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Tetracycline staining is actually inside the tooth and it gets darker towards the center of the tooth. Tetracycline stains are a result of taking the antibiotic while the teeth were developing from about age 3 to age 10. Doctors did not know that the antibiotic tetracycline would turn teeth dark until years later.
Unfortunately, many patients have teeth that have tetracycline stain from all over the world. The problem has been that when a dentist grinds away the tooth enamel to place porcelain veneers, the tetracycline stain gets darker and much more difficult to hide with veneers. The more grinding the dentist does, the more difficult it becomes to hide the dark gray color.
This patient had poorly shaped crowns and laminates. Her teeth were discolored with tetracycline stain along with gaps between her teeth that trapped food. Her gums were uneven, which made some teeth look short. She had porcelain crowns done by another dentist that needed to be replaced. The difficult part of her treatment was to match porcelain veneers and porcelain crowns to her lower teeth that would remain natural.
The porcelain thickness is different in a veneer verses a crown because they transduce light differently. Cosmetic dentists sometimes have multiple problems with tetracycline stains. Some teeth get porcelain veneers, others need crowns replaced and the lower teeth will remain natural but will get teeth bleaching to get them whiter. With the lower teeth whiter, the upper shade to the porcelain veneers and porcelain crowns can also be whiter.
Dental lasers are not very effective in treating tetracycline stains because they cannot remove the deeply stained teeth. If the power in the laser is set too high, the laser can damage the nerve inside the tooth permanently. Matching porcelain veneers is the best way to hide the stain but a combination of teeth whitening and porcelain veneers is a great approach for tetracycline tooth stain. The teeth are actually not damaged by tetracycline stain because it seems to only effect the color of the tooth. Tetracycline stains do not harm the tooth, it just makes the tooth color dark.
Dr. Sam Muslin, in Santa Monica California, treated this patient nearly 15 years ago. The photography is better today and the porcelain veneers are better today but the difficulty in treating tetracycline stained teeth that are not stained to the same degree poses a special problem. Hiding the color of teeth that are right next to each other yet, very different in color with porcelain veneers requires customized opacity control. When patients ask, “what is the best porcelain veneer”?
Dr. Muslin answers, “They need to understand that sometimes I need to use two different kinds of porcelain veneers on the same patient”. Sometimes one type of veneer will not hide the color evenly. This is one of Dr. Muslin’s secrets to his cosmetic dentistry success and this helps explain why his results clearly displayed on his untouched and unaltered, before and after porcelain veneer photos are of such high quality. The high quality results by this cosmetic dentist, are why he was chosen as LA’s Best Cosmetic Dentist for 2012.
The gums needed microsurgery to get the gum line even. The Biolase, Waterlase, or any other type of dental laser was not the best technology to get predictable results. Sometimes dental lasers do not get the most predictable healing, so even though he has the lasers, her prefers doing his microsurgeries by hand. As Dr. Muslin says, “When you do it by hand, there is no smoke from the laser”! Porcelain veneers and porcelain crowns can perfectly match the natural teeth if artistry and custom made porcelain is developed.
The results are durable, color stable and virtually undetectable. The lower teeth are natural teeth that were whitened by a technique that Dr. Muslin customizes for every patient. He thinks it is an improvement over the BriteSmile, Zoom and laser whitening techniques because no two patients are the same. By whitening teeth according to the sensitivity level and stain level, the patients will get better results that last a lot longer than a one hour dental visit.
It is a customized-to-the-patient technique done by Dr. Sam Muslin, and it helped lighten the tetracycline stain on the lower teeth significantly. The lower bleached teeth match the upper porcelain teeth. Matching porcelain veneers to the natural tooth structure is a big challenge for the cosmetic dentists.
For those patients interested in some of the finest level of cosmetic dentistry available, call for your consultation today.
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