Pediatric Sealants Aren’t Working

I don’t know what’s going on. My dentist insists my son’s sealants are on, but I don’t think they’re working. My son’s teeth look horrible. Will the sealants keep whitening from working? His teeth look so brown to me. He brushes. I’ve even started watching him to check, which really annoys him.


Dear Kathy,

Four children one behind another smiling

I wanted to go over dental sealants with you because there seems to be a miscommunication somewhere either between you and your pediatric dentist, or possibly I’m not understanding what you’ve written. Sealants are meant to go on children’s back molars. Those have deep grooves in them which are nearly impossible for them to get clean. Because of that, we’ll place sealants on them which keep things from getting down in there. They don’t cover their front teeth in any way.

The makeup of baby and adult teeth are slightly different. With baby teeth, the enamel over the dentin is not translucent which makes their teeth look brighter and whiter. Adult teeth are very translucent which can show more of the dentin underneath. That has a yellowish color. If your comparing the color of his adult teeth to his baby teeth, the newer teeth will look less attractive in comparison.

When Children’s Teeth Look Dark

Children’s bodies and dental health are as varied as their personalities. It sounds like you’ve been monitoring his brushing and he’s doing that fine. Have you noticed if he intakes and staining beverages or foods? While most children don’t drink coffee, I’m often surprised how many of them drink iced tea. That can make someone’s smile brown looking quickly.

There are also certain spices which stain your teeth as well. If you’ve checked all these obvious culprits, the next thing to do is look into medication he may be (or have) taken. For instance, certain vitamins and antibiotics stain teeth. Tetracycline stains are some of the worst teeth stains to deal with. Not even teeth whitening makes much headway with them.

Another possibility is that your son has thin enamel, which will reveal more of the dentin. There are steps that can be taken to help that. Have a good talk with your pediatric dentist to get to the bottom of his coloring. If he or she doesn’t know what to do, try a cosmetic dentist that enjoys treating children.

This blog is brought to you by Drs. Kevin and Hillary Peck.

Are There Affordable Dentists Who Care?

I hadn’t been to a dentist in years for financial reasons. I started to get worried about my oral health, not because of any specific issues, but it’s just been in the back of my mind. I did an internet search for affordable dentists and found two in my immediate area. I’ve been to both of them. They were both awful. The first one was just plain smelly. I don’t know why. It’s like he just didn’t care about bathing. I could barely stand to stay in the chair because of them smell. I know he said I needed some work. I expected that. But, I can’t remember anything he said because I just wanted out of there. I don’t think I could go back to him if it was free. The next one at least cared about personal hygiene. He was a bit rough in how he handles patients. He told me I have a tooth that could go any minute. I could try to save it with a root canal and crown or I can just extract and replace it. I tried to ask him some questions but he said he doesn’t have time to answer patients. I can call the office and leave a message and one of the hygienists will get back with me. On the way out I told the desk lady I didn’t understand why he doesn’t answer patient questions. She said if I want low prices he needs to keep people moving so he can make up profit losses. Is it possible to get quality service by a dentist who cares AND affordable prices? Please don’t make me go back to Mr. Stinky.


Dear Elaina,

Dollar sign hatched from an egg
Cheap does not always equal affordable.

It’s great that you’re working so hard to find a dentist which you can afford. It’s a shame your choices have been so limited. It doesn’t mean you won’t be able to find one, though you may have to go outside of your immediate area if those were the two closest choices.

Reasons Dentists Choose to Have Affordable Prices

There are several reasons dentists may choose to have prices that are lower than the average around them. Some of those motives are better than others, as you’ve unfortunately experienced.

  • To Draw in Patients

This isn’t a bad motive (in some cases). It mostly depends on why they need to draw in patients. Sometimes it is simply a matter of being a brand new practice. They haven’t had time to develop a patient base. We’ve all had to start somewhere. However, other times a dentist isn’t that great. They need to draw in patients because they have horrible patient retention. The only way to keep their income going is to lower their prices and draw in new victims.

  • Compassion

Other dentists simply know that every human being is working at a different budgetary level. They don’t want the working poor to be without dental care simply because their current job salary or life circumstances make affording those types of things feel like a luxury. Many of them have been in difficult circumstances before and still remember what it felt like.

