ASHISH PATEL BDS MSD DDS

 

reviews button Appointment Button
Or Call 313-885-9454

Why Can’t I Rinse with Peroxide to Whiten My Teeth?

Posted on by .

I have learned that the whitening gel that dentists use to whiten your teeth is simply hydrogen peroxide. If that is the case, why can’t I whiten my teeth by rinsing with the peroxide I have at home every day?

Lenny

Dear Lenny,

teeth bleaching trays

Teeth Bleaching Trays

 

While I love your “can-do” spirit, there are some differences between the peroxide you have at home and the peroxide your dentist has at his or her disposal. Your household peroxide is 3%. The peroxide your dentist will use is 25 – 33% hydrogen peroxide. That is a huge difference. To give you some idea. Crest Whitestrips, which you can buy over-the-counter only contains 6% peroxide and provides only the mildest whitening, used over a long period of time. Even that is twice what you can achieve at home with serious persistence.

A second consideration is how to get it to soak into your teeth. Most of the staining in your teeth is internal, with the dentin. The enamel itself is translucent. The peroxide needs to be in contact with your teeth a minimum of about 15 minutes in order to soak in and reach those internal stains. I do not know many people who can stand to rinse with peroxide for that long.

Truthfully, your most effective and safest option is to do your teeth whitening through your dentist who can provide you with custom-fitted trays that can reach all of your teeth while protecting your gums.

This blog is brought to you by Grosse Pointe Woods Cosmetic Dentist Dr. Theodore Hadgis.
Click here to learn how you can whiten your teeth in just one appointment with Zoom Whitening.

Dentist Said My Teeth are Too White

Posted on by .

I’ve been going to the same family dentist for years. Now my kids go to him. He doesn’t do cosmetic dentistry, so whenever I wanted to whiten my teeth, I went to a colleague of his that does. So, I go to him for my regular dental work and her for my teeth whtiening. I’ve recently been dealing with some health issues and had neglected my oral health care. As a result, I need my first crown. My dentist said my teeth are so white he can’t match the crown to the other teeth. Should I go to the cosmetic dentist for this? It seems like he should be able to do this so I hate to take business away from him.

Laura

Dear Laura,

I’m glad you wrote. So, it would not be taking business away from your dentist because, as you said, he does not do cosmetic work. In a way, matching a dental crown to teeth that have undergone teeth whitening is cosmetic work. Here is what your family dentist is up against.

tooth shade guide

Old Shade Guide

Before teeth whitening grew in popularity, the shade guide above is what dentists would use to match a tooth. The thing about teeth whitening is it does not just whiten the stains on your teeth. It can also whiten the natural pigment. That means some teeth, such as yours, will be whiter than the lightest shade on the old shade guide. This is probably the guide your dentist is working from.

updated shade guide

Updated Shade Guide

However, dentists who do a lot of cosmetic work use a newer shade guide that has a broader group of whiter shades. The way I see it, you have two choices. You can go to the dentist who does the teeth whitening and she should be able to match the tooth. Another option is to let your family dentist know about the newer shade guide and see if he’d like to try from that.

One word or caution, if this is a very front tooth, you may want to stick with the cosmetic dentist. Even among dentists who do cosmetic work only about 2% can accurately match a front tooth. So, whoever you decide to have do it, make sure they use a temporary try-in paste first and let you see it in a variety of lights before you give final approval for them to bond it on.

This blog is brought to you by Grosse Pointe Woods Cosmetic Dentist Dr. Theodore Hadgis.
An AACD accredited dentist.

Getting Four Front Implant Teeth To Look Good

Posted on by .

I am getting four dental implants on my front teeth. I decided on four separate implants with four separate crowns. I asked my dentist what to expect. He told me we’d do the implant surgery with an oral surgeon. Then, after everything heals he will do six dental crowns. He said that the other two are necessary to get the teeth to match well. Here is my concern. Why does it take an extra two crowns to get them to look right? Maybe I am being silly, but those other two teeth are healthy so I sort of hate to put crowns on them. Is there another option?

Elisabeth

Dear Elisabeth,

An illustration of a dental implant next to a natural tooth

I am very glad you wrote. You are not being silly. I would say you are being very smart. It is not necessary. Generally, when a dentist is suggesting extra crowns in order to match teeth, it is because they don’t have very good cosmetic skills and this is an easier way to match the teeth. Here is the problem for the patient when that happens.

First, it costs more money. Money that you could use elsewhere. Second, as you have pointed out, it unnecessarily damages healthy tooth structure. Third, just because the teeth match, doesn’t mean they will look good.

