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Retouching Teeth Whitening

I whitened my teeth several years ago and would like to retouch them before I have to get my dental crown. This way I can make it into the color I want. The problem is my dentist can’t tell me how to go about this. I’m hoping you can. My dentist has a 33% of whitening gel. Here are my questions. First, how many weeks should I use the gel? Second, for how many hours each day should I whiten?


Dear Audrey,

Image of teeth whitening trays
Professional teeth whitening trays

There are not specifics that work with teeth whitening like that. However, there are general principles. I don’t know exactly how white you want them. The most basic of these principles is that the longer you wear the whitening gel, the faster your teeth will whiten. If you wear them overnight, which is the most effective time to bleach, your teeth will whiten much faster than if you just wear the trays for an hour a day.

As an example, and this is most definitely not exact, if you wear them overnight, you could do in one week, what wearing them an hour a day would take you eight weeks. Again, not exact, and it depends on how white you want them.

The one sure principle, is something you have not asked. You will need to wait two weeks from the time you finish whitening until you match the crown color. This gives the whitening the time to settle to its final color before you start with the porcelain crown.

One thing to bear in mind here. If your dentist was not able to answer these basic cosmetic questions, then how can he or she provide you with a beautiful crown? You may want to at least make sure your dentist is going to do a temporary try-in and let you make sure everything matches in a way that is beautiful before permanently bonding them on. If you’re not happy with the crown, he should be willing to send them back to the lab.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
Click here to learn about same day crowns.

Novocaine or Sedation for Porcelain Veneers?

I am on the cusp of getting porcelain veneers. I am a bit concerned about the procedure. I have a sensitivity to Novocaine as well as any drugs which can make your heart race. A friend of mine recently had the porcelain veneers procedure done and said that the green topical agent they put on her teeth made her very shaky and nervous. This went on for almost fifteen minutes. Do you know if there is epinephrine in the medication used in the procedure? If so, would I be better off having this done with dental sedation?


Dear Sally,

An image of a porcelain veneer being held up to a tooth.

Epinephrine’s function in a Novocaine injection is to restrict the blood flow and keep the medication more effective. However, any epinephrine in a body would have very little effect on the symptoms your friend experienced. It is more likely that she was dealing with anxiety. That would be a much higher amount of epinephrine than what would be in the medication given to you.

My advice would be to use a mild relaxant along with the Novocaine, such as nitrous oxide. This will keep the epinephrine in your body from getting too high and causing the issues you are concerned about. As I mentioned earlier, any epinephrine in the medication would be miniscule compared to a body’s reaction to anxiety.

I do not recommend you use a stronger dental sedation such as oral conscious sedation. Though stronger, you will not be lucid. Your dentist should place your porcelain veneers on with a temporary try-in paste. This is so that you can get a good look at the veneers and approve of them before they are permanently bonded on.

If you are practically asleep, as you would be from oral conscious sedation, then you would have no way to approve or disapprove the smile makeover. That is important.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Can You Get a Refund from a Dentist Who Messes Up?

I had a dental crown placed on a slightly crooked tooth. A few weeks later, my tooth became sensitive to both hot and cold. He assured me that was normal for the first few weeks. But, a few months later, I ended up in the E.R. from the pain. They told me I needed to see a dentist. I called a couple of dentists but had trouble getting in. Two days later my face swelled up. Luckily, when I called the next dentist and told them, they scheduled an emergency appointment for me. At the appointment they told me there was something called an open margin on my dental crown. Apparently, that led to a tooth infection and I now need a root canal treatment and a new crown. The second dentist said this is because the dental crown wasn’t placed properly.

Here is my problem. I called the first dentist and asked for my money back because I had to get a new grown and root canal treatment. I didn’t think they’d have a problem giving me my money back seeing as they messed up. Man, was I wrong. They told me I am responsible with what happens after they place the crown. But, if the crown was defective, how can that be my fault?

The second dentist showed me the x-ray and it is huge. Should my dentist have taken an x-ray after the crown to see the margin? If so, will that help me get a refund?


Dear Presley,

Man in pain, grabbing his cheek in need of emergency dental care.

