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Can my dentist just “paint over” my white spots on my front teeth?

I have had white spots on my two top eye teeth since I was a teenager. I recently had Zoom whitening done. The rest of my teeth whitened but these white spots are still there. My dentist says that he can “rough up” the outer part of my teeth and paint over these two spots. I suppose this is safe? I do not want to damage my teeth just to get rid of a white spot. I also want them to look natural since they are front teeth. I am so undecided about whether to get this done or not. Any suggestions?
– Darla in Tennessee

Your dentist is partly right but not exactly, and I worry about whether he would be the right person for this procedure. This isn’t a difficult procedure to perform and doesn’t require much artistic talent, but there are a couple of things that need to be done right or the result will look funny.

Dentists who aren’t well trained in cosmetic dentistry often think that spots on the teeth can be eradicated by bleaching the teeth. It never works. In fact, bleaching usually makes these spots more noticeable. The correct treatment for spots is direct dental bonding with composite, if they are limited in area, or porcelain veneers, if the spots are more widespread.

White spots on the teeth are usually very superficial, and for the result to look right, the spot should be ground out and replaced with a fairly translucent enamel shade of composite. And this composite should be a highly polishable microfill. If this is done in this manner, the repair will be undetectable. If the spot isn’t completely ground out, the dentist will have to use a more opaque shade, and it will look like a repair. If your dentist is saying that he is going to “paint over” the spots, maybe he is just trying to convey the procedure to you in a simple manner. But it may be that he doesn’t understand that he needs to use a translucent material here. And many dentists don’t have these translucent shades of microfill composite in stock because they don’t do that much of this kind of work, and they are less artistically demanding of themselves.

There are two layers to a tooth. There is an inner dentin layer, and an outer enamel area. The dentin is less translucent than the enamel. When an expert cosmetic dentist does direct dental bonding repair on a front tooth, say for a corner of the tooth that is broken off, he or she will use several different materials. There will be more opaque materials laid down first, and if an extensive area is covered, it will be shaded to have slightly more color near the gumline. This material is usually a hybrid composite, which is stronger than a microfill. Then a more translucent microfill is layered over this. This layer simulates the enamel. Besides being translucent, it is polished to a high luster.

If your dentist does this bonding and muffs it, it could hurt your relationship. If you have concerns about his expertise in cosmetic dentistry, I would suggest you go to the mynewsmile.com website and look for a recommended cosmetic dentist need you. This website screens dentists based on training and artistic ability, and recommends excellent cosmetic dentists all over the country. (Dr. Newkirk is their recommended cosmetic dentist for Naperville.) Then, if you like your own dentist, you could return to him for your regular checkups and maintenance.

This blog is sponsored by Dr. David Newkirk, who is also a Naperville implant dentist.