Brown discoloration on front teeth.

I am in my early twenties, and I have always taken really good care of my teeth. Ever since my adult front teeth came in, they have been discolored and brown. I can’t remember who told me this, but I’ve always had the idea that this was because I was extremely ill when I was very young, and the discoloration was caused by the fever.

At the recommendation of my dentist, I’ve tried every whitening product on the shelf, but the situation just keeps getting worse. The areas around the spots are getting whiter, while the spots are getting darker. When I brought this to my dentist’s attention, he said he could try to grind away the material of my tooth until the discoloration is gone. I don’t claim to be a dentist, but this sounds like a terrible idea! He has no idea how much he might have to grind, and I have this horrible mental image of a mouth full of misshapen lumps where my teeth used to be.

Please help me figure out an alternative. Would professional teeth whitening help where the over-the-counter products have failed? I admit, I am pretty obsessed with getting this fixed. I hate my teeth. They create the wrong impression, and I feel like they are hurting my efforts to get a job. I just graduated from college (summa cum-laude) and my confidence is at an all-time low.

Please help.

Brianna from Charleston, SC

Dear Brianna,

You are wise to be uncomfortable with your dentist’s suggestion to grind away at your teeth. Not only will this probably still be ineffective at removing the spots, but he could do considerable irreversible damage to your teeth, too. I strongly suggest you seek the services of an accredited, experienced cosmetic dentist. You should not have to continue to be part of your dentist’s learning curve regarding stains and teeth whitening products.

If all those over-the-counter products did not work for you, it is extremely unlikely that a professional teeth whitening procedure will work. Both systems use the same whitening agents—the at-home systems just take more time. When your first attempts were not successful, your dentist should have been able to tell you that.

Depending on the kind and degree of severity of the spots, there is a chance that a procedure called “microabrasion” could help. If not, other treatment options open to you include dental bonding or porcelain veneers. Both procedures should absolutely only be done by an accredited, experienced cosmetic dentist.

Most general dentists are not at all qualified to do this kind of work, so it is very important that you locate the right dentist to help you.

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Bleaching natural teeth without damaging porcelain veneers

Are there any over-the-counter whitening products that are safe to use with porcelain veneers? I have six veneers that were placed several years ago. The veneers still look fantastic, but my other teeth have yellowed, and the difference is really noticeable.

Thanks for your advice,

Neil in Bethesda, MD

Dear Neil,

There are only a few teeth whiteningproducts that would be appropriate in this situation. Crest Whitestrips or other products that are similar are the only products I would consider both safe and effective. The active agent in the whitestrips is peroxide, which needs to be left on the teeth to penetrate and whiten them. The strips do a pretty good job, usually.

Whitening toothpastes, which are only on the teeth briefly, really don’t do anything at all. Some whitening products can actually make the problem worse over time. They contain acids that slightly etch the surface of your teeth, which allows the white pigment in the second step of the treatment to adhere to your teeth. Tests indicate that these products actually damage your teeth, and when the pigment wears away, the roughened enamel will pick up even more staining, making your teeth darker than they were before the treatment. If you are going to do this yourself, I would strongly suggest sticking with only the whitestrips type products.

There are, however, several reasons the whitestrips might not work for you. First, they are designed to work on the front six teeth, which are the teeth you have veneers on. You could try trimming them to fit, but you might wind up with strange gaps and uncovered areas. The whitestrips also take quite a while to really show dramatic results, as the peroxide solution that is legal to sell over the counter is so much weaker than  what is used in a dentist’s office. This could mean purchasing quite a few kits, and quite a lot of your time spent messing around with this.

It would almost certainly be worth it to get this procedure done in your dentist’s office. The bleach used in the office will not harm your veneers, and is simple enough that no special training is necessary, so your general dentist could take care of this.

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Can I bleach my teeth after getting Lumineers?

Two years ago, I got Lumineers on my top teeth. At the time, I did not have the money to fix the bottom ones, so I just left them alone. Now I want to bleach my teeth, but am not sure what that will do to my Lumineers. Thanks for your help.

