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Advanced cosmetic and general dentistry

What are my options for whitening one gray tooth?

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My upper left incisor is getting grayer each year. My dentist referred me to an endodontist who says the x-ray shows a possible horizontal fracture. She recommended a root canal, but I am wondering about cosmetic options. Will regular teeth whitening or internal bleaching help? – Thank you. Irina

Irina,

Thank you for your question.

Dr. Szarek would need to examine your x-rays, but root canal treatment is unnecessary unless you have a tooth infection, and it will not lighten the tooth. If you have a tooth fracture, root canal files that clean out the tooth might worsen a horizontal fracture.

What Else Can Cause a Dark Tooth?

If your tooth is not infected, it might be turning dark from trauma to the tooth that happened years ago. As your body responds to tooth trauma, it builds secondary dentin beneath your tooth enamel, which can darken a tooth.

Whitening a Dark Tooth

Teeth bleaching gel applied to teeeth

A cosmetic dentist can determine how bleaching gel will affect your teeth

Internal bleaching, dental bonding, and porcelain veneers are ways to whiten teeth, but their purpose varies.

  • Internal bleaching – The procedure follows root canal treatment for a tooth that a dentist has already opened from the crown. If you do not need root canal treatment, opening your tooth for bleaching is not recommended.
  • Teeth whitening – Bleaching gel breaks down stains from external factors that darken your teeth, like smoking or drinking coffee or tea. But if your tooth is dark from the inside out, bleaching gel may have limited results. A cosmetic dentist can explain the results you can expect with this option depending on the cause of the discoloration.
  • Dental bonding – A trained cosmetic dentist can blend dental composite (resin and glass), layer it on your tooth, harden each layer, and conceal the discoloration. Only a cosmetic dentist can perfectly match the bonding to your natural tooth color.
  • Porcelain veneer – A custom-made shell of porcelain covers the front of your tooth. An artistic cosmetic dentist and master ceramist must create the veneer to mimic the natural translucence of your teeth while hiding the gray beneath it.

Any treatment option that hides discoloration within a tooth is challenging for most general dentists to achieve beautiful results. We recommend looking for an advanced—preferably accredited—cosmetic dentist for natural-looking results.

Michael Szarek, DMD, an accredited cosmetic dentist in Lowell, MA, sponsors this post.

Will porcelain veneers help an adult’s primary adult teeth look larger?

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Two of my upper left permanent teeth grew behind my baby teeth. I’m wondering if two porcelain veneers will work to make the baby teeth look larger. I’m 26 years old and more conscious about my smile than when I was younger. Are porcelain veneers or some other type of cosmetic dentistry best for making my teeth look larger? Thank you. Zenoah from PA

Zenoah,

Thank you for your question. Dr. Szarek would need to exam your teeth for a complete diagnosis and treatment options. But we will explain how dentists, in general, handle permanent teeth that grow behind primary teeth.

What Can You Do About Primary Teeth that Grown Behind Permanent Teeth?

When primary teeth grow behind permanent teeth, a dentist can correct the issue with orthodontics if the permanent teeth have erupted. Brackets attached to your permanent teeth will help move them to the correct position.

  • Remove primary teeth – Your dentist or orthodontist must remove the primary teeth to make room for the permanent ones and help them erupt in the correct position.
  • Possibly remove a few permanent teeth – If your teeth are crowded, your dentist might recommend removing some permanent teeth.

When Permanent Teeth Never Develop

When permanent teeth never develop due to disease, a medical condition, or genetics, a dentist or orthodontist can

  • Use braces to correctly position the tooth on either side of the missing one
  • Remove a permanent tooth to make room for replacing the missing tooth if necessary
  • After orthodontic treatment, replace the missing tooth with a dental implant and crown

Will Porcelain Veneers Help Primary Teeth Look Larger?

Photo of a porcelain veneer, which cannot be whitened, held against a natural tooth for Lowell, MA cosmetic dentist Dr. Szarek

At times, porcelain veneers are an option for helping small adult teeth look larger

Although a porcelain veneer can help a primary tooth look larger, it may not be the solution when a permanent tooth is behind the primary one. But at times, porcelain veneers can improve the appearance of primary teeth in adults. Read the March 2017 Operative Dentistry article, Ceramic Veneers for Esthetic Restoration of Retained Primary Teeth, for details.

Conclusion

Each patient’s case is unique, so you will need an exam for a dentist to determine which treatments will work for your case. We suggest scheduling a consultation with an accredited cosmetic dentist and an orthodontist to discuss your options.

Look for accreditation from the American Academy of Cosmetic Dentistry or the American Academy of Esthetic Dentistry. Rather than tell either doctor that you want porcelain veneers, let them examine your teeth and explain your treatment options.

 

Michael Szarek, DMD sponsors this post. Dr. Szarek is an accredited cosmetic dentist in Lowell, MA.