One thing you did not mention is your dentist suggesting you have teeth whitening done. I don’t know how wide your smile is, but most smiles are 8-10 teeth wide.  Even with those two extra (unnecessary) crowns your adjacent natural teeth would still show.

Here is my suggestion. First, you need to find a different dentist to do this procedure. Your front teeth are one of the first things people notice about you. I don’t want you to end up in the cosmetic dentistry horror story files we’ve accumulated over the years hearing stories from people who went to bad cosmetic dentists.

My suggestion is you look for an AACD accredited dentist who is also highly trained in placing dental implants. Then, get your teeth whitened to the level of whiteness you want your smile to be. Then, when your implant dentist creates your porcelain crowns, they will match the color you will want permanently.

This blog is brought to you by Grosse Pointe Cosmetic Dentist Dr. Theodore Hadgis.

 

Teeth too White for Dental Crown?

Posted on by .

I broke a tooth and need to have it crowned, but my dentist said that my teeth are whiter than any of the shades on the shade guide. I do whiten my teeth at another practice. I go to my regular dentist for general dental care and another dentist, who is a cosmetic specialist, for my cosmetic work. What do I do? Can the cosmetic specialist whiten the crown?

Mary Bell

Dear Mary Bell,

tooth shade guide

Old Shade Guide

Your general dentist is way behind on the developments in his field; like decades behind. The old shade guide (pictured above), used to be sufficient and could match just about any tooth. Then, in the 1990’s more and more patients started whitening their teeth. Now dentists were seeing an influx of patients whose teeth were whiter than the shade guides. That is because professional teeth whitening can do more than remove stains. It also whitens the natural pigment of your tooth.

updated shade guide

Updated Shade Guide

To accommodate patients with these whiter teeth, the shade guides were updated. Obviously, your dentist is not aware of this. Above is one example of these newer shade guides. Most dentists have these attachments now. I am certain a dentist that has kept up with the changes in their field will be able to give you a dental crown that matches the white color of your teeth.

It’s time for you to find a new dentist. The best dentists will go beyond the minimum required continuing education hours and are continually increasing their skills and offering new services.  That is the type of dentist you want.

One thing I do want you to be aware of as you are choosing your new dentist. Cosmetic dentistry is not a recognized specialty. That means any general dentist can call themselves a cosmetic dentist. While almost any dentist can do teeth whitening and it doesn’t require that much training, if you decide in the future to get a more advanced procedure, such as a smile makeover with porcelain veneers, you will want to make sure they have significant post-doctoral training. I would only do that with a dentist who is AACD accredited.

As to your crown, go to the dentist who did your teeth whitening. I’m sure he has the updated guide.

This blog is brought to you by Grosse Pointe Woods Cosmetic Dentist Dr. Theodore Hadgis.

Pain when Teeth Whitening

Posted on by .

I have been using an over-the-counter whitening product. It was going fine. Then this week I had a painful zing while wearing them. The spot is right where I have some old dental bonding done to repair a chipped tooth. Does this mean the teeth whitening gel is weakening the bond on that tooth? If so, what should I do?

Tamara

Dear Tamara,

teeth bleaching trays

The good news is that not even professional teeth whitening, which is significantly more powerful than anything you could get over the counter, will weaken the bonding on your tooth.  When bonding weakens, you are more likely to have the entire repair fall off than just a zing. I haven’t examined you, but the most likely culprit is that you have a sensitive area that is being affected by the whitening agent.

My recommendation is for you to temporarily stop whitening until a dentist can look at it. if it is just a sensitive area, they can place some dental bonding on it so you won’t have sensitivity. I don’t know if you are aware of this, but teeth whitening, no matter what type will only work on natural tooth structure. This means the repair you had done for your chipped tooth will need to be replaced if you want it to match your whiter tooth color.

I am assuming you have a good dentist who has some skill with cosmetic bonding if you were happy with how your dental bonding matched your tooth. If so, have him look at your sensitive spot, cover it, then re-do all the bonding when you reach the level of whitening you want.

If you weren’t happy with how your dental bonding matched, then you need to find a more experienced cosmetic dentist. If you want a cosmetic dentist with proven skills, look for one who is AACD accredited. They are the best cosmetic dentists in the country.

This blog is brought to you by Grosse Pointe Cosmetic Dentist Dr. Theodore Hadgis.

Whitening Non-Veneered Teeth

Posted on by .

