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Advanced cosmetic and general dentistry

Are Veneers My Only Option for Tetracycline-Stained Teeth?

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I am increasingly self-conscious about tetracycline stains on my teeth. It is embarrassing to try to explain it to people who seem distracted by my teeth and unable to concentrate on our conversation. Last month, I had a consultation with a cosmetic dentist who recommended porcelain veneers. The cost of $20,000 – $30,000 would heavily impact my savings. My teeth and self-esteem are worth it, but I am interested in knowing whether I have other options. – Thank you. Aaron from Georgia

Aaron,

Thank you for your question.

The cost quoted to you is reasonable for premier porcelain veneers from a skilled dentist. We will explain more about the treatment for tetracycline stains.

Do Porcelain Veneers Work for Tetracycline Stains?

Photo of dental forceps holding a single porcelain veneers, from the office of accredited cosmetic dentist Dr. Szarek of Lowell, MA.

Porcelain veneer

Concealing tetracycline stains with porcelain veneers takes advanced training, skill, and artistry from a cosmetic dentist. If you find a dentist with low fees who claims to be able to hide the stains, you can count on getting inferior results. The stains may show through the veneers, or the veneers may look opaque or pasty, making it evident that you had dental work. But an advanced cosmetic dentist and adept ceramist can produce incredible results with veneers.

Will Bonding or Teeth Whitening Help Tetracycline Stains?

Whether dental bonding or teeth whitening will help tetracycline stains depends on the severity of stains and a dentist’s skill and experience.

  • Dental bonding – The skill and precision it takes a cosmetic dentist to blend composites and apply them to your teeth to hide tetracycline stains can be more costly than porcelain veneers.
  • Teeth whitening – A skilled cosmetic dentist may recommend a high-strength whitening system to improve tetracycline stains, but the results will not be as effective as porcelain veneers. Bleaching treatment is a tiny fraction of the cost of porcelain veneers.

Request Another Consultation for Tetracycline Stains

Comparing your options can help you understand whether you are making the right decision regarding cosmetic dentistry. We recommend scheduling another consultation with an accredited cosmetic dentist to examine your x-rays and teeth. The second opinion can clarify which treatment will give you results that help you feel good about your smile.

Best wishes.

Dr. Michael Szarek, an accredited cosmetic dentist in Lowell, Massachusetts, sponsors this post.

New dental crowns for a gap make my jaw and neck hurt

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I received a dental implant on a left incisor and crowns on all front six teeth. I received the other crowns to close a large gap between my front teeth. Now my speech is slurred and lispy, and I have neck and jaw pain, dry mouth, and numbness in my lips. I regret closing my gap. Are the crowns causing this problem? If so, I want them removed, and I will keep my gap. – Dahlia from CT

Dahlia,

Closing your gap is not the issue, but the quality of your crown placement is the problem. Correctly sized and seated crowns do not create the symptoms you described.

When Dental Crowns Cause Symptoms

When dental crowns cause symptoms, including pain, numbness, or dry mouth, it could be that the crowns are too thick, too long, or both.

  • Oversized crowns – Oversized crowns can prevent your lips from closing naturally and effortlessly.
  • Lip incompetence – When your bite is correct and you put your teeth together, your lips should close naturally without thinking about it or trying to close them. Your lip numbness and dry mouth suggest you have lip incompetence—the ability to close your gaps naturally.
  • Thick crowns – Too-thick crowns can disrupt your bite (the way your upper and lower teeth fit together) and cause jaw and neck pain. Speech problems can result, too.

What to Do About Faulty Crowns

When dental crowns cause pain and dry mouth, you must find a cosmetic dentist to correct the issue. A dry mouth and lack of saliva breeds bacteria and promotes rapid tooth decay. Saliva contains antibodies to help fight decay, so don’t let the problems linger.

Diagram of three phases of dental implants, for information on implants and diabetes from the office of Lowell, MA dentist Dr. Michael Szarek.

Get a second opinion to check your implant crown and crowns on your natural teeth

We recommend that you find an advanced cosmetic dentist—preferably accredited—for a second opinion. It is challenging for a dentist to place multiple crowns simultaneously and balance your bite correctly. But a trained cosmetic dentist who understands occlusion and bite (how your teeth fit together and come in contact when you bite) can evaluate your case.

The cosmetic dentist will do the following:

 

Unfortunately, you may need new crowns. But your oral health is essential to your well-being.

Best wishes.

 

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

How to Resolve It If Your Dentist Grinds Your Crown Down to the Metal

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In the late 1990s, my cosmetic dentist in NJ gave me a beautiful Maryland bridge. It’s held up well even though I grind my teeth at night and rarely wear my night guard. I’m not bragging about going without my night guard – my former dentist’s work is impressive. Even my current dentist in CT admitted it. In mid-April, I had some dental work completed. I couldn’t delay getting two crowns.

In the process of trying to adjust my bite with the new crowns, my current dentist reduced the Maryland bridge tooth. A few days later when I was looking at my teeth in the mirror, I noticed a silver dot showing through that same tooth. I scheduled an appointment for my dentist to look at the tooth, and he said the metal is finally showing through because I don’t wear a nightguard. He covered the dot with composite filling, but the metal is showing again. Could the metal suddenly show through the Maryland bridge tooth, although I didn’t have any problems before? Thank you – Tamar

Tamar,

Your dentist doesn’t want to admit that grinding down the tooth in your Maryland bridge caused the metal to show through. If he admits it, he’s obligated to replace your bridge. It is possible that after he thinned the bridge that your teeth-grinding habit exposed more of the metal. But the evidence suggests that the problem occurred after your dentist adjusted your bite.

When Your Dentist Grinds Your Crown Down to the Metal

Get a second opinion – Many dentists will give you a second opinion at no charge. How will a second opinion help?

  • Ask the dentist if there are signs of grinding on the porcelain where the metal is showing. A dental bur leaves distinct marks on porcelain, and it will be easy for the second-opinion dentist to see the marks.
  • Return to your dentist with the report form the second-opinion dentist. But don’t accuse your dentist of intentionally grinding down the porcelain. It’s a mistake that many dentists have made in the past.

Below is a photograph of three crowns on back molar teeth. The porcelain was adjusted so much that the metal shows through.

Lower molar teeth with metal showing through the crowns

An advanced cosmetic dentist can try to conceal metal showing through a crown or replace the crowns

Will You Need a New Maryland Bridge?

Your dentist bonded composite over the metal, but you didn’t mention if he prepared the surface of the metal first. Without preparation, the composite won’t hold.

Panavia is a dental cement that bonds to metal if a dentist takes these steps:

  • Grind away a little of the metal to allow room for the cement
  • Etch the metal with a micro-etcher, or small sandblaster
  • Prime the metal, coat it with a thin layer of opaque Panavia, and cure it
  • Place the correct shade of composite would over the cement and shaped and polish the composite

There is no guarantee that the composite will adhere to the metal for an extended time. But perhaps an advanced cosmetic dentist can use composite to resolve the issue with metal showing through on your Maryland bridge Schedule an appointment with an accredited cosmetic dentist to discuss your options.

Lowell, MA, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.