I am sorry this happened to you. One of the things I suggest you do is get these x-rays from this second dentist. This will really help you. I don’t think a malpractice suit will be worth the money, but there are some things you can do.

1. Tell them you are going to go to the dental board. It will be serious for this dentist if the board gets involved and that may cause your dentist to think twice about not giving you back your money.
2. While you are not going to get enough from a malpractice suit, that does not mean that that you wouldn’t benefit from having an attorney write a letter to your dentist on official letterhead. Your dentist doesn’t need to know you’re not going to court and it could get him nervous.
3. I would see if your second dentist would be willing to talk to your first dentist. Sometimes a dentist will be willing to listen more to a peer than to a patient.

I am glad you got the emergency dental help you needed. In your place, I would switch to the second dentist permanently, especially if they’re willing to confront your first dentist about shoddy work.

This blog is brought to you by Gilbert Emergency Dentist Dr. Matt Roper.

Are Same-Day Crowns as Good as the Traditional Ones?

I had a crown placed several years ago. It was done by the computerized machines that do it the same day. Before doing the crown, she used a drill to remove a metal post. When I went back for a checkup this year with a new dentist, she told me that the crown was not fitting well and would need to be redone. She also said the post should have been removed using an ultrasonic to remove the post by vibration. As I am about to replace the crown, I am hoping you can help with with two things. First, did drilling the post damamge the bone structure? Second, are the same day crowns as good as the porcelain ones? I liked the convenience, but want the best crown.


Dear Carol,

A CEREC Machine
When Should You Get a CEREC Crown?

The drilling will not have damaged the bone. Dentists are drilling on teeth regularly. There is a risk, however. That comes with the fact that the drill could slip while in use and perforate the root of the tooth, which would lead to needing to extract and replace the tooth.

As to whether your other dentist should have used an ultrasonic device or not, that is always the ideal and I hope they tried that first, but there are times that those posts will only come out with a drill.

Before you replace this crown, I would like you to get a second opinion. When she said the crown wasn’t fitting properly that was quite vague. Did she mean the margins were open, and by that I mean gaps? That would be a reason to replace the crowns. But, if that was the issue, why not just say that? If that isn’t an issue than your crown is probably fine. Hence, the second opinion.

You asked a great question about whether the same day crowns are as good as the porcelain ones. The answer is yes. In fact, both are porcelain. The same day crowns are milled by a computer from a single block of porcelain. Traditional crowns are created by a ceramist and may use a variety of blocks of porcelain.

I hope this helps.
This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Dentist or Oral Surgeon for Denture Surgery

I have always had a fear of the dentist. This really kept me from getting my teeth taken care of. I generally only ended up going in when there was a dental emergency. I know that wasn’t the best way to handle things, but what is done is done. I am now to the point that I need dentures. Most of my teeth are either missing, broken, or decayed. In that case, should I go to an oral surgeon or a dentist to have the remainder of my teeth extracted?


Dear Bruce,

Image of dentures

I would go to a dentist who can do both the tooth extractions and the dentures. Most general dentists do pre-denture surgery. It is not a difficult thing to do. I would call to several offices and ask them what the dentist’s normal procedure is. Do not hint to them what you are looking for, just ask about their denture procedure.

Because you struggle with dental anxiety, I am going to suggest that you see a dentist who offers oral conscious sedation. This is sometimes called sleep dentistry because most patients are so relaxed they just sleep through the entire procedure. This will ensure you do not have to have any fear or pain during your procedure.

The reason for using a dentist instead of oral surgeon is to get the best fit possible for your denture. An oral surgeon won’t be as familiar with designing and fitting dentures, as a result they don’t know the things that can be done during the extractions to make this work better.

