Drill

Brown Spots on Teeth

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• published: 08 Sep 2015
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Http://www.drtimmerman.com. A question was asked recently about a brown stain on a front tooth of a person's child, their adult child who had braces, orthodontic process, and had a stain on at least one tooth that had become brown. They didn't really know what to do and some of the advice seemed extreme and there was a lot of confusion. I thought I'd just share a few thoughts on different options that people can have. The goal in almost any dental office is to do the least amount of dentistry necessary to achieve a goal. In some cases that is just apply a material on the front of the tooth and in other cases it is remove some tooth structure in order to replace it. There are different options with their own pros and cons. One thing that can be done is using a product called MI Paste by GC America. It's applied usually through wearing trays, similar to bleaching trays, and we're trying to re-mineralize an area. By scrubbing with a material similar to when people are getting their teeth cleaned, this abrasive scrub plus the MI Paste can get the thing to re-mineralize and change the color a little bit and lesson the extreme color differences, which is fairly conservative and not a bad way to go with many people. But a step up from that is another material called Icon. It's essentially a filling without doing any drilling. What happens in the process, we're adding an acid to the tooth structure to create a certain micro-porosity and then a resin is impregnated into these porosities that will cover up that color. However if down the road as time changes and the teeth stain and discolor or even if one was to bleach their teeth, that spot won't change because it essentially has a filling in that position. But it was very conservative and you're only using acid to create the porosity, you're not drilling anything out. So that's not a bad way to go. In some of the more extreme stains then maybe perhaps a filling is the right way to go. That's where we just remove, using our typical dental drill, we'd remove a little bit of that tooth structure, remove some of the enamel and then we'd bond in a filling material. The filling material is very similar to any other filling that is done. We can use different shades of the filling material to get a good blend of color or a shade match, but it is a filling and as time goes on, like we say, any dentistry that is done is going to fail at some point and need to be replaced. Nothing that we do in dentistry lasts forever, but certain things last an awfully long time. Whereas fillings last several years, porcelain restorations last decades, implants are probably the longest lasting thing that we've got. Everything has a duration or a durability. The filling at some point would need to be assumed to be replaced at some point later on. One of the options that was brought up was Lumineers. Lumineers are a brand of veneer, it's just simply minimal prep or non-prep veneers that are porcelain that's bonded to the front surface of a tooth. They're okay in some situations. I think there are other products out there that I think have a certain improved appearance and may even be more durable. But Lumineers is a product. I like to offer people just simply the category, the minimally invasive or non-prep veneer. We can be very, very conservative when we do a veneer. I have had people express concerns saying removing tooth structure in order to do this process, we can be very conservative. We can remove maybe half of a millimeter, 3/10 of a millimeter of tooth structure and then replace that with a bonded porcelain restoration, which once bonded and if bonded properly, will last a very, very long time and not weaken the tooth in any significant way. I have no reservations adding veneers as an option and do believe that it has many, many benefits or improved expectations from it. When we do a veneer, especially if we're doing just a single tooth we're not really changing much to the appearance of the tooth, the size and shape. However if we were doing a smile makeover, where we're doing whatever shows when one smiles, we have the opportunity to make the teeth perfect. The right length, the right shape, the right color, whatever it is that one really wants their smile to appear like. We can do it very, very conservatively, especially if this is after braces have been done. Dr. Timmerman is known internationally, with licenses in multiple states in the United States plus Belgium and Dubai for cosmetic, implant, and sleep dentistry. With fellowships in the International Congress for Oral Implantology and the Academy of General Dentistry and a diplomate in the American Board of Dental Sleep Medicine. If you would like to become a patient of Dr. Timmerman, or simply have questions, please go to our website www.drtimmerman.com That is www.drtimmerman.com or call us at 206-241-5533. Or you could email questions for an episode of a future podcast at: thewholetoothpodcast@gmail.com