June 22, 2016
You will see my post from several years ago about teeth and white spots. Some white spots are due to acid damage and a period of reduced brushing effectiveness or higher sugar diet. This can be common after braces because it is harder to clean around the wires.
Other white spots are more natural occurring as a hypomineralised layer of the tooth surface that appears frosty. Some of these are very superficial and and be removed in less than 5 minutes with a mild acid that we use for tooth bonding, followed by a fine mineral particle that helps clog the porosity and allow the tooth to regain it’s transluceny. Here is another case we did last week.
July 10, 2010
I’ve shown this young guy before. We are just picking away at it a bit at a time. The most rewarding thing is this patient has listened to everything about home care and prevention and is looking after things beautifully. See how the gums are pink and healthy and the remaining decay is so clearly visible. Without good home care, nothing will last.
This was the first day we met.
The front 2 right teeth we managed to avoid exposing the nerve in the centre of the tooth despite severe decay. They have temporary fillings to keep things stable until we sort out the remaining teeth. The 2 teeth further back have permanent composite resin restorations placed.
This was today before we started to tackle the upper eye tooth and tooth behind. So far this has been four visits at about $300 a trip. We are just going at a rate our patient can afford. I’ll keep future updates as I get time.
Here is the latest.
December 14, 2009
Not all people want perfect even teeth. This patient of mine was concerned about the discolouration and poor longevity of the resin bondings that had been done on her front teeth. While is would be possible to do orthodontics and straighten these teeth, the patients chief concern was to keep her smile looking ‘like me!’ – that is, to maintain the crowded appearance which created character that she had had all her life.
The most conservative option was new resin bonding to replace the discoloured fillings, but the two smaller lateral incisors had more extensive damage. We opted for a veneer on one and a crown on the other. You can see by the following photo that a crown is a more aggressive approach (right) than a veneer (left). The bondings had been redone at this stage.
I think the final results have been fantastic – it is very difficult to match one tooth and often people get 6 or 8 front teeth done together to make an easier colour match. Although this was more difficult, it ended up with must less damage to the mouth overall.
I thought I would share it. Happy New Year!
December 9, 2009
This patient was a pleasure to treat. As you can see there was some crowding issues with the front 2 teeth and all the teeth were quite dark. We bleached the teeth using at home tray whitening for a couple of weeks, and match full porcelain Empress crowns cemented onto the front 2 teeth. The full porcelain allows the light through them just like natural teeth so the result is very aesthetic. Traditional porcelain fused to metal crowns (PFM’s) tend to result in a more opaque ‘non-vital’ appearance.
December 8, 2009
Well, I have been a bit slack in writing new info. It takes time to get interesting photos and new ideas, although I see them every single day at work. I guess this post is to ask people for their dental problems, queries. I am here for free consultation – obviously I can’t look in your mouth, but I can give advice generally about dental questions you have. It will give me more info on what are the dental concerns people have that I can help with via the net. I mostly get wisdom tooth questions but thought this post might stimulate some others.
I’ll have a post coming soon on bleaching and full porcelain crowns for crowded front teeth based on an interesting patient I have just had the opportunity to help. Come and check it out in the next day or so.
February 28, 2009
Just a quick case that came in the other day. There was decay in the pit on the side of the tooth which had penetrated all the way to the metal filling in the top of the tooth. These old metal fillings also swell and corrode over time. With chewing and cycling of hot and cold food/drinks, the teeth can crack. (you know – that wonderful uh-oh moment while eating crackling at Christmas). By the way – note the old white resin sealant on the tooth behind aimed at preventing getting the decay in the groove in the first place.
Tooth coloured resins are ideal in this situation. They bond to the tooth – especially to enamel above the gum, and help restore the tooths former strength. They may have to be replaced more often than the old metal fillings due to chipping or wear – but generally technology has advanced to the point where these are the first choice material for such cavities.
Apart from that they look great.
February 16, 2008
There are many ways to whiten teeth. This is what I have been investigating for a long time. The over the counter options are usually limited due to the strength of the bleach. Most dentist prescribed whiteners are 10 -20% Carbamide Peroxide, while chemist bought bleaches are usually 1-2%. Whitening toothpastes are not of sufficient strength and are only in the mouth for a minute or two so there is a negligable effect with these.
The key is to get a strong enough bleach on the tooth for a long enough time. We have started using a sopisticated system to make the best fitting home bleach trays EVER! I imported the technique from The States in December and now have bleaching trays that fit beautifully. This means the gel stays on the teeth, and saliva can’t dilute it. The results have been amazing.
The icing on the cake is to try deep bleaching – a specific technique using in surgery bleaching combined with at home bleaching. I have just started a few cases and have been really impressed to finally get some predictable results.