Frequently Asked Questions

At Charlotte Center for Cosmetic Dentistry, we enjoy helping our patients better understand their treatments as best as possible. Below, we’ve compiled some of our most frequently asked questions that we hear often. If you have questions not found on this page, feel free to send us an email and we’d be happy to respond!

Q: Due to an unexpected sudden move and the crazy things that life throws at us, I was not able to start my Invisalign treatment. I purchased nine trays last year and have only opened the first one. I can’t afford to pay for a new set and I really want to fix my teeth now that my life has settled down. Is it okay to start the treatment now, even though I am starting six to nine months late? The first set of trays seem to fit. I appreciate all your help and advice!

A: That’s an interesting question that is difficult to answer without knowing more information. It does bring up an opportunity to discuss the flexibility Invisalign offers patients. For discussion purposes we’ll make a few assumptions:

If your first aligner set fits perfectly then you could begin wearing them and begin to straighten your teeth. Typically, patients are given two to four aligner sets at each office visit but every situation is different. If we assume you will not need any tooth reshaping or attachments applied during any of the nine aligner sets and assume your teeth move exactly as planned, then yes you could progress through all nine sets and return to your dentist to pick up additional aligner sets.

Typical wear time for each aligner set is two weeks if worn 22-23 hours per day, every day. For patients that are out of state at school, or perhaps traveling abroad, we will extend the wear time to three to four weeks per aligner set. This will get you 27 to 36 weeks until all nine are finished. The ability to extend wear time and still progress through aligner sets and still make progress while away from your dental office is a unique feature of Invisalign.

Since life has settled down for you I would encourage you to call your treating dentist/orthodontist and discuss your specific situation with them. They will know the details of your treatment and can give you the very best information and suggestions for obtaining the new smile you want. I’m sure they will be more than happy to explain your options, plan aligner staging, and let you know when follow-up visits are needed. I’m almost sure they will be happy to help you work through any finance issues so you can finish treatment in a timely manner. Just be honest and let them know what’s going on with you and give them the opportunity to help. All the best!

Q: One of my lower teeth has shifted post orthodontic work as a result of my lower permanent retainer breaking. Should I redo orthodontic treatment on the bottom or is there any way this can be fixed with getting veneers?

A: You have identified two common options to correct crowded teeth. The least invasive option is to redo ortho/Invisalign to correct the alignment. I would suggest getting a clear plastic retainer as well as a bonded wire. The clear plastic retainer is a safety net just in case the wire breaks. A veneer or veneers would be a quick fix but requires significant tooth structure removal to reposition them. I would suggest ortho/Invisalign since it allows you to conserve tooth structure and is more than likely less costly. Best of luck!

Q: Can I use the Crest whitening strips right after getting my teeth professionally whitened? I want to make sure there is no interference with the whitening procedure nor do I want to damage my teeth. I went through the Luma procedure, if that helps.

A: You could use Crest white strips. There would be no issue with damaging your teeth. You may experience tooth sensitivity or gum irritation but your teeth will be fine. Consider that over-the-counter whitening products are low levels of peroxide compounds that break down stains on your teeth. The in-office procedure breaks down stains as well but is a significantly higher percentage of peroxide and must be professionally applied and monitored. Crest white strips can work but require consistent application for several weeks and typically cover only the six front teeth. Professional strength whitening gel is available from your dentist for home use. The concentration in these gels is higher than you can purchase over the counter and provide a faster result. Give your dentist a call and find out what options they suggest. Best of luck!

Q: I am having a great dilemma on what I should do with my teeth. Should I do an orthodontic treatment to close some spaces and turn one of my front teeth (my lateral left incisor) and then do bonding on my incisors and canines? Or just get veneers on my incisors and canines and don’t do the orthodontic treatment and try to close those gaps with the veneers? Any advice is welcome. Thank you very much. Lastly, what is the average cost for veneers? My dentist told me $1209 each. 

