All posts by writeradmin

writeradmin writes blog posts on behalf of Dr. Kevin Peck
Teeth Whitening

Dealing with Brown Spots on Teeth

I have very healthy teeth. The one thing that bothers me about them is the fact that there have been brown spots on some of my adult teeth ever since they came in. I’ve been told that this is because of a fever I had as a child. My dentist has been trying to help me. We’ve tried just about every over-the-counter whitening kit we could find. But none of them have done what we were hoping. She’s considering trying something where she grinds down the brown spots a bit to get to the white underneath. However, she’s not sure how much she’d have to grind. I’m a bit nervous to do this. Would professional teeth whitening do better than the stuff we’ve been trying from stores? She probably wouldn’t mind me going somewhere else just for this.

Elaine

Dear Elaine,

Teeth whitening trays
Teeth Whitening Trays

Please don’t let your dentist grind down the enamel on your teeth. I can tell that she means well and is trying to help, but she is in over her head. She can do some serious damage to your teeth. Teeth whitening is the easiest of cosmetic procedures and she has a fundamental lack of understanding about how that works. She is probably a great family dentist, but cosmetic dentistry is out of her reach, at least right now.

Unfortunately, professional teeth whitening won’t give the results you are looking for. They will whiten your teeth evenly, which means the rest of the tooth surrounding the brown spots will get whiter. This has the effect of making your brown spots look worse instead of better.

You do have a couple of good options, but both of them will require an expert cosmetic dentist. The first option is dental bonding. This uses a composite resin, where the dentist can sand the spots and then add the bonding on top to cover it. It has to be done freehand and very few dentists do this well.

A second option is to get porcelain veneers. This is what celebrities go to for that complete smile makeover. These use tiny wafers of porcelain to change the shape, size, and color of your teeth.

This blog is brought to you by an affordable Phoenix Dentist, Dr. Hillary Peck.

Dental implants

Does My Dental Bridge Have to Be Replaced?

I have a bridge on my upper right side. I was in for a regular appointment and my dentist said that one of the teeth that he called an anchor tooth was cracked and because of that I needed to replace my entire bridge. If I have no pain or symptoms, could he be wrong? If not, is there another option?

Sandy

Dear Sandy,

An illustration of a dental bridge versus a dental implant.

I am a bit sceptical of your dentist’s diagnosis. Here is why. First, it would be highly unusual for a tooth with a dental crown on it to get crack on it that needs to be extracted. When a tooth is cracked, the usual solution is to place a crown on the tooth in order to protect it. Second, you have not had any symptoms. If a tooth is cracked, you would normally have a sharp pain whenever you bit down on the tooth. I can’t say no dentist has seen a tooth with a crown of it have a crack at the root, but I’ve never heard of one.

Needing to replace an entire because of one problem (even though I’m not convinced your dentist diagnosed you correctly) does illustrate one of the downsides of replacing a missing tooth with a dental bridge instead of a dental implant. Not only do you have to place a crown on two healthy teeth which are adjacent to the fake tooth, but if anything goes wrong with one part of the bridge, the entire unit needs to be replaced.

On the off chance that something is seriously enough wrong with the adjacent tooth that it does need to be extracted, you have a couple of choices. First, you can get another dental bridge, but the second one would need to be even longer. Just be aware that the more extended the bridge the greater the pressure on the anchor teeth (the teeth with crowns on the end of the bridge). Another option is to replace those two teeth with dental implants. Sometimes it is possible to do one implant for two teeth that are right next to each other.

My suggestion is you get a second opinion on that tooth. Don’t tell them the dentist or his prognosis. Instead, just go and say, I want a second opinion on my tooth.

This blog is brought to you by a compassionate dentist in Phoenix, Dr. Hillary Peck.

Root Canal Treatment

Root Canal Hurts Again

I had a root canal treatment. It hurt for a bit afterward, then it stopped hurting. A few days later it started hurting again. My dentist said that it is normal for tooth pain to gradually increase after a root canal for several days. I’m just worried about it because I was fine. Have you heard of this happening?

Lisa

Dear Lisa,

Illustration of a root canal treatment

While it is true that pain after a root canal treatment can increase and then peak a few days later, that does not seem to be what you are describing. You said the tooth did that but then stopped hurting. Then, a few days after that it began hurting again. That is a completely different scenario.

What you are describing could be a failed root canal treatment. There are lots of canals in those back teeth and some can be tucked away somewhere that the dentist may not be able to find it easily. I would make the clarification with your dentist that it had recovered and started hurting. There may still be an active infection there.

It is better to have it looked at than to leave it, assuming everything is fine, and then have it blow up into a dental emergency. It could be that a second root canal treatment can solve the issue. Or, it might be that this tooth cannot be saved and it will need to be extracted. If it does need to be extracted, make sure you replace it. Otherwise your other teeth will shift and that will throw off your bite and could lead to migraines. The best tooth replacement option is a dental implant.

