Re: Teeth Whitening and Bonding

Posted by cs on 3/14/2012, 11:39 am, in reply to "Teeth Whitening and Bonding "

Hi, Anna . . . Good questions, though as just a patient, I can't answer all of them. But other forum members may be able to fill in some of the blanks: "My fear is that I have been reading on the interent that some of the white spots that show up after you start whitening will not ever go away."" Based only on my experience as a patient, while whitening (i.e., bleaching) can remove many spots . . generally, they are not particularly effective on damage to tooth enamel. A good professional cleaning and whitening can remove many spots, as well, but they can't replace defective or missing enamel, which may seem more noticeable next to freshly whitened teeth. "Also, do you think its a good idea to whiten them first so the composite (which will yellow over time) and my teeth will age and yellow over time together? " That probably depends on your goal for your teeth. If most of your visible teeth are natural and you ever wished they were whiter or brighter, this is a good time to whiten them. If so, personally, I've found it makes sense to do it 10 days to 2 weeks in advance of selecting a new or brighter color. That's because, as your dentist has told you . . . natural teeth undergo several changes during whitening. They include dehydration,which occurs when the bleach dehydrates the teeth — which usually makes them look especially white or bright But as they start to rehydrate, generally, they also seem to settle down to the intended new color. (If that sounds confusing, just picture a sheet of white typing paper . . . i.e., bright when dry/dehydrated; darker when damp/rehydrated). On the other hand, because bonding and natural teeth are different in composition, they may or may not age simultaneously. The only benefit of whitening in advance is to have them start off as close in color as possible. But if you are satisfied with the color of your teeth now, the bonding can be made to match that, as well. "How long does teeth take to yellow over time if you smoke sparingly on the weekends and drink one to two cups of coffee day? Like five years or in a few months?" If you're talking about natural teeth, I've never see any statistics on that . . . but according to my dentist, the materials used in bonding today are considerably more durable and stain resistant than those of the past. Additionally, however, regular brushing and rinsing helps slow the pace of staining of natural teeth and probably bonded ones, as well. I've even read that rather than drinking it directly from a cup, heavy coffee drinkers sometimes sip it with a straw. By the way, coffee is not the only offender. Red wines and some vegetables (e.g. beets) are known to stain teeth. Also, if the bonding does not hold up and you ever decide to to change to an alternate treatment — like fine teacups, porcelain veneers and crowns are less susceptible to permanent stains. "I hate to keep changing the filling every so often cuz the colors dont match up. Any way to have the composite professionally cleaned instead of replacing it?" Over the years, I've had bonding on two teeth: the first time in the late 1980s, when my dentist at that time offered an early form of bonding to cover the white bright white spot on each of my top central incisors when they grew in. . . . and the second time approximately 7 years ago, when minor gum recession over a premolar revealed a small yellowish patch of exposed dentin (i.e., not covered with enamel) on the neck of the tooth. Although the bonding on the front teeth lasted almost 25 years, I'm not sure if I was just so happy to have those spots covered (or maybe just unobservant), but I never noticed any serious staining or mismatching of color worth worrying about. As for the bonding on the premolar — it was the result of a "compromise" with my dentist" who was so pleased with the recently completed enhancements to my smile (i.e., an implant to replace a failed post and crown on one of those incisors . . . crowns to match on the 3 adjacent teeth . . . and Invisalign to broaden my narrow upper and lower arches), he felt a crown on that molar would perfect the project. Although it sounded like a great idea, I was reluctant to grind down the tooth for the sake of a crown . . . agreed to bonding — at least temporarily . . . and have never gotten around to switching to a crown. Although close in color to my other crowns, because the composition of bonding products differs from that of porcelain crowns, it does not look like a perfect match to me, but the difference probably is not noticeable to anyone else. "And how does the dentist get such a perfect match in color and shape?" Personally, I believe how well a crown or veneer matches the adjacent or nearby teeth probably depends on the skills, talent and artistic eye of the dentist . . . but tools (like molds to make impressions and charts to compare colors) generally are used in the process. However, bonding to repair chips and other damage (like the kind I experienced) are handled differently; at least mine was. My dentist used a chart to select a color for the bonding material, which he prepared at a nearby counter, just out of eyesight from my chair, so I'm not sure if it already was colored or if he added color to the "raw" mixture. He then used a small instrument to apply it manually to my tooth, shaping it as he worked. Once he was satisfied with the shape, I think I was asked to sit in the chair for several more minutes while it "cured." I don't recall the use of a light, although I'm sure one was used the first time my teeth were bonded. "And does the composite last for 15 years if well maintained?" The most recent bonding was only placed 7 years ago, so I don't know how long i will last; but as mentioned above, my first experience with bonding lasted 25 years. Just one more note on whitening: While whitening one's natural teeth before receiving crowns, a bridge or partial makes sense — especially for patients interested in a whiter or brighter smile . . .it's also worth remembering that it's not a permanent solution. While porcelain-clad prosthetic teeth (crowns, bridge or partial) don't attract permanent stains, any that show up usually can be removed with professional cleaning; however the whitening of natural teeth usually has to be redone (topped-off) periodically. (The reason the iniital whitening is done BEFORE major dental work is because if a patient later wants a brighter color, the porcelain can't be changed. Since the products used in bonding are man-made, their surfaces are different than both natural and porcelain teeth. In other words, if you want to avoid surprises (or the necessity of replacing the bonding on your chipped tooth) . . . you might want to discuss with your dentist (a) how stain-free the bonding product he intends to use will be; (b) if it will respond to topping off the same way your natural teeth will when the time comes for that; or (c) if any difference in color after whitening (compared to your natural teeth) will be so noticeable, you will have to replace the bonding immediately. Hope this info helps and that it doesn't confuse you more than you were before asking;

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