What is tetracycline stain?

June 27, 2011 alexnguyen

Tetracycline is an antibiotic. At the age of three, children have already developed tooth buds of the permanent teeth inside the jaw. When tetracycline is given to children, this drug penetrates the developing tooth buds and incorporates itself into the tooth structure. When the teeth erupt into the mouth, the result is bands of dark stains with usually a combination of brown, gray, and yellow colors. These stains make up the actual colors of the teeth and are impossible to bleach completely into normal white teeth colors.

Note: Once a tooth has erupted into the mouth and the root of that tooth has completely formed, tetracycline cannot affect that tooth. It is also a misconception that all antibiotics will cause yellowing of teeth.

The human eyes are used to seeing the smile with white teeth. Smiles with dark tetracycline teeth are not as esthetically pleasing as smiles with normal white shades of teeth.

Porcelain veneers done on tetracycline stained teeth are very difficult for many reasons. A clinician has to mask out the dark colors underneath, and create at the same time the proper tooth form, contour, texture, and details of the edges of the natural tooth.

Here are the before and after photos of a case where I used porcelain veneers to enhance a severely tetracycline stained smile. The after photo was taken two weeks after delivery. The gum tissue will continue to heal and adapt to the new porcelain, and the colors of the porcelain teeth will become even more realistic after some time. In this case the patient opted for a super white shade, yet with proper planning and execution we can still create a natural looking smile.

Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

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Alex Nguyen, DDS is a Saratoga Dentist who practices General Dentistry, Cosmetic, and Implant Dentistry. For over 20 years the practice has been serving the residents of Santa Clara County and San Francisco Bay Area.

Naturally Beautiful Smiles

March 5, 2011 alexnguyen

Occasionally I have the pleasure to invite some of my patients to do a photo shoot for ... fun ! Here are some samples of our latest collection of beautiful smiles. Whether it is a full mouth of restorative works or a few enhancements, I want the smiles to be simply beautiful and natural looking.

Thanks to Ivy, Alydia, and Saifon for allowing me to showcase your smiles.

My sincere appreciation to our stylist Jackie ( www.jolidejackie.com) and our photographer Paul (www.ferradasphotography.com).

Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

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Can a Smile Makeover be Done in Two Visits?

February 14, 2011 alexnguyen

On December 19th, 2010 I posted a blog entry with a wonderful smile guide sent to me by a well-informed patient. Last Friday I delivered the porcelain restorations which completed his smile makeover process. I will still have to bring the patient back to fine tune and touch up some of the detail work. I could not have done the job in two simple visits like many advertisements claim to be able to do. The process cannot be done in two visits because a number of critical steps must be carried out:

- Diagnostic work-up of the case

- Laser contouring of the gum

- Equilibration of the bite

- Bonding of some of the teeth

- Preparation of the teeth for porcelain

- Working with the ceramist while the case is at the lab

- Tryin/delivery of the final restorations

Depending on what level of quality you are looking for, the process typically defines the end result.

Here is the feedback I received from the same patient today via email about his feelings regarding the end result of the case.

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From: S

Subject: teeth

Date: February 14, 2011 11:54:26 AM PST

To: Alex Nguyen

Hi Dr. Alex, just wanted to drop a quick note to express how happy I am with how my smile has turned out (the gums are much better and closer to normal now) The teeth are exactly what I wanted: shapes/edges are just as envisioned, and the whiteness and translucency couldn't be any more perfect. I noticed the very slight decalcification on the inciscor is exactly as I wanted. The bite feels solid and like my own teeth.

In short I can't stop myself from looking in the mirror and smiling :) Thanks for your hard work and attentional to detail. Looking forward to the fine-tuning and tweaking of the bicuspids and wrapping up the case.

See you soon

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Details in the Fabric - Fine Cosmetic Dentistry is All About the Details

January 24, 2011 alexnguyen

Whether you like the shape of your teeth to be more square or more rounded, the key to a life-like porcelain restoration is the details of translucency layering, internal color structure, and reflection of light on the surface texture. Visually, depth is perceived in the fabricated piece of porcelain when light penetrates the porcelain to the same degree that it will penetrate natural tooth structure. Like a painter's canvas, the smile is my fabric.

Images of actual patients of Alex Nguyen, DDS are Copyrighted and Digitally Embedded to track Unauthorized Use.

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What Brand or Type of Porcelain Should We Use for the Best Cosmetic Result?

January 15, 2011 alexnguyen

A recent new patient consultation this week has inspired me to write this blog entry... Sometimes I hear this question during my discussions with the patients. In reality, as a patient you should not have to worry about the "name" or "type" of porcelain. In fact, it is always the "technique" employed by the dentist that makes a difference in the outcome of a case.

In the photo below, three front teeth are marked with arrows. They look different from the rest of the restorations because our eyes can see dark areas on the teeth. In particular, the patient was most bothered by the tooth on the far right of the screen. This lateral incisor had an extremely dark tooth structure build-up underneath. When the same "type" of porcelain is used in a series of teeth, color differences of the underlying tooth structure will affect how the final restorations look.

In this case, proper technique can be used to mask out the dark underlying tooth structure in order to allow better color blend. This "technique" is a coordination between the dentist and the ceramist, and it is not a choice that the patient would have to make.

In order for your restorations to look natural, a number of factors must come into play. Those factors are not limited to just ... the porcelain.

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