Dr. Guy M. Lewis

The ingredients of the whiteners you get at the dentist office are the highest concentrations of the active ingredients, which is more efficient in changing the color of the teeth. They work better and will give you a better result, but I will say that over-the-counter whitening products do work. They just take a lot longer. Crest Whitestrips for example work; however, they don’t cover all of the teeth, which is one drawback. On the other hand, some patients come in because they didn’t get the result they wanted from over-the-counter whiteners. What’s good about going to the office is that the dentist can monitor the treatment and make sure it’s done safely.

The porcelain itself is not going to change colors, but it’s kind of like eating on fine china. If you eat blueberry pie on fine china, the plate is going to look stained but if you wash it off, then the stain will go away. So when people notice crowns or veneers getting yellower, it really just stains building up on the surface. If they have them professionally polished, then they can restore the color and luster. However, the tooth underneath can get darker with age and that can show through the thin veneers. It’s not something we see a lot, but we have seen it.

You can get a natural-looking smile through many different treatments. Veneers can look very natural, but going too white may make them look less natural. I find that a patient’s preference is sometimes a matter of geography. My patients in Texas tend to want their teeth whiter than people do in other parts of the country. However, whiter teeth do make you look younger so you have to find the shade that fits your goals.

a black spot in the middle of the crown most likely means that the crown is a porcelain to metal crown and that the metal is exposed in that spot.  This ususally happens when there is not enough space between the top and bottom teeth and the dentist ahd to grind off the porcelain to adjust the bite.  This often happens when not enough tooth structure is removed during preparation of the tooth for the crown.

Myofunctional therapy can be an useful adjunct to appliance therapy as it helps the muscles relax and adjust to the new placement of the teeth and jaw.  It is also helpful to break some scar tissue in muscles that can form in cases of severe bruxism or some other form of bite problems.

Yes, veneers can be replaced.  It is a very good idea to replace them when there is gum ressesion and food trapping as these conditions can lead to gum problems and even catavities forming.  New veneers, placed properly can keep the mouth healthy and clean.