A: A complete esthetic analysis would need to be completed to properly answer your question. A few questions we would ask are: Are your teeth properly sized (height x width)? What are your esthetic expectations? Do you have any time limitations? Ortho/Invisalign/bonding could be a great option. Porcelain veneers (standard prep, minimal prep, or no-prep) are all beautiful, fast and effective. Each option has “pros and cons.” We see new patients every day that come to our office asking to have their existing veneers replaced. Often, it was a price only decision and they went with the “low cost” option. So, instead of a low-cost procedure, they now have to pay again to have them removed and replaced. We find that many patients don’t realize how critical planning and design are until it’s too late. If the end result is very important then consider what you’re really paying for. It’s not the wires, brackets, plastic, or porcelain. You’re paying for the expertise and the end results (a great smile). We wish you the very best of luck!

Q: I am 22 years old. I have bow-shaped central incisors. One of my central incisors also has a rotatory movement too I think, but I don’t want braces. I want to improve those teeth esthetically what should I do?

A: Great question! Based on the single photo you posted it appears that traditional braces or Invisalign would be a great option. You have a common issue that can be corrected by an orthodontist or a general dentist experienced with orthodontic treatment. Give your dentist a call and schedule a consultation. Our patients are our best referral source so be sure to ask your friends or co-workers who they would recommend. All the best!

Q: How long do you leave trays on for home use? How often? (Zoom teeth whitening)

A: The duration of time you should wear home whitening trays depends on the concentration percentage of whitening gel (bleach) you are using. We have many different strength options so we like to determine each patient’s sensitivity level and build a custom home whitening plan for them. This plan includes concentration and frequency required to reach their desired whitening goal. Everyone is different in what level they can comfortably use. Visit with your dentist and find out their suggestions. We wish you the best of luck!

Q: How do I fix my smile? When I smile or laugh, one side of my lips/cheeks are higher than the other. What is the best way to correct this?

A: It is difficult to see the issue you mention from the photo you provided. Your situation may be a lip volume issue, a muscle pull issue, or a gum tissue display problem. Each situation is different and will require a different approach. I would suggest that you visit a dentist that focuses on cosmetic dentistry or a facial plastic surgeon. These doctors will have knowledge of proper facial proportions and can provide solutions that will work best for you. This will save you time and provide you the very best opportunity to find a solution. We wish you the best of luck!

Q: Are porcelain veneers an option for me? (I’ve had ortho twice). I’m 22, I’ve had ortho twice, both times I’ve been very unpleased with the results, especially after the four front teeth started shifting back, not fully but enough to notice. I am looking into getting veneers on my four front teeth but I don’t want them to look fake or bulky. I would really like a straight beautiful smile but I’m not sure if veneers are for me and if they are how many would be recommended? btw I hate how my lateral teeth come out on the sides and don’t follow the rest of my teeth.

A: Based on your photos I would not suggest veneers for you. Your upper lip has great volume and your front teeth touch your upper lip in the photos you posted. This rules out conservative veneers and would require very aggressive preparation of your teeth in order to avoid the bulky or thick look. From a cosmetic dental standpoint you have a great smile and very nice lips which frame your smile. This means no additional tooth volume can be built onto the front of your teeth without looking bulky. If you came to our office for a consultation it would be extremely important to understand exactly what you didn’t like and what your ideal end goal would be. I’m assuming the smile inspiration photos you posted are your end goals. In each photo with the exception of #3, the lip volume and proximity of the teeth to the upper lip are very different than yours. I would strongly suggest you visit an orthodontist or an AACD (American Academy of Cosmetic Dentistry) dentist that can evaluate your smile in person during a consultation. They can help provide options to help you obtain your smile goals. We wish you the very best of luck!

Q: I have an open bite not sure if it requires surgery or if I need traditional braces instead of Invisalign. I am 25 years old.

A: Your best option would be to visit with an orthodontist or an experienced Invisalign dentist. They can do a complete evaluation and suggest the best option for you.

Q: Bonding, veneer or crown for dental restoration? (photos) I’m 56 years old. I am having orthodontic work (Incognito) to fix the problem with my left upper canine and a bite issue. The left upper lateral incisor is damaged because of the bite issue, and that canine is also slightly chipped (both of these are from contact with the lower left canine). Looking ahead to getting the left lateral incisor and canine restored, what would be my best option? Yes, I will be asking my own orthodontist and dentist for their opinion, too! Thanks.

