My Tooth Looks Like Frankenstein

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I went roller skating with my son and ended up chipping a tooth. I went to see my dentist and he said he could fix it with dental bonding. When he did, the color didn’t match the rest of my teeth. It almost looks like I have a Frankenstein tooth, as if someone just stitched someone else’s tooth onto mine. That’s how off the color is. I’d like him to re-do it. Should he charge me for that? If so, would I be better off going to another dentist?

Franny

Dear Franny,

Before and After Dental Bonding

I am glad you wrote. Let’s see if we can tame that monster tooth and replace it with something that does not look like necromancy. In your place, I would give your dentist another chance. Everyone is learning new skills and this may be new for him. Cosmetic dentistry is not adequately taught in dental school. To become skilled at it, dentists have to invest in post-doctoral training. This will help your dentist know what skills he has and which he needs to develop still.

As to the cost, he should not charge you for it. Having your dental bonding match the remainder of the natural tooth is a basic expectation in the result of this procedure.

On the chance he can’t get it right the second time, then it will be time for another dentist to step in and take over. If that becomes necessary, he should refund your money.

The best cosmetic dentists are accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the world. You’ll get a result you will be proud to share with others.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

Problems with Dental Bonding

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I used to have a beautiful, white smile until my dentist got a hold of it. I had these sensitive spots at the top of my gum line that were filled in with composite bonding. But, the color is off and it’s noticeable. Plus, the bonding looks opaque. How do I fix this? Do they remove and replace it or just put a different color on top?

Casey

Dear Casey,

Image of an abfraction lesion

Abfraction Lesions

What you are experiencing with the sensitive open spots at your gum line are known as abfraction lesions. It used to be thought these were caused by brushing too hard. That has changed. Now we think it has more to do with teeth clenching and grinding. The exposure of the open area can be very sensitive to air and touch. The solution you and your dentist decided on can work, and it shouldn’t have been that hard for him to do.

You can have this re-done safely. I’d go to a different dentist this time. If the only thing wrong with your teeth are these notches, you don’t need an expert cosmetic dentist like you would for a smile makeover. However, he or she does have to be aware of the type of material they’re using. Because you are likely clenching your teeth, he doesn’t want to use a stiff material. That can cause the filling material to essentially pop out. He will need to use a more flexible composite resin so when you clench the material can move with it.

When Do You Need an Expert Cosmetic Dentist?

If you were getting cosmetic bonding done on a chipped tooth or a total smile makeover with porcelain veneers, then it would be time to find a cosmetic dentist with serious expertise both technical and artistic. The easiest way to do that is to find a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry.

AACD accredited dentists have done a considerable amount of post-doctoral training, passed stringent exams demonstrating their technical knowledge, and turned in a large number of cases showing visual evidence of their artistic abilities. Any one of them can give you a stunning new smile.

This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.

Dental bonding has become discolored

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Several months ago, I had my dentist perform dental bonding on my top front teeth, all four of them. This is something that I have had done every few years for the past couple of decades, so I suspect I have a fair amount of composite built up on these teeth. Now, I am noticing that these teeth look somewhat yellow. Since the bonding procedure was done only about 8 months ago, I wonder if this discoloration can be corrected by having them polished instead of completely redone. I would like to know your thoughts.

– Laura

Laura,

Dental bonding is a type of veneer process; a direct veneer. This is different than indirect porcelain veneers, which are harder and more resistant to staining than softer composite material. Because dental bonding is done with composite material, the longevity of results is much shorter.

There is good news though. It may be possible to polish stains from your dental bonding; it just depends on the type of staining that has occurred.

There are two types of stains that develop on composite. Surface stains may result from tiny abrasions in composite. If discoloration is only surface staining, polishing will most likely work to restore brightness by smoothing out those scratches and releasing the stains. That being said, the nature of composite, being a combination of glass or quartz in a plastic binding agent, enables it to absorb tiny molecules from foods and beverages. If your morning cup of coffee or tea has been absorbed into the composite, polishing is not likely to resolve discoloration because stains have actually become a part of the bonding. This type of staining typically takes years to become obvious.

Now let’s talk about maintaining your dental bonding.

There are a few simple ways that you can make sure your bonding remains in tip-top condition:

1. Have bonding done by an accredited cosmetic dentist. In our La Jolla practice, we maintain a large inventory of composite materials for dental bonding. Many of the composites stocked by general dentists lack the capability to be polished to look like a natural tooth.

2. Brush your teeth with a gentle toothpaste that does not contain abrasive particles. The wrong toothpaste will cause scratches on the surface that invite stains.

3. Make sure your hygienist knows that you have dental bonding. This way, only the finest abrasives will be used during your routine cleanings. Ask for a fine aluminum oxide polish.

4. Be mindful of what you are drinking. Use a straw when you can to avoid direct contact between your bonding and substances that could stain.

One last note. Since you have continued your bonding routine for as long as you have, perhaps you should consider having porcelain veneers made for these teeth. Porcelain resists stains better than composite, and even better than natural enamel. When done by an experienced cosmetic dentist, porcelain veneers can sustain their aesthetic value for 20 years. If you do choose to have porcelain veneers, it is best to consult with an accredited cosmetic dentist – this isn’t a job for your family dentist.

This blog is sponsored by La Jolla dentist Dr. Stephen Doan.