Their quality doesn’t suffer from their compassion. Often you won’t find them the absolute cheapest, though. Why is that? Because they also think patients deserve quality care. They refuse to sacrifice their patients at the altar of cheap parts to make up profits. That leads me to an important warning.

A Cheap Dentist isn’t an Affordable Dentist

A man holding his jaw in pain.
When a dentist uses having the lowest prices to draw patients in, sometimes they try to make up the profits by purchasing low quality (cheap) materials. One place we’ve seen this often is with dental implants.

In the United States, an implant fixture can cost several hundred dollars. That’s because we have high medical standards and regulations designed to keep the safety of patients in mind at all times. But, if a dentist wants to come in significantly lower in price than his nearby peers he has a couple of choices: make less money or make up the profits somewhere. Too many of them choose to make up the profits elsewhere. The dentists can simply purchase is implant part from out of the country for just a few bucks, saving him hundreds on just one phase of the procedure. Unfortunately, those cheap parts have led to many infections causing not just a dental emergency, but complete implant failure. I’ve even seen some patients come for help because their implant simply snapped in half.

Now, that patient has to start over again, missing more work. Plus, in addition to having to get their dental implants done again from scratch, they have to add bone grafting to the mix because dental implant failure removes too much bone structure. Instead of saving money, they end up paying more than double.

How do You Know if You’re Getting a Good Affordable Dentist?

There’s no foolproof way to ensure yourself against a dud, but there is one simple step you can take— check their reviews. People post reviews of their experiences when they’ve either been very good or very bad. Either way, you’ll have some idea of what others experienced at the dentist’s hands.

This blog is brought to you by Drs. Kevin and Hillary Peck.

Can Lower-Middle Class Afford Lumineers

The kids at school have been making fun of my teeth. I thought this would stop after I was done with braces, but for some reason, my teeth developed some white spots on them during my braces. They keep pointing that out now. I’ve been thinking I should get one of those smile makeovers that Lumineers advertises. But, my mom works hard and stresses over money, so I don’t want to bother her if it’s not affordable. She works at a clothing store in the mall and sometimes drives for Uber at night. Is this do-able for her or would I just be stressing her more? I know the braces weren’t easy for her to pay for.

Kara L.

Dear Kara,

An advertisement for Lumineers

First, I want to commend you. You seem to be both considerate and mature. Your mother should be proud of you. It distresses me the way young people can be so cruel to one another. Even with you feeling the brunt of some of that cruelty, you’re still considering how this will affect your mother. That says so much about your character.

Next, I want to make sure you understand that Lumineers is simply a brand of porcelain veneers, just like there are many brands of clothing at the store your mother works.

While there are many different brands, each of them has different strengths and weaknesses. Even if you and your mother decide porcelain veneers are a good option for you, the dentist will know which brand is more likely to give you the smile you want.

Are Lumineers Your Best Solution?

A woman and her dentist smiling
A Good Dentist Tells You All Your Options

It sounds like you’re still in high school or possibly even an extremely articulate middle-schooler. What that means for your dental care is your jaw and bite are still developing. Something, like Lumineers or some other brand, will have to be re-done several times as your jaw and bite change. Porcelain veneers cost between $1,000 to $2,000 per tooth. That is a very pricey procedure to have to re-do several times. I can’t imagine if your mother struggled with braces, this will likely be out of her reach.

But, don’t despair! There’s always more than one solution to a problem! There’s one for you too.

You’re concerned about the white spots which developed on your teeth after your orthodontics. Based on what you’ve said, you developed some decalcification on your teeth. This is a common problem with braces. Lumineers won’t fix the spots. It’s possible they could hide the color differences. But, Lumineers are an ultra-thin brand. Without some color manipulation and possibly some filling, it’s possible the blotchiness will show through.

There is a way to fix the decalcification spots, though, using tooth mousse or some other method. I think your best solution is to discuss with your mother what’s been going on at school. Ask her to make an appointment with a cosmetic dentist just to find out what options you have. Some will even do a complimentary consultation in situations like yours. It doesn’t obligate you to anything, just informs you of all the possibilities, along with their differences in price.

This blog is brought to you by Drs. Kevin and Hillary Peck.