Dr. Mike Malone’s Blog

I am in my early 20’s and just recently graduated from college. For almost as long as I can remember, my front teeth have been discolored. I have ALWAYS taken really good care of my teeth (no cavities!), but my mother told me the discoloration was caused by an illness I had as a small child. Now I am trying to get my professional career off the ground, and I feel like my teeth are making an awful first impression.

With the support of my dentist, I have tried almost every over-the-counter teeth whitening product available. If anything, my teeth look WORSE now. The spots did not change in color one bit, but the contrast with the surrounding tooth material (which whitened considerably) is even more noticeable and ugly. Now my dentist is suggesting a “trial” treatment, where he will grind away at the spots until they are gone. The problem is he doesn’t know how much he will have to grind, and I just cannot imagine how this will ever look good!

What about professional whitening? I just really need to get this issue addressed. My teeth are holding me back, and my self-confidence is really taking a beating. I don’t want potential employers to think that I am the type of person who doesn’t even properly care for their teeth!

Thanks so much for your help,

Leta in Albany

Dear Leta,

First and foremost, find a different dentist. Your current dentist obviously does not understand the principles of teeth whitening or he would not have had you wasting your time and money on repeated attempts of the same treatment. Professionally whitening is unlikely to yield the results you want, either. And the idea of grinding away the spots could go horribly wrong.

You need to seek the services of a talented, experienced, educated cosmetic dentist. Make sure you thoroughly check their credentials, and ask to see pictures of their work.

Depending on the severity of the spots, there is a very small chance that a technique called microabrasion might work. This is often used with white spots, but is only effective with brown spots when they are very superficial.

If the spots are small, dental bonding may work to cover them. This is one of the most difficult and artistically demanding skill sets in cosmetic dentistry, so make very sure the dentist you chose is not just competent, but exceptional. If bonding will not work, porcelain veneers may be a solution. Both of these treatments require a high degree of artistry and skill.

I hope you can find the right dentist to help you.

In your professional opinion, which is better, Zoom whitening, or one of those at-home whitening systems? I know your office does the Zoom whitening, but I trust you to give me an honest opinion.

Heather in St. Joseph

Dear Heather -

The short answer to your question is “It depends.” Used according to the instructions, both at-home and Zoom whitening systems yield similar results. Deciding which system is best for you depends a lot on your personality, time constraints, budget, and the nature of the stains on your teeth.

At-home whitening systems need to be applied every day, according to a specific set of instructions. It can take weeks or even months to see results. If your personality lends itself to this kind of patient, consistent approach, then an at-home whitening system would be great for you. They are less expensive than Zoom whitening, so if you have more time than money, an at-home system might be the right choice for you.

Zoom whitening is accomplished in one or two visits to your dentist’s office. If you have a tight schedule, or tend to have trouble sticking to a strict routine, Zoom whitening is a great choice for you. It is more expensive than an at-home system, but many people consider the savings in time to be more than worth the difference in price.

I do recommend checking with your dentist before you go with an at-home system, as some stains will not respond to teeth whitening procedures. If your teeth are stained by tobacco, coffee, tea or some foods (such as berries), an at-home or Zoom whitening procedure will be effective. If your teeth have tetracycline stains, then you will have to make different choices to get whiter teeth. Zoom whitening (or at-home systems) are not very effective in treating tetracycline stains. In fact, sometimes the tetracycline staining is MORE noticeable after a whitening procedure is done.

Also, if you have a tooth or teeth that have become discolored after root canal treatment, that tooth will have to be taken into consideration during the whitening process. If that is your situation, you really should consider having your whitening done under the watchful eye of your dentist.

I hope this information helps.

Hello, I had my 8 front upper teeth fully bonded about 14 years ago to close in gaps between them. I have taken extremely good care of them and they have held up well, although they have stained now from food and drink. I have been told my only option for white teeth is to remove the bonding altogether,then bleach and rebond or go the more expensive route, porcelain veneers. My question for you is this… if the tooth is actually what has become stained and it is showing through the bonding, why wouldn’t bleaching work? If the coffee, tea, etc. got through, wouldn’t they bleach also?? Thank you.
- Patti from Minnesota

Dear Patti,
I think you’re being given good information.

I’m not clear whether you want your teeth generally whiter or you want the stains removed. If you just want the stains removed, the bonding could maybe be re-surfaced. The cosmetic dentist would just remove enough of the surface of the bonding to get rid of the stain, and then bond new material over that. But if you want your teeth whiter than they are, too, then you need to remove the bonding, have the teeth bleached, wait a couple of weeks for the new color to stabilize, and then re-bond.

We do a lot of direct dental bonding, and the bonding material can produce beautiful results. But the bonding resin is a little bit porous, and over the years it will absorb stain. This stain doesn’t respond to any of today’s bleaching techniques, even the state-of-the-art Zoom whitening that we offer.

If you were my patient, I would encourage you to upgrade to the porcelain veneers. Porcelain has the added advantage of being extremely stain resistant year after year. You could have the whitest shade of teeth you want, and as long as you have to have the bonding removed anyway, why not go for the porcelain?

Other links:
Read more about dental bonding.

I had the rare opportunity to have a professional Zoom tooth whitening done at cost at a cosmetic dentist. Unfortunately, we didn’t realize until after the first go-around that the color of my teeth seems to be due to natural variation and not stains. That said, the color differences are rather stark after the treatment and I’m unhappy with how noticeably uneven the color of my teeth are. Is there any way to reverse or fix this without having to get expensive bonding or veneers?
- Marcy from DC

Marcy,
I’m hoping your dentist knows more than you seem to be indicating, because from what you’re telling me, there’s a lack of expertise in cosmetic dentistry in your case. One problem with dentistry in the United States is that cosmetic dentistry isn’t a separate specialty recognized by the American Dental Association, and because of this any dentist, with no extra training at all, can call himself or herself a cosmetic dentist.

Zoom whitening will whiten teeth that are naturally dark. It isn’t just for accumulated stains. Most Zoom whitening patients, when they are done, will have teeth that are whiter than any natural color. It removes stains, but it also bleaches out the natural darker colors that are in everyone’s teeth.

However, Zoom whitening and other professional whitening techniques are not appropriate for teeth with uneven coloring. Many general dentists who attempt cosmetic dentistry make this mistake - they try to whiten teeth with spots or stripes, and this only exaggerates the problem. Spots, stripes, and other uneven colorations need to be treated with tooth bonding or porcelain veneers.

Unfortunately, there isn’t a simpler solution for your problem

Related links:
Lafayette dentist
Lumineers - a specific brand of porcelain veneers