A: Composite (plastic) bonding or a porcelain restoration are the two options that are available to replace missing tooth structure. We explain to patients that bonding is plastic so it will gather stains faster, is not as strong as porcelain, and will need to be replaced more frequently. Porcelain is exceptionally stain-resistant, has the most lifelike appearance, and will have a much longer service life. Your options will depend on how your teeth function (back to front and side to side slide) and how much room is available for restorative material. Bonding may be a nice short term fix. Once your orthodontic treatment is complete your dentist will be able to suggest the best option based on your specific needs. We wish you the best of luck!  

Q: Implants for tooth lost to resorption? My dentist wants to remove tooth 31, the last bottom molar, due to external resorption. He says they do not use implants for that last molar, that I will simply be missing a tooth. Is that true?

A: Implants are used to replace 2nd molars every day. It’s a very common procedure in our practice. However, there are many factors that must be considered when implant placement is considered in any location. Nerve proximity is a common consideration that must be addressed in 2nd molar implant placement. An experienced surgeon can handle these issues. A 3D scan (cone beam CT) can provide exceptional planning capability and avoid complications. We feel it is important to have a cost/ benefit discussion with our patients and determine if an implant would offer a clear advantage for them. We wish you the best of luck! 

Q: Why is one of the veneers changing color after three months. It appears grey and a shade darker. I have four porcelain veneers yet had one replaced twice due to bonding & fit errors hence one tooth has sustained more trauma in this procedure. It has been three months and now that problem tooth veneer now looks duller/greyer by a shade and I feel this is becoming more noticeable as each week goes by. What might be causing this? They were all fine and only really started to bother me over the last four weeks. 

A: The most common causes for discoloration to occur after veneers are placed is leakage or tooth color changes. A break in the adhesive seal of the veneer can allow leakage between the veneer and tooth surface. This allows fluid/ stain to gather underneath and cause a darker color to be perceived. Another possible cause is that the underlying tooth is changing color and this darker shade is showing through the veneer. Since veneers are thinner at the gum line this is usually where you see leakage or tooth color changes. Go visit a dentist that is familiar with porcelain veneers and have them evaluate it. We use the Waterlase iPlus laser system to remove veneers so we can be very conservative. There is a possibility that if you find a dentist with the laser system they could remove the veneer and evaluate the problem without removing any more tooth structure. We wish you the best of luck! 

Q: What is the cheapest option to whiten your teeth? And how safe is it? I am getting married and would like to whiten my teeth.

A:  Your concern about safety when it comes to whitening products is well founded. Many “cheap” whitening options contain little if any ingredients that actually provide any whitening results. Major name brand over-the-counter products can work but take a very long time for any appreciable whitening to occur due to the low concentration of bleach they contain. Professional products available from a dentist contain much higher levels of active whitening agents not available over the counter. 

There are many safe and effective whitening options available today at a wide range of price points. Philips has a product called QuickPro which is a fast and very effective low-cost option that provides excellent results. Home whitening gels are available in different strengths and cost around $40 for a typical one month supply. Remember, the cleaner your teeth the better the whitening results will be. Many people don’t realize that any bonding or dental work that are on front teeth will not whiten. The best option is to visit a dentist that offers a wide variety of whitening options and have a brief exam. That way you can avoid any surprises and they can suggest the best product to meet your needs. We wish you the best of luck!

Q: I had full upper and lower tooth bonding done yesterday, I hate how it feels, like it’s too thick and pushing my cheeks and mouth out, feels like a mouth guard in which I can’t take out. I haven’t stopped crying and can’t eat or speak properly. As it’s a Sunday the dentist isn’t in his practice. Please help, can I have it removed? I’d be so grateful for help.

A: Yes, bonding can be removed in a conservative manner. Without pictures it is difficult to provide specific comments about your situation. However, cosmetic bonding should replicate ideal tooth contour and function like natural teeth. Bonding should feel smooth. It is common for patients to mention that the additional composite material feels “thick or thicker” for a few days but after that it becomes normal. It’s similar to braces or Invisalign. The first one to three days it’s weird but after a few days you accommodate and speak normally. Give the dentist that placed the bonding a call and go back in and discuss your concerns with them. They may be able to re-contour, or polish it so everything feels better.