You should be aware that even the best fitting dentures will reduce your chewing capacity by 50%. There are also long-term consequences, including shrinking of the jawbone. Dental implants can help with both of these issues and I recommend discussing this with your dentist before making any final decisions on your treatment plan.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Emergency Dentist Caused Massive Problems

I had a problem where my tooth number 19 became sensitive to cold. I didn’t have a regular dentist because I have a bit of a dental anxiety. Generally, my teeth stay healthy, but this time I could tell something was wrong. I looked online and there was a dentist who called himself an emergency dentist which meant he would see patients who didn’t have a regular dentist. I went in and he did a quick examine and some x-rays. He told me that one of my wisdom teeth is impacted and should probably be extracted, but if I wanted him to do a filling instead, that could fix it as well. I went ahead to have him do the filling. It was just a few days after that when everything blew up. I was in tremendous pain. I went back to the dentist and he adjusted the filling and told me to take over-the-counter pain meds. I mentioned the pain felt deeper and closer to tooth 19, but he said the only other option was to extract the tooth. I asked for a referral to an oral surgeon and went to have the tooth extracted. That seemed to help things and I was relieved. However, when the prescribed antibiotics and pain meds wore off, the pain returned. I could not understand that because there was not tooth left. Eventually, I ended up at the ER in so much pain I didn’t know what to do. They told me that I had an abscess on the tooth which I’d been telling the dentist all along was the problem. I called him and he just told me to give it time. Instead, I went back to the oral surgeon because I didn’t trust the dentist any longer. He said that he didn’t do root canals and I need an endodontist. So, I found an endodontist. I’m out a ton of money and time, not to mention all the pain I’ve been in. To be honest, I’m more likely to avoid the dentist than ever before because of this. Is there any way I can get at least some of this money back from my dentist for all these unnecessary procedures?


Dear Dennis,

Man in pain, grabbing his cheek in need of emergency dental care.

What a horror story! I am so sorry this happened to you. I would consider this gross malpractice. Here is why:

1. The sensitivity to cold should have told your dentist right away that a root canal treatment was likely needed. If he didn’t like doing root canals, he could have simply refered you elsewhere.
2. The pain didn’t go away with the filling and he is just adjusting your bite? That was another symptom of the need for a root canal treatment.
3. You have an extraction and that doesn’t help the problem, should have told him he had the wrong tooth. Instead he tells you to “give it time.” Time for what? To develop a bigger infection and leave you with a dental emergency?

My suggestion is that you go to the dentist and ask him politely to pay for all the extra, unnecessary procedures. If you end up losing the tooth, he should pay for its replacement as well. If he refuses, you have a good malpractice case.

Help for Your Dental Anxiety

I want to make sure you are aware of dental sedation. This can allow you to get your dental work done without anxiety and without pain. There are different levels of sedation. My suggestion for you would be to use oral conscious sedation until you are comfortable at the dentist again. It is administered by a pill. However, it is so strong you will need someone to stay with you a ride to and from the dentist as well as stay with you for a few hours after your procedure until you are steady on your feet and lucid again.

Patients who use this say it changes their life. In fact, they are so relaxed that most people just sleep through their entire procedure. Give this a try, with a different dentist than the one who was such an incompetent disaster.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

High tolerance for Novocain

I have always had a high tolerance for Novocain, which has made all of my dental appointments a living nightmare. I’ve been avoiding the dentist for quite a few years as a result. I am in a position now where I cannot put it off any longer. I feel certain at least two of my teeth will need to be extracted. I just need to grab the bull by the horns. Do you have any recommendations for how to do this with the least amount of pain possible? Also, I’ve been reading up on tooth replacement options. Are dental implants as good as they are advertised to be?


Dear Carla,

woman smiling in the dental chair with her dentist standing nearby

I can actually help you on both counts here. Your dentist may not have been aware that when a person has a high resistance to Novocain, it is usually a sign that they have dental anxiety. The higher the anxiety, the greater the resistance to the numbing medication. This is because your metabolism kicks in and burns the medication off.

What you need for the numbing medication to actually work is a way to deal with the anxiety. Most people can’t just turn it on and off at will. Instead, you need a dentist who offers dental sedation options. I recommend oral conscious sedation for you. It is sometimes called sleep dentistry because it is so strong that you can sleep through the procedure. You will need someone to drive you to and from your appointment as well as stay with you for a few hours after your appontment until you are lucid and steady on your feet. You will have an anxiety-free/pain-free dental appointment.