I have four porcelain veneers that look great, but my adjacent teeth are yellow compared to them. I wasn’t thinking about the difference in color when I got my veneers, I just made them the color I want them. Is there an over-the-counter product I can use to whiten the non-veneered teeth? Is there a way to do this without damaging the porcelain veneers?

Eva

Dear Eva,

teeth bleaching trays

First, let me point out it wasn’t your job to think of the color difference on your teeth. Very few smiles are only four teeth wide. Most are 8-10 teeth wide.  It was your dentist’s job to discuss the color difference. You could still have your porcelain veneers as white as you’d like. However, your dentist should have suggested you whiten your teeth before having the veneers placed. That is standard practice.

Fortunately, it is not too late. You can still get those teeth whitened. If you have your heart set on an over-the-counter product, the only one I would recommend is Crest Whitening strips.  Whatever you do, don’t use any over-the-counter whitening toothpaste. These use an abrasive to get rid of stains. They will damage not only your veneers, but your natural teeth as well.

Crest Whitestrips will work, though you will have to do some manipulating. They only cover the front six teeth. Four of yours are already covered with veneers, so I would use two strips and put them on each side of your veneers. Be aware that these are much weaker than what you’d get with your dentist.

If you want this done more efficiently, have your dentist make you custom-fitted teeth whitening trays and provide you with professional-strength gel. Initially, it is more expensive than the Whitestrips, but the number of kits you’d have to purchase to get the same results over a longer period of time eventually ends up costing you more.

This blog is brought to you by Grosse Pointe Woods Cosmetic Dentist Dr. Theodore Hadgis. An AACD accredited cosmetic dentist.

Teeth Whitening Touch Ups

Posted on by .

I’m about to get a dental crown on a front tooth so I want it to look very nice. I need to touch up my teeth whitening in order to make sure my crown can be made a color I’ll want to keep. I just need someone to give me some advice on how to go about that. My dentist wasn’t sure. Here are my questions: First, how many weeks do I need to plan to whiten? Second, how long each day? Third, is there a waiting time between finishing whitening and getting my dental crown?

Alicia

Dear Alicia,

teeth whitening trays

I’m going to answer the last question first because it is the easiest. You’ll want to leave at least a week, preferably two, between the time you stop your teeth whitening touch up and the time you choose the color for your dental crown. This will give the whitening time to stabilize.

As for the first two questions, a lot of the answer depends on how white you want them. Each patient has a different level of whiteness for their goal. The bottom line is the longer you whiten, the whiter they’ll get. That goes for number of hours a day in addition to how many days a week.

I’d suggest wearing your whitening trays for as long as you can tolerate during the day or, if you are able, wear them overnight. The longer they’re on, the faster your teeth will whiten and the fewer days you will need to wear them.  If you can’t tolerate them overnight or can only wear them about an hour a day, then plan on making that whitening time up in the number of days you wear them.

Dental Crowns on Front Teeth

The one concern I have here is your dentist wasn’t able to answer these questions for you. Teeth whitening is a pretty basic (if not the most basic) type of cosmetic dentistry procedure around. Yet, he couldn’t guide you. Placing a dental crown on a front tooth is much more advanced. I’m worried he may be in over his head.

Here are some things to look out for to ensure you get the beautiful results you want.

First, he needs to place an all-porcelain crown. Make certain he doesn’t place a metal-based crown on your tooth. These never look as natural and eventually develop a dark line at the gumline. Second, make sure he uses a temporary try-in paste before permanently bonding on the crown.

This will allow you to see what the crown will look like and make certain that it matches your other teeth. If it doesn’t, he needs to send it back to the lab. Even the best cosmetic dentists, will usually need a couple of try-ins with a front tooth so don’t expect him to get it first go-round.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

Does Premium Home Whitening Work?

Posted on by .

I received an offer in the mail for a Premium Home Whitening Kit. Do they work?

Callie

Dear Callie,

teeth whitening trays

Looking at this product I’ve got a positive and some potential negatives. First, the positive. The active ingredient is 35% carbamide peroxide. This whitening agent will work. That is quite a positive!  The blue light they offer doesn’t really have any value, though it won’t hurt anything.

Any over-the-counter kit is going to have a tray that doesn’t fit your teeth as well as what you would get with a custom fit tray you’d get with your dentist. That looseness can cause some negatives:

  • Leakage of the gel:  This will weaken the effectiveness of the gel. In turn, this will require you to need more gel to get the level of the whitening you desire, costing you more money with additional kits.
  • Vulnerability to your teeth: Just as your gel can get out, there will be things that can get in and pool there. This could be your drink or some food and bacteria. Sitting there will cause it to eat away and weaken the enamel of your teeth.
  • Irritation: A secondary problem with the leakage is that you risk irritation to your gums. In some cases, there can be more serious consequences such as one patient I know of, who needed a root canal treatment as a result of whitening her teeth outside of her dentist’s care.

