Archives for February 2021

My new dental bonding is turning dark

Posted on February 28, 2021 by AllSmiles.

I’m not sure how to get out of finishing dental treatment with my dentist. I found the dentist after I fell off my bike and chipped four teeth. He examined my teeth the day after I fell and took x-rays to make sure my teeth were stable. I didn’t have a regular dentist, so he offered to fix the chips with bonding whenever I was ready. I like the dentist because he is friendly and doesn’t pressure or try to upsell me. So a month later, I scheduled an appointment for dental bonding. Within two weeks, the bonding began to look a little darker. Unfortunately, I scheduled some other work with this dentist, but now I wonder if I made a mistake because the bonding doesn’t look good. Am I able to whiten the bonding myself? – Thanks for your help. Vernon

Vernon,

Unfortunately, dental bonding cannot be whitened. Although you cannot find a product to whiten it, Supersmile toothpaste is designed to maintain boding and keep it in good shape.

Why Is New Dental Bonding Turning Dark?

New dental bonding can turn dark if a dentist uses inferior materials or is not maintained properly.

Inferior bonding materials – Inferior bonding materials, which most general dentists stock, can wear or stain quickly. Advanced cosmetic dentists keep a variety of high-quality composites available to match tooth color and translucence.
Improper maintenance – After you receive dental bonding, your dentist should give you instructions for cleaning and maintaining it. Some basics for caring for dental bonding include:
Hygiene – Daily floss between your teeth and brush them daily with non-abrasive toothpaste. Avoid using abrasive products like baking soda to try to brighten your teeth. If a dentist or hygienist other than your current one works on your teeth, tell them which teeth have bonding on them.
Avoid unnecessary stress – Avoid biting sharp or hard objects or using your teeth to open them.
Limit things that can weaken or stain bonding – Excessive drinking can weaken dental bonding. Dark drinks like coffee, tea, and cola can darken your natural teeth and dental bonding.

High-quality dental bonding restores teeth and retains its color

Since your bonding is new, you can return to the dentist and ask him to freshen or polish your bonding. Although you had an emergency appointment with the dentist that he handled well, it doesn’t necessarily mean that the dentist has advanced cosmetic dentistry training. If you feel comfortable, you can give the dentist a chance to improve your bonding. Otherwise, you can find an accredited cosmetic dentist and ask for a second opinion.

David Finley, DDS of Monroe, LA, sponsors this post.

Is my sinus perforation after tooth extraction healing?

Posted on February 25, 2021 by AllSmiles.

After I had an upper wisdom tooth extracted in January, my cheek and nose were swollen. My nose started running with yellow mucus that smelled. The same yellow stuff was coming out of the tooth socket, too. I returned to the oral surgeon, who said I have a small sinus perforation. She prescribed Augmentin. The swelling went down, but after taking a CT scan, the surgeon said the sinus was completely infected. I finished a Z-pack, but some yellow draining is still coming out of the tooth socket, although it is not as bad as it was. My gums feel okay, a 3-4mm hole is left, and I feel slight pain and pressure in my sinus. Now I clean the site with the surgeon’s prescribed rinse and saltwater rinse. I use Flonase, too. Although I rarely am congested, I still feel sinus pain and pressure. Does it sound like the infection is improving, or should I visit an ENT? I’m anxious about needing surgery and sedation to correct this. Thank you. Kyle from GA

Kyle,

Thank you for your inquiry and thorough description. Although Dr. Finley would need to examine your tooth and CT scan, some things about your situation are unusual.

Sinus Perforation and Infection

It is unusual for a sinus perforation after wisdom tooth extraction to lead to an infection. Your tooth was probably severely infected before the surgeon removed it. Augmentin controlled the infection that caused facial swelling, but you need a Z-pack for the sinus infection. It seems that something might have infected your sinus during the extraction—maybe something was pushed into your sinus.

The infection must be removed first when an infection is still draining through a sinus perforation. Otherwise, closing the perforation will trap the infection and cause it to spread.

Persistent Pressure with Sinus Infection

If you still feel some sinus pain and pressure, you may need a refill of the Z-pack. It would be best to continue taking the antibiotic until the infection is completely gone to prevent relapse and antibiotic resistance. Continue to take the Flonase as directed. It is a corticosteroid that will reduce sinus inflammation.

Photo of a young woman who has received sedation dentistry and is relaxing in the chair during treatment.

Sedation and surgery for a sinus perforation are probably not needed for this case

Although we do not have all the facts about your situation, it sounds like your oral surgeon’s treatment is effective. At this point, you do not need to worry about seeing an ENT and needing surgery and sedation. It is unlikely that your condition will get worse, but if it does, your oral surgeon will handle it or refer you to a specialist if needed. Ensure your oral surgeon knows about the draining; she will probably refill or re-prescribe the Z-pack.

We hope you will have a steady recovery.

David Finley, DDS of Monroe, LA, sponsors this post.

My denture adhesive doesn’t help much. Which brand is best?

Posted on February 23, 2021 by AllSmiles.