This blog is brought to you by a gentle dentist in Phoenix, Dr. Hillary Peck.

Teeth Whitening

Pain with Teeth Whitening

I have been whitening my teeth for a few weeks. It has recently started having a sharp pain for a few seconds. I think the pain is emanating from the repair I had done on a chipped tooth several years ago. That tooth was repaired with dental bonding. They did tell me that it would have to be replaced periodically. Does that zing mean that it is time to replace it or is the bonding being damaged by the teeth whitening?

Harper

Dear Harper,

Teeth whitening trays
Teeth Whitening Trays

Teeth whitening gel has not been known to weaken dental bonding. If, by some odd chance, the bonding was weakened, the repaired part of the chip would just fall off. I don’t think it would cause zings of pain but stay in place.

The type of pain you are describing could be from an exposed part where there is bonding that the bleach has caused to be sensitive. If that is the case, then your dentist could coat that part and you would be able to whiten that area without pain.

This is one of the important reasons to do bleaching under the care of a dentist. They should be checking your teeth for any weakened fillings, etc. and shore them up before you start your whitening. In fact, I know of a woman who did over-the-counter whitening and had a weak spot on her teeth. This led to her needing a root canal treatment.

This blog is brought to you by a friendly Phoenix dentist Dr. Hillary Peck.
Click here to learn how she keeps dental care affordable.

Teeth Whitening

Did Crest Whitestrips Cause Her to Need a Root Canal Treatment?

I went to my dentist telling him that I’m not happy about the color of my teeth. He suggested Crest Whitestrips. I used them for a bit but then I started having some pain. I took a break from them but even a week later, one of my teeth was still hurting. I went to my dentist and he did a cold test. He said that indicated I needed a root canal treatment. Could this have happened from the Whitestrips? I just wanted to whiten my teeth, especially because my dental bonding on the front of that tooth is starting to stain.

Annie

Dear Annie,

Teeth whitening trays
Teeth Whitening Trays

It would be highly unlikely that Crest Whitestrips would cause a tooth to need a root canal treatment. We generally suggest that people use a dentist for their teeth whitening so that they have professional supervision of their treatment, reducing the chance of anything going wrong.

We don’t worry about that with Crest Whitestrips too much because it isn’t very strong. It’s just not potent enough to do much damage. The one thing which gives me pause is that you said you had a dental bonding repair. It’s possible that your dental bonding had a vulnerability like a small exposed part which allowed the whitening gel to get in there. Then it could cause some damage.

So you are aware, the Crest Whitestrips won’t whiten your dental bonding. In order to get that the color you want, it will have to be redone.

My suggestion is this. Get a second opinion on your root canal treatment. A cold test alone does not necessarily mean that you need a root canal. If you don’t, then get any exposed area of the bonding fixed, then have professional teeth whitening done. From there you can replace the bonding to match the new color of your teeth.

This blog is brought to you by an affordable dentist in Phoenix, Dr. Hillary Peck.

Lumineers

Daughter Teased for Her Lumineers

We had Lumineers placed on my daughter’s teeth to improve her smile. We were told by our dentist that this would be the least invasive. We were also told that we would get to see and approve the results before anything permanent was done. However, that did not turn out to be the case. When they came in, I could tell right away they were going to look too big for her mouth. They did use a temporary try-in paste. We were told she’d get to walk around with them and decide what she thinks, but that didn’t happen. When I expressed concern about them looking too bulky and box-like, they told me that they would look normal once they were bonded in. That did not turn out to be the case, either. I said that and they told me to give it a week and we’d probably love it. When she went to school, the kids teased her mercilessly. Most called her horse teeth. The “nice” kids told her they looked okay but not natural. Now she’s in tears and doesn’t want to go back. I don’t want her falling behind. Now they are saying they can shave them down, but I’ve lost confidence in them, what do I do?

Lisa

Dear Lisa,

A porcelain veneer being held up by a dental tool

Under no circumstances should you allow them to shave your daughter’s teeth. This is a horrible idea that can not only permanently damage her teeth, but will also take off the glaze from her Lumineers. They will be completely vulnerable to stains.

Lumineers are just one brand of porcelain veneers. However, they are highly advertised as being easy to place to inexperienced cosmetic dentists. Unfortunately, that rarely works out well for the patient. It sounds like the dentist who did your daughter’s work isn’t very skilled in porcelain veneers. This is an advanced cosmetic procedure which requires a significant amount of post-doctoral training.

I recommend you just ask them for a refund and then have her work done by a dentist with post-doctoral training.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Teeth Whitening

Can I Whiten My Dental Bonding?

I have dental bonding that is looking pretty rough. My dentist told me that once it is made, I won’t be able to get them any whiter than they were when I made them. What I am wondering is if I could get them as white as they were when I first got them? Will teeth whitening work that way?

Evie

Dear Evie,

teeth whitening trays
teeth bleaching trays

Teeth whitening does not work on dental bonding. In fact, it doesn’t work on any dental work. What it does work on is natural tooth structure.

