast, as well as how white your teeth get. This truly whitens your teeth, oxidizing them from the inside out. The change is permanent, though teeth can pick up new stains. If you’re diligent with your oral health, you can get rid of those while they are surface stains. Some people do like to “touch up” their teeth every few years.

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

Teeth Whitening Before a Dental Crown

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I am getting a dental crown on a white tooth and I want to do a touch-up on my teeth whitening before I get it. I asked my dentist how long I would have to whiten my teeth each day and for how many days to get them back to their original color when I first whitened them three years ago. He couldn’t tell me so I am wondering if there are some tips you have.

Bethany

Dear Bethany,

teeth whitening trays

 

I am going to help you with this, but before I do I want to let you know that I am concerned that your dentist was unable to answer these type of questions. Teeth whitening is a fairly straightforward procedure. If he can’t deal with that I would not trust him to place a dental crown on your front teeth. We’ll go over how to find a dentist who can in a moment.

The Basic Principles of Teeth Whitening

The main idea behind whitening your teeth is the longer you wear the whitening gel, the faster your teeth will whiten. You can wear them one hour a day, but they whiten faster than if you wear them several hours a day or overnight. Because each person’s teeth are different in the amount of staining and how white they want them, there is no way to quantify a number of days/hours. The one constant is you want to leave a week between when you stop your teeth whitening and when you begin the procedure for your dental crown. This is because the teeth will continue to whiten during that time period.

Getting a Crown on a Front Tooth

Crowns on back teeth are no big deal. The color doesn’t have to match exactly. However, matching a single crown to a front tooth is a completely different story. All the light hits your front teeth making all the differences much more visible. Even the best cosmetic dentists will do a couple of try-ins before settling on it being just so.

Ideally, you would want an expert cosmetic dentist to do this. Look for a dentist who is AACD accredited. Then you can be certain they will get it right. If your dentist cannot tell you about teeth whitening, I would not let him near this crown.

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

 

Crowns Versus Veneers for Tetracycline Stains

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I have tetracycline stains on my teeth and really want a pretty smile. I spoke to one dentist who has a good reputation in cosmetic dentistry, name Dr. —–[name withheld].  He wants to charge me $42, 000 for upper and lower full mouth veneers. Another dentist is suggesting porcelain crowns and is only $28,000. I really only have $30,000 to budget for this, so I should probably go with the crowns. However, I wanted to double check with someone not invested in getting my business as to crowns versus veneers for tetracycline stains. Is one better than the other for this? Plus, you should know I have a tooth grinding problem, which may impact your answer.

Carla

Dear Carla,

a porcelain veneer being placed on a tooth

 

The first dentist you mentioned, who is suggesting porcelain veneers is one of the top cosmetic dentists in the country. If you decide to go with him, he will provide you with a stunning smile. You didn’t give the name of the second dentist, but I am cautious about recommending him either way because he is suggesting dental crowns.

Tetracycline stains are some of the trickiest to deal with when it comes to a smile makeover. You have to get the teeth opaque enough to cover the stains, while still creating a natural looking translucency to the teeth. To compensate for the difficulty, some dentists will suggest dental crowns instead of porcelain veneers thinking the added thickness will make it easier for them. It doesn’t. I find porcelain veneers to be the superior treatment. As for your bruxism (teeth grinding), if you get a nightguard to wear while you sleep it will protect you from the grinding damage. So that will not be an issue.

If your budget is the main reason for going to the cheaper dentist, I am going to suggest a different approach. I know the quality you will get with the first dentist. Why don’t you have him just do your upper arch and use a strong teeth whitening, such as Kor Whitening to do on your lower teeth. It will take a bit to get the lower teeth to match, but if you are persistent they will. Then, you are only paying $21,000, which is below budget and will have a stunning smile.

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

Dentist Wants to Crown My Tetracycline Stains

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I mentioned to my dentist how much I hate my smile because of my tetracycline stains. He said the best solution is to put crowns on all my visible teeth. While my teeth are ugly, they are also healthy. I hate the idea of grounding them all down. Will they look natural if I do? Would teeth whitening solve the problem instead?

Miranda

Dear Miranda,

Woman covering her mouth

 

It is difficult having a smile you are embarrassed by, especially when our smile is the first thing people notice about us. I agree with you that dental crowns is not the way to go for this. If you have healthy teeth, it is always best to keep them as intact as possible. While teeth whitening could help IF you were very persistent. Even then, they would never be completely gone. Because of that, it is not the best solution for tetracycline stains.

My recommendation is that you use porcelain veneers. These remove hardly any tooth structure. Unlike dental crowns, which have to fit around the entire tooth, porcelain veneers go on the front of the tooth. One important word of caution. I am going to recommend you do not go to your dentist for this.

Tetracycline stains are one of the most difficult to address. It takes advanced cosmetic dentistry training to do it properly. Training that is not available in dental school. The trick comes in getting the veneers opaque enough to cover the stains, but still translucent enough to look beautiful and natural.  A dentist has to invest in that instruction post-doctorally. The fact that your dentist is suggesting crowns instead of veneers tells me he does not have the right training for this. Many dentists think they can make up for that lack of training by using dental crowns, which are thicker. But that is not enough to make them look beautiful.

When dealing with tetracycline stains, I would only go to a dentist who is AACD accredited. You can find them on aacd.com. Accreditation is different than membership. Any dentist can join the American Academy of Cosmetic Dentistry. To become accredited, however, requires passing extensive examinations as well as proving your artistry to a board of examiners.