After wearing dentures for 28 years, denture adhesive barely keeps them in. My dentist has relined my denture three times and keeps telling me to switch up the adhesives brands that I use. Relining my dentures and trying different adhesive brands are not helping much. Which brand of adhesive is best? Thank you. Elise from TN

Elise,

After many years of wearing dentures, what you are experiencing is common. We will answer your question about denture adhesives, although changing the brand probably will not help in your case. More importantly, we will explain why dentures loosen over the years and what you can do about it.

Which Brand of Denture Adhesive Is Best?

Some of the best brands of denture adhesive are approved by the American Dental Association (ADA). A denture adhesive brand earns the ADA seal by providing scientific evidence that it is safe and effective. The evidence must support these facts about the adhesive:

Increases biting force
Increases denture retention
Will not damage your denture

You can visit the ADA’s website to find denture adhesive brands that earned the ADA seal of acceptance. One of the brands might be right for you, but you may prefer another brand. But when all your teeth are missing, and you’ve been wearing dentures for years, even the best adhesives will not help.

Why Do Dentures Loosen Over Time?

Photo of natural-looking upper and lower dentures.

Without dental implants, even well-made dentures will loosen over the years

Dentures loosen over time because when all your teeth are missing, your jawbone shrinks. Without tooth roots to stimulate the bone, your body will resorb the bone and use the minerals from it elsewhere.

Jawbone shrinkage creates several problems

When missing teeth cause your jawbone to shrink, several problems result:

Your denture will not stay in – When a denture rests on your gums, as the bone shrinks, the denture can easily lift, shift, or fall out. Eventually, you will not be able to wear a denture.
Denture irritates the bony ridge – A loose denture will rub on your gums and remaining bone, irritate them, and make them sore.
Facial collapse – Shrunken jawbone causes your facial muscles to sag.

How to Prevent Dentures from Falling Out

You can prevent dentures from falling out by building up the jawbone with grafting and stabilizing the dentures with dental implants. Although some implant techniques—like All-on-4 dental implants—eliminate the need for bone grafting, not everyone is a candidate for them.

Look for a dentist with post-graduate dental implant training and years of experience with implants. Schedule a consultation with one or two implant dentists. The dentist will explain your options for implant-supported dentures. If your budget is limited, a dentist can secure your dentures with as few as two implants. Your dentures will be stable and relieve much of the anxiety associated with loose dentures.

Best wishes.

David Finley, DDS, a Monroe, LA fellow of the American Academy of Cosmetic Dentistry, sponsors this post.

My tooth is turning black. What’s the right treatment?

Posted on February 15, 2021 by AllSmiles.

Last month I saw an endodontist for a left canine tooth that has gotten darker and darker over the past four years. The endodontist examined my tooth and took an x-ray. She said there is a faint fracture across the tooth, and I have the option of getting a root canal.

I think that I will pass on the root canal because the endodontist didn’t think that it would improve the tooth color. I’ve never had a root canal, but it seems that the tooth would become weak from her description of it. I’m afraid of making things worse and causing the tooth to fall out. Then I would need a dental implant. Will a cosmetic procedure help or would it weaken the tooth, too? – Thank you, Rene from Montgomery, AL

Rene,

You are wise to pass on getting root canal treatment. If your tooth is not infected, you do not need the procedure. And if your tooth is fractured, root canal treatment increases the risk of causing the fracture to expand.

Why Causes a Tooth to Turn Dark?

A tooth can turn dark for several reasons, including trauma, decay, amalgam fillings, some medications, a medical condition, and tobacco use.

Trauma – When trauma affects your tooth, secondary dentin (the layer beneath the enamel) builds us. The buildup can darken the tooth and cause the tooth pulp (living tissue in the tooth) to shrink.
Decay – Tooth decay destroys dental enamel and darkens teeth.
Amalgam fillings – As they age, amalgam (silver), fillings darken and make teeth look dark.
Prescription medication – Certain medications, including tetracycline and some antihistamines, can stain or darken teeth. Research side effects for any medication you are taking.
Medical conditions – Liver disease, gastric reflux, eating disorder, some metabolic diseases are some medical conditions that can darken teeth.
Tobacco – Smoking or chewing tobacco stains teeth.
Poor oral hygiene – Stains, plaque, and tartar build up on teeth and discolor them.

Treatment for a Darkening Tooth

Diagram of of three side-by-side dental implants: 1 - implant components, 2 - implant root in the bone with abutment and crown above it, 3 - all components in place and in the jawbone.

Whenever possible, preserve a healthy tooth rather than replacing it with an implant

If your tooth is not decayed or infected and there is no other diagnosis for it, a cosmetic dentist can conceal the darkness with a porcelain veneer or composite bonding. An otherwise healthy tooth would not require extraction and a dental implant.

We recommend that you look for a skilled cosmetic dentist to apply the bonding. Advanced cosmetic dentists have a variety of composite in the office to blend the correct shades and match the color, gloss, and translucence of your natural teeth. Few general or family dentists have the training and materials required to achieve natural-looking results.

David Finley, DDS, of Monroe, LA, sponsors this post. Dr. Finley is an Accredited Fellow of the American Academy of Cosmetic Dentistry and a Fellow of the Academy of General Dentistry.

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