Q: What is happening? I am tired of going back and still having pain. Should I see another dentist? I had a root canal done on my bottom left molar. I was then prepped for a crown which left me in discomfort for two weeks because of the amount of cement used, I also had four fillings done on the same side. I have had to return three times for my bite to be corrected after the fillings. Now two weeks later I have gotten my permanent crown and had the fillings filed down again to perfect my bite. I am now in pain, my gum is inflamed and all my filled teeth are sensitive to cold. I cannot bite or drink on left side. 

A: Sorry to hear you are having discomfort. Dental pain can be frustrating and confusing. Let’s cover the basics. A root canal removes the nerve of a tooth so you will no longer have any (hot or cold) pain sensation on that tooth. You can still experience pressure when biting due to nerves still present in the ligament space around the tooth. Pressure sensitivity on a tooth after a root canal is very common. We typically prescribe anti-inflammatory medication that helps patients manage any discomfort during this time. Sensitivity to hot and cold after composite fillings are placed is also very common. If the damage that was repaired by the filling was close to the nerve then the body will need time to build more dentin and re-insulate the nerve. This can take a few weeks to a few months. The extent of the damage caused by decay, old fillings breaking down, or chips and fractures can be traumatic to the teeth. We tell patients that lingering pain (lasting longer than 30 seconds) is an indication that the nerve of a tooth is not healthy. If you have lingering pain, swelling, or pain that is getting worse you should contact your dentist immediately. It’s important for your dentist to have an opportunity to evaluate the situation and try to determine the best option for your situation. If you feel you are not getting a satisfactory resolution you could always see another dentist or have a root canal specialist (endodontist) check it out as well. We wish you the best of luck!

Q: Recently got two lumineers on the teeth directly next to my front two teeth. Coloring on the lumineers is good but now I feel that I should get lumineers on my two front teeth as well to make it more uniform. I have fluorosis, it was very difficult to match the color. Will the teeth look more uniform with four lumineers versus two? The lumineers are also laying quite flat and the rest of my teeth after it are curved slightly. Is there a way to contour them now to make them look more like my normal teeth?

A: It is not unusual for patients who have treated a limited number of teeth to wish they had treated more. Treating eight to 10 teeth (the typical number most people show when they smile) allows for the most freedom when trying to create a uniform whiter color. The only time treating one, two, or four teeth works is when the patient is very sure they only want to match to their existing tooth color or when repairing specific tooth damage. If your goal is to eliminate the fluorosis appearance and build a new smile with a uniform white color then your existing veneers can be removed and new ones placed. I use the Waterlase iPlus laser system to remove existing veneers without removing any additional underlying tooth structure. Patients love this conservative approach and it’s one of the reasons conservative veneers are so popular in our office. I typically like to avoid grinding or cutting on porcelain veneers. They are extremely thin and have a surface glaze applied by the lab. If a patient feels the veneer is over-contoured then we send the veneer back to the lab for a remake instead of grinding on the porcelain. Since yours have already been bonded I would suggest removal and remaking when you have the other teeth treated. Best of luck on your new smile!

Q: How to get rid/removal of blackness on a temporary tooth? (photos) I got temps the other day before I get my veneers and one of the teeth are black, so I’m wondering how can I get rid of the blackness on it? thanks.

A: Based on the photo it appears you either have contamination, micro-leakage under the temporary restoration, or the tooth structure under the plastic material is very dark and is showing through in a thin area. Contamination can occur from various medicaments the dentist may have used. These can react with the oral environment and turn black. Micro-leakage is a situation in which the cement seal around the temporary is broken and fluid and pigment can leak under the plastic temporary and cause staining. If the tooth is dark underneath then the crown preparation may need to be modified to eliminate the “show-thru” you see. Give your dental office a call and tell them what’s happened. I’m sure they would want you to come in right away to determine the best steps they should take to correct the problem. We wish you the best of luck!

