My six year old has brown spots on her teeth. I want to get some cosmetic work done on her, but wondered if you can do cosmetic work on young children. What do you think?
Jennifer R.- Maumelle, AR
Sometimes children get brown spots on their teeth from a fever while the teeth are developing. Are the spots on her permanent teeth, or her baby teeth? The fever will only have affected the teeth that were developing at the time. If they’re her baby teeth, her adult teeth may be unaffected and you can just let the baby teeth come out naturally without doing anything.
If they’re her adult teeth, you can do dental bonding on the spots, to repair it, but I would wait until she is a little older, maybe eight or nine years old. She needs to be able to sit still in the chair while the dentist shapes and tints the bonding work. At that age, if the spots bother her, or if the children are making fun of her, then go ahead and have the bonding done. But, if it doesn’t bother her, you can wait until she is even older.
If you do decide to get work done, just do bonding–a conservative treatment. I wouldn’t recommend anything like porcelain veneers. Even with adult teeth, the teeth are still erupting in young people. As it erupts further, the neck of the tooth will start to show above the veneer.
Be careful not to just go to your family dentist to have her cosmetic treatment done. You want someone who is highly qualified and can make her teeth look beautiful and natural. See if there is a dentist in your area who is accredited with the American Academy of Cosmetic Dentistry (AACD).
This blog is brought to you by Boston Cosmetic Dentist Dr. Randall Burba.
My 15 year old son had a bicycle accident, which chipped his front two teeth. I was thinking about getting veneers put on his teeth, but when I took him to the dentist today, he said it was better to place crowns on the teeth. I thought it best to get a sort of second opinion, so I’m writing your blog.
My opinion is to not put crowns on his front teeth. Crowns will require his teeth be filed down to stubs. On a 15-year old, the teeth are very young with a large pulp inside. Since crowns require the removal of a considerable amount of tooth structure, there is a very real risk that the dentist would run into the pulp, which would kill the pulp and mean that the tooth would also need a root canal.
For something like chipped front teeth there are two more conservative options: The most conservative is dental bonding. Though if you have this done, you need to be sure that your dentist is artistic enough to do this work, because it involves shaping and tinting the restoration freehand. The advantage is that it wouldn’t require the removal of any additional tooth structure.
Another option would be porcelain veneers placed on his two front teeth. The dentist would shave off about half a millimeter of the enamel on the front of the each of these two front teeth and place porcelain veneers.
I suspect that your dentist recommended crowns because he is not comfortable with doing either direct dental bonding or porcelain veneers. They require specialized cosmetic dentistry techniques that most dentists aren’t familiar with. But I would definitely discourage doing the crowns on a fifteen-year old.
This blog is brought to you by Boston Cosmetic dentist Dr. Randall Burba.