You are likely looking at this option because you feel it will save you money over the professional teeth whitening your dentist offers. While that is possible, a lot of that will depend on how much whitening you want. What your dentist can offer is stronger and more effective, so it will take fewer treatments.

If all you will need is one kit, then yes, you could save money this way. But, looking at the maximum results you can get from one kit, I find it unlikely that would be someone’s end goal. You would need several kits. At that point, you are equal, if not more, to what your dentist would charge, without the benefit of being under their care where they can monitor for the start of any complications. I would talk to your dentist. If finances are keeping you from moving forward, ask if he or she offers any payment plans which would allow you to get started.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.

My Composite Bonding Doesn’t Match My Teeth

Posted on by .

I had some composite bonding placed on my two front teeth which had some brown spots on them. She made them whiter than the adjacent teeth. I do like the color, but it is obvious next to my natural color that they are not the same.  Is there a way to remove the bonding without damaging the underlying tooth in order to get them to match?

Candy

Dear Candy,

teeth whitening trays

Yes, it is possible to remove dental bonding from your teeth as long as it is on the enamel and not the underlying soft dentin. Here are three ways for your dentist to approach it:

Option One: Sandpaper Disks

These are the same disks your dentist uses to polish up the bonding. This can create a smooth surface and it is flexible which is an advantage in getting the shape of the tooth. The method is fairly slow though.

Option Two:  His Speed Carbide Drills

This is a much faster option. It will do a good job, but its shape leaves steaks so your dentist would want to finish off and polish it up with the sandpaper disks.

Option Three: Air Abrasion

This isn’t a common piece of equipment, though some advanced cosmetic dentists will have it. This is another slow but accurate method that would leave a good polish.

Getting the Color You Want

You mentioned that you liked the color of the bonding your dentist placed, but just didn’t like that it didn’t match your adjacent teeth. An option you have is to have your teeth whitened. It will only whiten the natural tooth color and not have an impact on the bonding itself.

If you do teeth whitening trays, you will have more control over the level of whitening. You have a decent chance of getting the color close enough that you will not need to take off and replace the bonding.

Based on your case thus far, I don’t have the highest confidence in your dentist’s cosmetic abilities. I’d rather you take this safer option first. Though, of course, the decision is yours.

This blog is brought to you by Grosse Pointe Cosmetic Dentist Dr. Theodore Hadgis.

Tanda Pearl Ionic Teeth Whitening System

Posted on by .

I’ve recently read some reviews of the Tanda Pearl Ionic whitening system. This allows you to whiten your teeth in just 5 minutes a day. People are saying it’s working. I’ve been using the tray my dentist provided for me, but I’ve noticed when I use it, it aggravates my TMJ. I wondered if the Tanda system is a better option for me because it works so much more quickly. Do you know if this option is safe?

Kathryn

Dear Kathryn,

teeth whitening trays

The type of whitening that Tanda Pearl uses is similar to how most teeth whitening works. It uses a peroxide gel. The light they use isn’t special, but my guess is that it is just there for psychological reasons. If they had a light that made whitening work that quickly in reality, they’d make a total fortune selling that to dental offices. The fact that they’re not even trying tells me they know it doesn’t really do much.

However, there is a MAJOR difference between the trays your dentist likely provided you and the whitening tray available through Tanda Pearl. Your dentist should have made a custom-fit tray for each arch of your teeth. The Tanda Pearl system has one tray that you have to bite down on in order to keep it in your mouth. Even for just five minutes, that will cause your TMJ pain to be significantly worse. You don’t want to have to clench your jaw for any period of time.

In your place, I would do two things. First, tell your dentist that the trays are aggravating your TMJ Disorder. Maybe there is something off about their fit. If he doesn’t have significant TMJ training, you may want to see a dentist who does. It’s not something that is taught in dental school. A dentist has to invest in post-doctoral training in order to properly treat TMJ Disorder.

If the trays are fine, then just cut back on the amount of time you’re wearing them. If the idea of five minutes appealed to you, wear them for five minutes. The amount of time the gel is worn only affects how quickly the teeth whiten. They’ll still whiten. As you’ve already paid for the trays, I wouldn’t bother wasting money on something else.

This blog is brought to you by Grosse Pointe Woods Dentist Dr. Theodore Hadgis.