Q: Is Kor Whitening the best in office whitening treatment? I currently have braces and want to get my teeth whitened once their removed. I did some research and a lot of people said that they didn’t see any significant results. I know everyone is different and get various results. I just want to make sure this is the best option available. Can Kor Whitening make a dramatic difference?

A: Kor whitening is an excellent option for some patients. You may or may not need Kor. It will depend on your goals and the current situation of your teeth. Professional whitening products that are found in dental offices are not “one size fits all.” There are different types of whitening products, different strengths, different durations they are used, different delivery methods, and different techniques that can be used depending on the product selected. We find a customize whitening plan actually saves patients money and helps them avoid disappointing results. I encourage you to find an office that offers many different whitening options and visit with them to find out what would be the best fit for you. We wish you the best of luck!

Q: I’m about to just say I’d be better off getting dentures. What should I do? I got composite bonding on front four teeth in 2011 to hide the gaps. It’s now discolored, rough, and chipped out a little in my two front teeth. I had my first premolar pulled bc it was a baby tooth. I am missing a couple teeth on top that just never grew in as a child/teen. I wanted veneers and a bridge done for pulled tooth (quick fix) but my dentist is saying no because I need braces (without removing the bonding?) and space is too small for bridge. Won’t braces make bonding pop out? What should I do?

A: It is not uncommon for new patients to come to our practice seeking a correction for existing anterior composite bonding. While there are many patients that have had excellent results from bonding the difference typically involves three aspects: planning, material and the artistic skill of the dentist. When spacing is involved careful planning, which includes gathering records and the creation of a prototype design that can be replicated in the mouth, yields the most predictable results. Sizing of teeth (length and width) along with proper function can all be built and tested prior to your appointment. We find this planning stage is often skipped because dentists are applying the composite bonding freestyle. Small quick fixes can be handled with a freestyle approach but complex aesthetic cases require a more detailed approach. Composite bonding is built layer by layer and can be very technique sensitive. When high-quality materials are used by a clinician that is skilled with that material the results can be outstanding. A couple points to consider, bonding is not the best material for many situations and bonding is not always the less expensive option. Many people ask for composite bonding because they think it is less expensive. The time and artistic skill required to seamlessly blend even a very small filling is considerable. Seek out a dentist that focuses on the procedure type that interests you. These individuals likely have the experience and expertise required to get a great result if composite bonding is the best material choice. Hopefully, you can avoid tooth lose and obtain the aesthetic solution that will make you happy. We wish you all the best!

Q: Will dental implants (with bone grafts) “help” rebuild my old jawline/face shape?
I had a lower back molar (the second from the back) extracted about three years ago and since then, I’ve noticed that my jawline (on only that side) has “shrunk” and is now much shorter than the other side of my face. It makes my jawline incredibly asymmetrical! I am also missing two teeth above that tooth. Will getting those missing teeth replaced with dental implants (with bone grafts/sinus lifts) reverse this noticeable shrinkage/collapse, or has the damage already been done? I am 33 years old.

A: Without pictures it’s difficult to see the extent of the “rebuilding” needed. If your jawline is “shorter” and an asymmetry in arch length is present then the required correction may be more extensive than just bone grafting or a sinus lift. Patients with deficiency in mandibular length may require a “mandibular advancement” along with bone grafting to rebuild lost bone height and width. Once a tooth is lost/ removed the body quickly begins to reshape and “melt away” bone that is no longer needed to support a tooth. This is why early planning of an implant/bone graft is important. More and more dentists are placing bone grafting material when teeth are removed even if an implant is not immediately planned. It is more cost effective to place the bone grafting material immediately after a tooth is removed instead of letting bone loss occur and then grafting later. Often grafts that are placed many years later are significantly more expensive because the amount of bone and technique required to obtain a successful result.

It is possible that bone grafting and a sinus lift will solve your issue, but you should seek out a restorative dentist experienced in reconstruction or smile rejuvenation. The restorative dentist will act as the “quarterback” by coordinating, planning, and working with any specialist required to get you to your desired end result. The first step will be to gather records which will include a 3D cone beam scan. From there the design of your case can begin. Today, 3D cone beam scanners are used to virtually design and plan your surgery including bone grafting, sinus lifts, implant location, as well as the spacing for final abutments and crowns. The very best cosmetic and/or complex restorative cases require that planning begins with the desired end-result in mind. We wish you all the best!

