Archives for February 2020

Will a Root Canal Treatment Damage My Porcelain Veneer?

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I just had eight porcelain veneers done and now I found out one of them needs a root canal treatment. I’ve read that a root canal treatment can turn a tooth dark and I don’t want that to ruin my veneer. I really like them. I can’t imagine why I’d need a porcelain veneer. I’ve been so careful taking care of them because I’m happy I finally have a smile I like and I don’t want it ruined. What do you recommend?

Lisa

Dear Lisa,

I’m concerned about why you needed the root canal treatment to begin with. I hope this wasn’t the result of your dentist being too aggressive. When teeth are being prepared for porcelain veneers, it doesn’t take much. At the most, your dentist should remove about half a millimeter.

photo of tooth preparation for porcelain veneers

The photo directly above shows a depth limiting diamond bur being used to prepare some teeth for porcelain veneers. Using a tool like this helps protect the tooth from the dentist going too deep in the preparation. Some dentists get carried away and will reach the dentin. Others will actually do porcelain crowns and just call them porcelain veneers. When doing a crown the dentist has to grind the teeth down to nubs.

Protecting the Beauty of Porcelain Veneers with a Root Canal

There is a way to help prevent the darkening of the tooth which needs the root canal treatment. Most of the darkening comes from the root canal filling material itself. This can be significantly reduced by following the procedure I’m about to outline.

1. Have your dentist clean out all the material from the crown of the tooth.
2. He or she should then place a white fiberglass post into the root.
3. Fill the remainder of the space with a light/white colored composite material.

Doing this will delay any darkening for quite a few years.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Teeth Whitening with Peroxide

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I’ve done some reading and learned that the main whitening ingredient in teeth whitening is peroxide. If that is the case, can I just rinse with peroxide to whiten my teeth?

Kurt

Dear Kurt,

teeth whitening trays

You ask a good question. It seems like it would make sense, right? Rinsing with peroxide may have some extremely mild whitening benefits, but I don’t think it will be anything near what you are hoping for. One of the biggest obstacles you’ll face is the fact that the whitening agent has to soak into your teeth. That will need to happen for a minimum of 15 minutes to have any decent use. I don’t know if you’re willing to rinse with peroxide for that long.

With the teeth whitening you get at a dentist’s office, your dentist will make custom-fitted trays that fit your bite exactly. You’ll wear them, for a minimum of 20 minutes, at a time convenient to you with the whitening gel inside. Many patients prefer to sleep with the trays on.

A second issue is its strength. The peroxide you get for home use is 3% peroxide. Crest Whitestrips has a strength of between 5-6%. These are significantly less strong than the whitening you get with your dentist. Professional strength teeth whitening will be between 15-43% peroxide.

It would take many years for you to get the same effect you would from a visit to your dentist. By the time you purchased all that peroxide, you will have spent almost as much. You just dragged it out over years.

In all honesty, you’re better off seeing your dentist for teeth whitening. You can do at-home whitening with the trays or in-office whitening with Zoom Whitening which allows you to whiten your teeth completely in just one appointment.

Plus, you have the added benefit, because you will be under the care of a dentist, of having someone there in case complications develop, such as gum sensitivity.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Dental Implants with Metal Allergies

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I am 63 years old and lost my first tooth. This old fella has his pride though and I want the best replacement possible. My dentist told me that would be dental implants. I did some reading and it looks like they are made of metal. What if I have metal allergies? I’m allergic to nickel and cobalt. Is there a metal substitute for dental implants?

Elijah

Dear Elijah,

dental implant being placed in three stages

The older I get, the less 63 seems old. I’m glad you are looking for dental implants as your replacement though. Your dentist is right. It is the best tooth replacement. Nickel and cobalt allergies are fairly common. I hope you’ve told your dentist about them, because there are certain things he will want to avoid in your dental care. One that will be especially important for you is to only get mercury-free fillings.

As for dental implants, they are made completely of titanium. These are highly biocompatible and it is quite rare for someone to have an allergy to one.  Titanium has been used for decades in multiple types of joint replacements, such as hips. You should be just fine to have traditional dental implants.

However, if you are concerned, you have a couple of options. First, you can have allergy testing. You will want the testing to be specific to titanium. A second option is to find a dentist who is willing to place zirconia dental implants. Zirconia is known as ceramic steel and is strong enough to place a dental implant. They have been doing quite well.

The only reason some dentists hesitate to use them is they don’t have the long term data the titanium implants do. That’s because they’re new and not because they are inferior. It could be in two decades the data shows them to be superior. It takes time to gather that kind of data though.

Where Your Dental Implant is Placed Matters

If your dental implant is placed in a visible place, your dentist can make it match your teeth perfectly. You need to be aware, however, that the color the implant is made is permanent. If you are happy with the color of your teeth, then you’re good to go. If you are considering whitening your teeth, you will want to do that before the implant crown is made.

Once your teeth are whitened, your dentist can match the crown to the new color and you’ll be happy with it on a more permanent basis. If you are in a hurry, some dental offices offer Zoom Whitening which can be done in one appointment.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.