As for dental implants, yes, they are the top tooth replacement available. Once completed, it will be like having healthy, natural teeth in your mouth again. Just make sure you see an experienced implant dentist. It is an advanced procedure. Ask them how many dental implant procedures they have done as well as what their success rate is. Don’t settle for anyting under 95%.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

One Discolored Porcelain Veneer

My daughter had porcelain veneers placed a few months ago. All of them are doing fine except one, which seems to be turning dark, sort of a bluish color. We tried to get an emergency appointment at our dentists, but he said this wasn’t considered a dental emergency. She is terrified that this veneer will fall off while she is at university. What should we do?


Dear Becky,

Porcelain veneer being added to a tooth

While not technically a dental emergency, it could be considered an aesthetic emergency. I don’t know what is going on with this veneer because I have not examined her or seen any images of her porcelain veneers. However, based on the description of the darkening and bluish color, I am leaning toward thinking she has a leaky veneer. This is when the bond is breaking between the tooth and the veneer, allowing food and other bacteria to get in between the two. This is causing the darker color.

The bad news is that eventually this veneer will fall off as the bond breaks down. When it does fall off, it is fairly easy to bond it back on. Depending on where she is going to school, I am sure you can find a decent cosmetic dentist who will get her in and bond it back on.

If it remains but becomes so unsightly that it embarrasses her, then she can have the veneer removed and replaced. The dentist who originally did her porcelain veneers is ethically obligated to share all his notes and diagnostics with the whichever dentist she ends up going to see to have this repaired.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Lemons for Teeth Whitening

Is it possible to use lemons to whiten your teeth? I read something on a website about this method. Before I tried it, I thought it would be best if I checked with a dentist before I did something I might regret.


Dear Angie,


You were wise to write and ask. It is the citrus acid that is the problem here. A while back I looked into an at-home teeth whitening kit that someone asked me about. It contained a citrus acid rinse that the patient would start with. This would give the tooth a frothy appearance because the acid etches the teeth. Then, they would use a white pigment that they would attach to the teeth. For a short period the teeth would look much whiter. Unfortunately, because the citric acid etches the teeth, they will begin picking up stains fairly quickly and you will end up with teeth that look darker than when you started.

The second problem you will have as a result of using lemons is the damage that the citric acid will do to your enamel. Prolonged usage will thin out your enamel. Not only will this add to tooth sensitivity but will make you more susceptible to tooth decay.

My suggestion is to have your teeth whitening done safely, with a dentist. The materials they used are proven both safe and effictive. Additionally, they use a special tray custom fit to your bite. This will make sure the teeth whitening gel stays on your teeth while simultaneously protecting your gums.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

Discolored Baby Teeth

My five year old son has two front teeth that have become discolored. Is there something I can do? They used to be so white and beautiful. Will teeth whitening work?


Dear Donna,

Happy girl in pediatric dental chair

I don’t know of a dentist that would do teeth whitening on a child that young. In fact, he would probably resist it anyway because the whitening gel doesn’t exactly taste like a peppermint candy. Plus, he would have to keep the whitening trays on for a minimum of fifteen minutes. Good luck with that unless you want to sit by him the entire time. Additionally, messing with his teeth like that could cause them to fall out prematurely.

There is good news, though. Your son is five years old. It will only be a year or two before those front teeth fall out. Then, he will have nice shiny white adult teeth in there.

If it is surface stains and your regular toothpaste isn’t working, you could try Supersmile Toothpaste. This does a fantatic job in removing surface stains in a safe way. Do not use over-the-counter whitening toothpaste. These contain abrasives that actually damage tooth enamel, leading to more stains.

Other than that, make sure he is brushing after each meal and flossing his teeth before bed. It sounds like you really care about your son’s oral health, so you are probably already doing all of this.

Children at his age rarely pay attention to the appearance of their peer’s teeth. while kids like to make fun of each other, they are more likely to find something else to tease him about than some tooth discoloration.

If after his adult teeth come in there are still stains, then I would speak with his pediatric dentist to get to the root cause of the problem. With baby teeth, they’ll just let nature take its course.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.