Taryn in South Fork

Dear Taryn,

Are you looking to bleach just your bottom teeth, or both the bottom and the top? If you are hoping to make both your natural bottom teeth and your Lumineers whiter, I am afraid you are in for a disappointment.

Your bottom teeth will certainly respond to the bleaching process. Check out our page on Zoom Whiteningto read more about what is involved with that procedure. That being said, teeth whitening procedures will do nothing to change the color of your Lumineers. They are as white now as they are ever going to get, so I hope they are a color you like. This is true not just of Lumineers, but of all brands of porcelain veneers. Bleaching will not harm them, but it also will not whiten them.

If you were coming into our office to get Lumineers or some other brand of porcelain veneers, we would advise you to chose the shade you want to wind up with, rather than trying to match the shade of your lower teeth. Hopefully your dentist has done the same, and now the bleaching process on your lower teeth will make them closer to the color of your Lumineers.

I hope you wind up with the result you want!

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I want to whiten my teeth, but have some bonding in the front.

My front tooth was chipped a few years back and I had it filled in. The dentist did a nice job of matching the material used to fill it in to the the color of my teeth, however, I can see that it is darker (yellow) than the rest of my teeth when I look at pictures of myself. I really would like to whiten my teeth, but every product I’ve found says that I cannot because I have had the tooth filled in. It is my front tooth so I am particularly anxious about this. Are there any products I can use to evenly whiten my teeth and start being confident about my smile again?

Thank you! Best,
Sarah from New York

Sarah,
It sounds like you’re trying to whiten your teeth with over-the-counter products. You need the help of an expert cosmetic dentist. The over-the-counter products are generally pretty weak and ineffective, anyway. Some of them actually make your teeth slightly lighter over the short term but then they turn even darker than they were originally.

The problem is that the bonding on your front tooth will not whiten, no matter what you use. Find an expert cosmetic dentist. I’d suggest using the mynewsmile.com cosmetic dentistry referral service to find a good cosmetic dentist. Have them whiten your teeth. Then, about two weeks after you’re done whitening, after your new whiter color has stabilized, you’ll need the bonding either re-done or at least re-surfaced, to match.

There aren’t really any shortcuts.

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Can you whiten crowns?

Hi. I have two crowns that are significantly more yellow than my other teeth. I do whiten my teeth but I cannot afford to have my crowns replaced. I understand there is nothing on the market to whiten crowns. Any suggestions?
- Michelle in New York

Michelle,
There are ways to whiten porcelain crowns, but they are more trouble and just as expensive as replacing them. There is a technique that expert cosmetic dentists know how to perform where the porcelain of the crown can be shaved down and new porcelain can be bonded over the top. Kind of like a porcelain veneer over an existing crown. But the fee for this is usually the same as for a new crown, because it is just as much or even more work as doing a new crown. Plus, the lifespan of this work is shorter than a new crown. That means that your best option is just doing the new crown.

Dental insurance plans may have different rules for when they will consider providing benefits for replacing an old crown. Generally the crown has to be five years old, and then your insurance may help you pay for it, depending on the circumstances. If you can’t afford to replace the crowns, this may affect how much you want to whiten your teeth. Zoom whitening and other whitening treatments will whiten your teeth, but not any dental work.

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Snap-on smiles

Is there such thing as dental flippers that cover all of your teeth (such as the ones beauty pageant contestants wear). If so, can you please provide me with more information?
-Jeri from Seattle

Jeri,
I’m guessing you may be referring to what is called a “snap-on smile.” This is a set of temporary acrylic teeth that are made to snap over your existing teeth for a temporary situation, such as a wedding.

But these aren’t worn by beauty pageant contestants, because while they may look okay from a distance, from close up they look a little fake, not first class. For beauty pageants, they get regular smile makeovers with porcelain veneers and/or porcelain crowns. Many of them also have Zoom whitening done or some other tooth whitening procedure. For beauty pageants, they need to look their best and snap-on smiles simply aren’t good enough.

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