Q: 10 months post-op Invisalign. Is he right or giving me a runaround to avoid revisions? I have been wearing Invisalign for about 10 months now and just went in for my last three trays. I pointed out to the orthodontist that one of my teeth hasn’t moved much and we are almost at the end. He said I have to wear my last tray for six weeks because the last tray has the most force and he wants to see what it does. I have been wearing them for three weeks each and I don’t see how extra three weeks is going to make a difference. Is he right or giving my a runaround to avoid revisions?

A: The easiest way to answer your question is to tell you how we would handle your situation in our office (based strictly on a hypothetical with the details you provided). We would evaluate the ClinCheck software which shows us how each tooth movement was planned and when movements were staged. The evaluation of the tooth you feel did not move could be specifically examined. Some questions I would have would include: What movement was prescribed? What was the assessment of that movement (easy, moderate, advanced)? What attachment type was used? Did all previous aligners fit as designed? When/where did the tooth movement stop? Was slenderizing (IPR) indicated around that tooth? Typically, if we determine there was planned movement and it did not occur as planned we would proceed directly to a “refinement” and take new scans or impressions.

Over-correction aligner sets are included with each case and are designed to squeeze the teeth together and eliminate any spaces. Bodily movement and rotation will take longer than three aligner sets and are not typically part of any over-correction movements. I would encourage you to return to your dentist and discuss your concerns. Together, you both can determine the best course of action. We wish you all the best!

Q: Veneers or crowns? I recently had a consultation with a dentist because I would like gum contouring and preferably eight veneers on my upper teeth. I was quote alarmed to be told that all five upper teeth would need crowns and all four teeth on my bottom arch would also require crowns. The reason given was that the four bottom teeth needed pulling outwards, and the one tooth that protrudes at the top would not be suitable for any kind of veneer. The thought of having so many crowns is something I feel uncomfortable with!

A: The right solution for you really depends on what matters most to you. Is speed of treatment paramount or are you willing to take a slower more conservative route to achieve your smile goals? The fact that your teeth are not in the correct position presents you with two options: (1) Restorative Only – aggressive removal of tooth structure to reposition them and obtain a correct arch form for more ideal aesthetics and function by using a combination of crowns, veneers, and even extractions, etc. or (2) Ortho and Restorative – use orthodontic therapy to reposition your teeth then proceed to correct the aesthetic issues with conservative restorations such as veneers. Patients that want a quick fix and do not mind aggressive removal of tooth structure typically will select the restorative only route. Patients that want to conserve as much of their natural tooth structure will typically invest the time required for Invisalign or traditional braces to move their teeth to the proper position first then proceed with porcelain restorations. There is not a right or wrong answer. It depends on your goals, time constraints, risk tolerance, and personal preferences. Best of luck with whatever option you select!

Q: I want my teeth to show when I smile, but all you can see is the very tip of them. What can I do to help this? What would be the best thing for me to do to improve my smile? I hate smiling because of how my teeth look.

A: I would suggest you visit a dentist that focuses on cosmetic dentistry or an orthodontist. Those are two great places to start since they are both familiar with facial and smile aesthetics and can offer suggestions for meeting your goals. It may be best to start with the cosmetic dentist first since they can help the orthodontist understand any planned cosmetic or restorative work. Based on the photos it appears that you have great lip shape so improving the position of your teeth and brightening them up can help you become more confident in your smile. Invisalign or traditional braces would be an excellent first step. By leveling, aligning, and improving your bite you can eliminate many aesthetic issues and provide a much better foundation in which to build any cosmetic work you may elect to have done. Often patients come into our office asking for veneers and we find we can accomplish their aesthetic goals with more cost effective options such as Invisalign and whitening. The best option for you depends on your unique starting point, time constraints, the specific outcome you are looking to accomplish, your expectations, and the shade (color) you would ultimately wish to obtain. We find once those questions are answered the best option becomes clear. We wish you the best of luck and hope you obtain a smile you can be proud to show off!