You didn’t mention how long you’ve had the bonding. It’s only designed to last a few years. Then, it will need to be replaced. If you’re looking for something more permanent, I would look at porcelain veneers. These can last a lifetime if well cared for. Though, they are much more expensive up front.

If money is an issue for replacing them, then you could see if the dentist can polish them up a bit with a special diamond polishing kit. If that doesn’t work enough, your best bet is to wait and save up. Don’t look for a discount. That will end up not looking the way you want it. There are certain procedures you do not want to just go with the cheapest dentist for. Bonding is one of them.

This blog is brought to you by a friendly dentist in Phoenix Dr. Hillary Peck.

Pediatric Dentistry

My Child’s Baby Teeth Aren’t Falling Out

My daughter has some adult teeth coming in, but the baby teeth haven’t fallen out yet. They do not even feel loose to me. Should I take her to the dentist in order to have them removed or just keep waiting? She’s never been to the dentist before. I’m afraid it will be scary if she does have to go in.

Deborah

Dear Deborah,

four children smiling

I am glad that you wrote. I know there is a tendency to think that a child doesn’t need a dentist, especially with baby teeth that will fall out anyway. Many parents have fallen into that same fallacy so don’t be too hard on yourself. Ideally, you want to bring your children in to see the dentist early, well before there are any problems. This way they start life thinking the dentist is fun.

But, the ideal does not always happen. When baby teeth are not coming out, and they won’t even wiggle, then it is time to bring them to the dentist. A dentist who works with children will be able to get those teeth out. If you leave the baby teeth in, then they’ll end up deflecting the adult teeth. That will lead to her needing expensive orthodontics, and the teeth will have to come out either way.

Because it won’t be a simple appointment, you may want to look for a dentist who offers some type of dental sedation. Generally a dentist can help prevent this before it becomes a problem but you are in management mode now.

This blog is brought to you by a friendly Phoenix Dentist Dr. Hillary Peck.
Click here to learn about mercury-free dental care.

Teeth Whitening

Best Way of Touching Up Teeth Whitening?

I’m getting crowns on one of my front teeth. I had whitened my teeth a few years ago and I’d really like to touch them up to get them back to where they were before I get this dental crown done. I asked my dentist about it and he didn’t have any advice for me. What I kind of need to know is how many weeks I need to whiten and for how long each day before I’m ready to get the crown.

Barbara

Dear Barbara,

Teeth whitening trays
Teeth Whitening Trays

I can give you general principles, but not exact amounts. This is because I can’t know how white your teeth are now, nor how white you want them to get. That being said, the general idea is that the longer you wear your teeth whitening trays, the faster they will whiten.

The fastest way to bleach your teeth will be to wear the trays all night. If you can tolerate that, then that would be my recommendation. If that is too challenging for you, then just wear them during the day for as long as you can tolerate them.

The one hard and fast rule I can tell you is that it will be best to wait two weeks after you have finished whitening before you get your dental crown made. This is because the whitening gel will continue to whiten for up to two weeks after you stop.

Because this is a front tooth, make sure that your dentist provides an all-porcelain crown for you instead of a porcelain fused to metal crown. Otherwise it won’t look as natural. Plus, metal based crowns eventually develop a gray line at the gumline.

I am a bit concerned that your dentist could not give you this information. It is all pretty basic. A dental crown on a front tooth is a tricky procedure. If he can’t handle teeth whitening, then I worry that he won’t be skilled enough to give you a beautiful result on your crown.

This blog is brought to you by a friendly Phoenix Dentist Dr. Hillary Peck.

Affordable Dentist

Dentist Used a Cheap Alloy and Called It a Gold Crown

I went to a new dentist because I needed a dental crown. I asked for a gold crown. Unfortunately, I had a weird feeling that is not what I got. I asked him for the alloy certificate he told me that they didn’t give it to him. I asked him to get it, which he did. There was only 2% gold. The rest was 35% Palladium, 30% Indium, 30% Silver, 3% Zinc. Now I feel cheated. Should I be concerned about any systemic issues from the palladium and indium? I’m mad and worried.

Jack

Dear Jack,

Yeah, I’m not having a lot of faith in your dentist. First, he lied to you in order to provide a cheaper alloy. If he charged you for a true gold alloy then he stole from you, too. In order for something to be considered a gold crown, then it requires a minimum of 40% gold. I also believe he lied to you about the alloy certificate. Labs are legally obligated to provide the dentist with the certificate, who in turn is supposed to place the certificate in your file. My guess is that he threw it out and then got another one when you asked about it.

My suggestion is that you tell your dentist that if he doesn’t give you a refund or replace the crown with a true gold crown you will contact the dental board. You should also switch dentists as soon as possible. I don’t think that you have anything to worry about with the iridium or palladium. If you did, you would be seeing some type of inflammation on your gums.

This blog is brought to you by friendly dentist Dr. Hillary Peck.
Click here to see how she keeps prices affordable.