Dr Hardeep Bhatta & Dr Allen Friesen
Suite 205 - 1465 Salisbury Ave
Port Coquitlam, BC V3B 6J3
If you have discolored teeth, the cause is often staining on the enamel surfaces from foods, beverages, or smoking. But tooth discoloration may also originate deep within the root of a tooth. Sometimes this happens to a tooth that had to have earlier root canal treatment because of injury or decay.
In such cases the living pulp tissue and its blood vessels and nerves had to be removed from the root canals, resulting in the death of the dentin layer, which makes up most of the tooth's body. Over time this caused the dentin to darken. The color may come from remains of blood that was left in the tissue, or from filling materials left in the root canal that are showing through.
Since these stains are caused internally (intrinsic) and not on the outside of the tooth (extrinsic) they must be whitened from the inside. This is usually done by putting a bleaching agent into the empty chamber from which the pulp was removed. Usually the bleaching agent is a substance called sodium perborate.
When it is mixed with a solution of hydrogen peroxide, sodium perborate slowly bleaches the color from the tooth's internal material. It is considered to be safe and reliable for this use.
The work begins by taking x-ray images to make sure that the root canal is correctly sealed and the bone is healthy. After this, we will make a small hole in the back of the tooth through which the root canal space will be cleaned. The root canal space will be sealed and the bleach will be applied in a putty-like form and sealed off from the rest of your mouth. Every few days this procedure will be repeated until the bleaching reaches the desired level.
At this point a tooth-colored composite resin will be used to seal the small hole that was made in the dentin to insert the bleach. After the tooth has reached the level of whiteness that matches it to your other teeth, veneers or crowns must sometimes be used to repair the surface if it is chipped or misshapen, for example.
Contact us today to schedule an appointment to discuss your questions about whitening internally discolored teeth. You can also learn more by reading the Dear Doctor magazine article “Whitening Traumatized Teeth.”
You may have heard the term “veneer” with reference to woodworking, where it means a thin layer of attractive wood that covers and enhances the surface of a piece of furniture. Exactly the same principle applies to porcelain veneers used in dentistry: A thin layer of ceramic material is used to cover parts of a tooth in order to improve its structure and appearance.
Porcelain is a non-metallic ceramic material that is fired in an oven at a high temperature to make it hard and durable. Dental porcelain veneers are thin layers of ceramic that can be applied to the outside of the tooth so that the end result mimics the natural color and translucency of tooth enamel. The underlying tooth structure has to be prepared by removing a small amount of the enamel, about 1 mm, which the veneer replaces. The veneer is then bonded to the prepared surface using a light-sensitive resin.
In woodworking, a veneer may be used to match the grain between the left and right sides of a piece of furniture, creating a beautiful effect on a curve, or simply to bring the appearance of expensive wood to a backing that is less expensive.
Just as a wood veneer improves the appearance of a dresser or table, porcelain laminate veneers may be used to improve teeth that have a number of cosmetic and functional problems. These include staining that cannot be removed by tooth whitening, teeth that are too small, misshapen, chipped or spaced too far apart. After an assessment of your teeth and your smile, we can create a mock-up using temporary tooth-colored materials so you can decide whether the suggested changes will work for you, or you can make suggestions for further improvements.
Porcelain laminate veneers may not be the best solution for you if your teeth are severely stained or damaged. In cases where a large proportion of the original tooth must be replaced, porcelain crowns may be the best solution. The crown is the part of the tooth that is visible above the gum line, and it can be covered with a porcelain crown that looks exactly like a tooth in shape and color. After studying your needs, together we can decide on the most satisfactory method to restore your most attractive smile.
When choosing among different ways to solve a problem, knowledge is power. In the case of selecting the best repair for a dental problem, count on your team of dental professionals to advise you. But you as the patient make the final decision, and it helps to thoroughly understand the different options, their advantages and disadvantages. If you have a chipped or broken front tooth, your likely repair options are composite resin or porcelain veneer.
Composite resins are synthetic materials that can be colored to match your natural teeth. The material is bonded to the tooth surface using adhesives that become part of the tooth structure, strengthening the original tooth. The repair looks as good as, or even better than, your original tooth. Such repairs can be used to restore small to large chips and other damage caused by decay or trauma.
Since the composite resin repair is applied directly to the tooth in the dental office, the repair can be made in a single appointment. You do not need to use a temporary repair while waiting for the final replacement to be made at a dental laboratory. This also means that the repair will cost less.
Another advantage of composite resin is that less of the healthy tooth needs to be removed to prepare the tooth to receive the replacement, since it bonds directly to the original tooth structure.
Porcelain veneers are very thin layers of tooth-colored porcelain that are also bonded to the tooth. They are usually recommended in situations with more serious injury or risk to the tooth, such as teeth that have been fractured, treated for root canal, or injured in contact sports.
Application of porcelain veneers may require more tooth preparation (in which more of the original tooth material must be removed) before the restoration can be bonded in position. Bonded porcelain veneers are likely to be longer-lasting than composite resins. They must be fabricated in a laboratory, so they require more than one visit and cost more.
All of the above are factors to consider in choosing composite resin or porcelain veneer to restore your chipped or damaged tooth. As usual in making such decisions, the final choice will depend on your individual situation.
Contact us today to schedule an appointment to discuss your questions about bonding to repair chipped teeth. You can also learn more by reading the Dear Doctor magazine article “Artistic Repair of Front Teeth with Composite Resin.”
A recent study revealed that on average there are 22,000 dental injuries in children under the age of 18. This alarming reality makes it clear that parents, caregivers, and coaches need to understand the risks for dental injuries so that they are best equipped to prevent them...or at least be prepared to manage one should it occur. The four most common categories for measuring risks associated with sports injuries are:
Knowing the above categories can help you assess your risk for a dental injury while playing in a sport or recreational activity. To learn more about sports-related dental injuries, read, “An Introduction To Sports Injuries & Dentistry.” Or if you have a traumatized, damaged, chipped or missing tooth from a sports or any other type of injury, contact us to discuss your situation or to schedule an appointment.