Q:  I had teeth whitening today. It has left in between my front two teeth a very bloody black mark on the gum. Any suggestions? I get married in three days and I had teeth whitening today. The biggest day of my life is happening what can I do except smile with not showing teeth?

A: If you had an in-office whitening session there should have been a tissue barrier placed over your gum tissue. Your picture shows a fairly typical whitening gel tissue burn. This is a known possible complication of the in-office system and should have been part of the informed consent information you reviewed prior to the whitening procedure. These tissue burns occur when the whitening gel touches your gum tissue for a period of time and causes irritation. The gum tissue may appear bruised at first and then usually turn white or grayish-yellow as the surface tissue sloughs off and regenerates. This process can be fairly painful and unnerving. The tissue will heal and be just fine but that may take a few days to a week. You can use Vitamin-E gel as well as swish with warm salt water that will speed healing and provide some relief. Congratulations on getting married and we wish you the best of luck!

Q: For teeth whitening, what benefits would there be between working with a general dentist and a cosmetic dentist? It seems that the general process for teeth whitening is fairly standard, and not much ‘artistry’ is involved in it, and so, is there any particular qualification I should be looking for in searching for dentists?

A: Whitening is a common procedure and most general dental offices will have at least one whitening option. One key difference is an office that focuses on cosmetic dentistry typically will have an extensive knowledge base related to whitening, a broader selection of whitening options, and tend to be on the leading edge of materials and techniques. There are many different whitening systems, bleach concentrations, and techniques we use for different patient needs. Instead of just selling gel, we build a solution that meets the needs of each patient. There is not a one size fits all approach. I would suggest that you call a few offices and ask what they offer and how they determine what is best for each patient. When you find an office that tells you there is not a one size fits all approach you have found an office that is focused on what you need instead of just selling whitening gel. We wish you the best of luck!

Q: Is laser or conventional crown lengthening better? And why? I had an old root canal infected and recently had 90% of the bacteria removed. The remaining 10% will be removed next week. I was told I need a crown lengthening. If this were your tooth, would you choose laser or conventional crown lengthening? What are the pros and cons of each? Thank you!

A: Great question! It’s important to understand that dental lasers are basically new tools that are used to accomplish a wide variety of common dental procedures. The exciting aspect of dental lasers are the new minimally invasive techniques that are now possible. There are very specific parameters that must be right to use these minimally invasive techniques and not every patient is a candidate. The end result of either method depends on the knowledge, experience, and clinical expertise of the dentist doing the procedure.

Hard-tissue lasers offer precision, do not cause the same histamine release by the body when tissue is removed, and provides faster healing and dramatically reduce post-operative discomfort. If I needed crown lengthening I would 100% prefer that a hard tissue laser be used by a skilled dentist that had lots of experience doing that procedure. I use lasers everyday for crown lengthening, gum sculpting, and decay removal so I see first hand what an amazing tool it is and all the advantages it offers. FYI, the same laser that can re-contour the bone for crown lengthening can also be used during root canal procedures and used to kill bacteria and improve the final results. Best of luck with your procedure!

Q: I had my back molar extracted. Can I continue using my Invisalign trays? I’m in another country.

A: Yes, you can still continue to use your aligners. I would suggest that you remove the last molar from the aligner that covered the tooth you had extracted. Consider using a small pair of (very sharp) scissors to trim the aligner. By continuing to wear your aligners you will keep all the other planned movements moving forward and prevent any relapse. Consider emailing your dentist and let them know your situation. We wish you the best of luck!

Q: Two Veneers vs a Full Set? Hi there. I have some slight discoloration/banding on my upper front two teeth. It’s not noticeable in some lights but pretty noticeable in others. I’m 28 years old, male, and brush/floss every day. At $1500 per tooth, I don’t have enough cash to get a full set of veneers. I’d like to only get the front two done; however, I am worried about them changing colour at a different rate to my other teeth over time. My natural teeth are quite white. Is anyone able to offer any advice? Many Thanks.

