April 2024 - Arnold Dental

I have had brown spots on my teeth ever since my adult teeth came in. My dentist and I have tried several over-the-counter whitening treatments. While some of them have whitened my teeth, the brown spots are still brown compared to the rest of my teeth that are getting even whiter. My teeth are perfectly healthy. In fact, I’ve never even had a cavity. I’m just so embarrassed by these brown spots. My dentist is suggesting we grind the spots off, however she can’t be certain how far to grind them. I’m a bit worried about this. Have you heard of someone in my situation? Is this the right direction to go?

Stacey

Dear Stacey,

I am glad you wrote. I can tell that your dentist is well intentioned and wants to help you. She is just in over her head. Teeth whitening will whiten teeth evenly, which you discovered. In situations with brown spots, it tends to make your spots look even more obvious. The good news is that there is a solution for you. I don’t think your current dentist will be able to do it, but from what you’ve described about her, she won’t mind you going somewhere to get the help you need. In fact, it is quite common for patients to go to one dentist for general work and another for serious cosmetic dental work.

Please don’t let your dentist grind the spots down. This will do horrible damage to your teeth. If you had white spots, microabrasion might be useful. I write that for the benefit of others reading this blog. With brown spots, however, that rarely works. Instead, you can get beautiful results with either dental bonding or porcelain veneers.

If there is just a small amount of the brown spots. Dental bonding will be sufficient, though there is certainly nothing wrong with you getting veneers in that case either. If the spots are more extensive, I would only do porcelain veneers.

The big issue here, though, is getting the right dentist to do the work. I would say only about 2% of cosmetic dentists in the country could do this well. In your place, I would look for an AACD accredited dentist. These dentists have proven skill and artistry. It will be worth it even if you have to travel to have the work done.

This blog is brought to you by Lexington, KY Cosmetic Dentist Dr. Fred Arnold.

I am getting a dental implant on an upper front tooth and have a couple of questions. I am trying to choose between two dentists. The first one insists on a CT scan. Is this completely necessary in preparation for an implant? I am a bit concerned because I have had a LOT of x-rays in my life and the radiation exposure concerns me. My sister was recently diagnosed with cancer and it has me jumpy about everything. A second question I have is about the type of implant. The other dentist said he uses a brand called Southern Venturi, but I can’t get much information on it. I don’t want there to be a problem done the road if I need some adjustments.

John

Dear John,

You are asking some great questions. I’ll answer them, plus add a couple of other things to look out for as you prepare for your dental implant procedure. First, the CT scan. I would consider this an absolute necessity. The reason behind that is two fold. One, you have nerves that need to be avoided. Two, your upper teeth are very close to your sinus cavity. You don’t want the dentist perforating it. Placing dental implants is a three dimensional procedure and you really want three dimensional images so the dentist is able to target things accurately.

I am sorry about your sister’s diagnosis. I know that is scary. Today’s x-rays are much different. Dentists use digital x-rays. You actually get more radiation from walking outside than you will from the dental x-rays. While CT scans do use some ionizing radiation, it is minimal. I hope this puts your mind at ease.

As for the brand of dental implant, I would not be concerned about replacement parts or adjustments as much as the quality control of the manufacture. What concerns me about the one you mentioned is that I don’t know any skilled implant dentists who use that brand, which makes me wonder.

That brings me to a third issue. You want to focus more on the dentist doing the work than which brand. A skilled implant dentist will know much more about the manufacturers than you would be able to find online as a patient. You will want a dentist with post-doctoral training in dental implants. Additionally, because you are dealing with a tooth that is visible when you smile you also want a dentist who is an expert cosmetic dentist. I would start by looking for an AACD accredited dentist, then see which of them have dental implant training. It’s easier to find an implant dentist than a skilled cosmetic dentist.

This blog is brought to you by Lafayette, LA Dentist Dr. Fred Arnold.

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