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

Zoom Whitening and Uneven Teeth

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My daughter got her braces off not too long ago and there were a bunch of white spots around her teeth. The orthodontist said this was fairly common in teenagers and that our dentist could take care of it. When we went to see our dentist, she suggested we try Zoom Whitening. She had just gotten the equipment and would even give us a discount as her first patient using it. I liked the idea of getting a discount for the treatment that she would need anyway and agreed. When we were done, the teeth seemed worse, not better. Is it possible because this is a new thing for our dentist she did something wrong?

Sally

Dear Sally,

Patient under a zoom whitening light

 

I am very glad you wrote and believe I can be a great help to you and your daughter. Zoom Whitening is an effective teeth whitening procedure that can produce remarkable results in just one appointment.  The problem wasn’t with her not understanding how to do Zoom Whitening. The real problem was her not understanding the principles behind how teeth whitening works.

No matter what method of teeth whitening you do, it will always whiten the teeth evenly. That means the white spots will get whiter along with the remainder of her teeth. The good news is there is a solution.

The white spots your daughter is dealing with are actually decalcification spots. Decalcification is a precursor to decay. My guess is your daughter used traditional wire and bracket braces. Those can be very hard for patients, whether adults or teenagers, to really get in there and brush well around all the metal clutter. This leaves food and other bacteria trapped, which in turn leads to the decalcification which your daughter is dealing with now.

There are two possible ways to fix this. One only works sometimes but is less expensive, so I’ll make sure you know about it in case it works for her.

Repairing White Spots on Teeth

The first thing I would try is a product called Tooth Mousse. This is applied topically and can sometimes remineralize the teeth.  You can purchase it over the counter. It doesn’t always work so if you don’t start seeing results, I would move on to the next option before decay sets in.

The second solution is dental bonding. This needs to be done by an expert cosmetic dentist. I’ll tell you how to find one in a moment. With this repair, the dentist will gently remove the decalcified spots and then fill in the area with the composite bonding material. The dentist will use a variety of colors, textures, and translucencies to match her tooth structure and appearance perfectly.

As I mentioned, she will need an expert cosmetic dentist. This has to be done freehand and is one of the most difficult cosmetic procedures. I cannot stress enough that I do not think your current dentist is up to the task. In your place, I would look for an AACD accredited dentist or one who has been recommended on the mynewsmile.com website. Any of those dentists will be able to give your daughter a beautiful result.

This blog is brought to you 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.

Tanda Pearl Ionic Teeth Whitening System

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I recently read an advertisement about a Tanda Pearl Ionic Teeth Whitening System. It said I could whiten my teeth in just 5 minutes a day.  I like that idea because the system I am using now aches my jaw and is aggravating my TMJ Disorder. Do you know if the advertisements about this system are accurate?

Laurie

Dear Laurie,

teeth whitening trays

I am glad you wrote because I think I can help you.  I looked up this system. It functions on the basic system that other professional teeth whitening systems use. It uses a peroxide gel that is placed in a bleaching tray. In that aspect it is fine. However, there are some differences you need to be aware of that could cause some issues.

First, the tray. This system uses just one tray that you bite down to form to your teeth. Here are my concerns about that. When you have trays made by a dentist, they are form-fitted to your specific bite. This keeps the gel from leaking out and saliva from leaking into the tray. Both of those things weaken the effectiveness of the teeth whitening. This means you will have to get more whitening gel than you normally would in order to get the same results.

However, there is another difference with the tray that will be a bigger problem for you. Custom-fitted trays can be worn anywhere and are more comfortable than most. With the Tanda Pearl System, there are not really trays as much as a single tray you have to bite down on the entire time to keep it in place.  Even for just five minutes, that is going to cause serious problems with your TMJ Disorder. Because of that, I would not recommend this system for you.

You did not mention what you were currently using, but if it isn’t a system through your dentist, that may be why you are experiencing the aching. Talk to your dentist about what is going on and have him make you trays that won’t ache your jaw when you wear them.

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

Dentist Says I Can’t Whiten My Teeth

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I have really ugly teeth and wanted to get them whitened. However, my dentist said my teeth are endogenous and because of that, I cannot get them whitened. Is that true? If so, is there anything I can do to make them look better? I am so embarrassed by my smile.

Kelly Anne

Dear Kelly Anne,

teeth whitening trays

There is always something you can do to make your teeth look better. I’m sorry your dentist was zero help to you. I am not crazy about it when dentists use clinical words with patients without explaining what it means. That doesn’t help you at all.

What he is trying to say is the stains on your teeth are endogenous, not your teeth themselves. Endogenous stains are simply stains that were acquired while your tooth was developing. There are two categories of this that dentists see most often.

The first is tetracycline stains. These are the result of taking the tetracycline medication during childhood while your teeth were still developing. Even professional teeth whitening does not make much headway with these type of stains. They are just too deep and dark.

The second is fluorosis stains. These are the result of consuming too much fluoride during your teeth’s development. While they are more superficial, teeth whitening is still not a good solution because the fluorosis stains usually result is splotched teeth. Because teeth whitening bleaches the teeth uniformly, the teeth will be whiter but still splotchy. That’s not an attractive look.

The Solution for Endogenous Teeth Stains

The best solution in both of these cases is to have porcelain veneers placed. These tiny wafers of porcelain that cover your teeth are the go-to procedure for celebrity smile makeovers. They can change anything you want about your smile, including the shape, size, and color.

The only real catch with these is it requires an advanced cosmetic dentist to give you beautiful results. Smile makeovers are not taught in dental school. It is up to the dentist how much training they invest in to do this type of work. Tetracycline stains, especially, are among the most difficult cases for a dentist to do. In your place, I would only go to an AACD accredited dentist.

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