A: Great question! I help patients answer this question by finding out what end result they are looking to achieve. If a limited (two veneer) approach obtains that result you desire, then that’s your best option. If, however, you would like to improve your overall smile, then more would be required. We find financing options help patients get the smile they want without compromising. Flexible financing options can open up possibilities for patients that can’t or don’t want to pay cash for the solution they really want. Make sure to ask your dentist what financial options they offer. They may be able to find a way to make an investment in 2 or more very comfortable for you. With respect to color change – porcelain veneers do not change color. Older adhesives and bonding resin did change color over time but the new advanced materials we use today do not. I would not be concerned that properly designed and bonded veneers would change color. However, your natural teeth will change color over time. If you select a limited option (two teeth) you will need to use whitening gel to touch-up the color of your natural teeth in order to maintain the match with the porcelain restorations. Discuss your concerns with your dentist and they should be able to help you make the very best decision for you. We wish you the best of luck!

Q: Do I need to fix my crowding or overbite before getting veneers?  I have some crowding on my bottom row of teeth. Does it look severe enough that I will have to have orthodontist fix it first before I get veneers? I also have a 100% overbite. will that have an effect on getting porcelain veneers?

A: Yes, for ideal results I would suggest that you correctly position your teeth via orthodontic treatment first. This will address your deep bite and also improve overall fit and function of your teeth. Once orthodontic treatment is complete you may be able to whiten your teeth and not need porcelain veneers. The time invested in the orthodontic treatment will be worth it over your lifetime. Porcelain veneers may be a quick fix, but not the most ideal solution for your situation. We wish you the best of luck!

Q: What are your thoughts on GLO Whitening Professional kit? Yesterday, I asked my dentist about whitening trays or in office whitening. He only uses (sales) the GLO Professional whitening product. He said this product is different than the OTC product they sale because of the higher percentage of active ingredient in the product and my teeth with slight yellowing would make me an ideal candidate. Is this all correct and does the product work? Thanks for your responses!

A: The take home product contains 6.5% hydrogen peroxide and the in-office contains either 24% or 30% hydrogen peroxide. The professional products do work and produce noticeable results much faster than over the counter (OTC) products. The percentage gives you an idea of the strength of the active whitening agent. Your dentist will determine the correct level for you and your situation. The lower percentage will work, but it takes much longer. The benefits of visiting a cosmetic focused dentist is that most have a variety of whitening options they can suggest based on your unique needs. Most patients want quick results. OTC products are slow to produce results. Many patients tell us they have tried multiple OTC products without success and have spent much more than our professional products cost. They simply assumed they cost more. You should contact your dentist and find out the various options and determine for yourself. We wish you the best of luck!

Q: How can I have a more natural smile? It takes lots of effort to show teeth when smiling &when I do it’s strained &sometimes asymmetrical, Considered lip fillers but don’t know if they’d bring top lip down or fill lips up so that smiling is even harder? Read about lift lifts, but in one of the photos my gums are even showing so think I’d end up needing work done to gums/teeth? Heard botox in muscles can help with tight looking smile but got no idea if I’d be a candidate? Feel so vain but It really annoys me, just want a nice smile!

A: I think you are correct with your assessment about your upper lip. From the photos provided you appear to have nice teeth arranged in a good position. Your lips at rest look more full than when in a full smile. I have the opportunity to work with a facial plastic surgeon specialist everyday on cases like yours. Your situation is fairly common and is best treated with the correct technique to provide volume to your upper lip without making it drop further onto your teeth. Botox would limit the distance your upper lip travels. So that is a great option for patients that show lots of gum tissue. You do not appear to have that problem. I would suggest whitening your teeth and seeking out a facial plastic specialist that can show you examples of cases they have treated like yours. That way you can see what results they have obtained for others and decide if that is right for you. If you still have dental questions I suggest finding a dentist that focuses on cosmetic dentistry and visit with them for a complete smile analysis. They can evaluate your smile in relation to your overall facial aesthetics and make suggestions. Based on your photos, I would suggest whitening your teeth and consider an upper lip filler. We wish you the best of luck!

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Whatever you are looking for, our skilled dental team is ready to meet your needs today. By contacting the Charlotte Center for Cosmetic Dentistry, you can trust that your smile is in skilled hands. Get in touch with Dr. Broome and Dr. Hsu today to make an appointment!

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