I’m wondering if there’s a direct composite veneers technique that resists smoking stains better than others. I’m 46 and a lifelong smoker. (And, yes, I know I should quit, but that isn’t going to happen right now.) I went in for my regular checkup and everything is fine. I haven’t had a cavity in years. My gums are great. I’m as healthy as a horse. But, I want to make my smile look better and I had heard the dentist could do them up right there in the office. I asked him about what our options were and he said he could do them, but that because I’m a smoker, they won’t look right. He told me to quit smoking and come back after I’ve been clear for six months.

Well, first, I resent that quite a bit. It’s my mouth. Shouldn’t I get the final say? Then, I got to thinking, maybe this guy just doesn’t have what it takes to do it up right and he’s putting that on me. Is there a direct composite veneers technique that works well for smokers and keeps the staining to a minimum? Should I go with what he says or find a new dentist?

-Ron

 

Dear Ron,

Consider the surface of your natural tooth. It looks like it’s a nice flat smooth surface, but it’s actually covered in lots of tiny pores. So, what happens with smokers is that they breathe in and pull that smoke across their teeth. The tar, which is a dark brown color, tends to adhere, while the yellow of the nicotine soaks into the tooth a bit. Ultimately, the surface stains come off fairly easily when you brush or when you get your cleaning, so you’ll see some improvement. The stuff that seeps into the tooth can’t be removed by scrubbing, though, so many turn to whitening products. In-office whitening does a better job of it because it’s stronger.

Now, what the dentist uses with any kind of direct composite veneers technique is a composite material. It’s a mixture of things, including ceramics, which help it look natural and reflect light the way your natural tooth will. However, it’s actually a bit more porous than your natural tooth. Meaning, no matter what he does, it will eventually stain. Because you smoke, it’ll stain faster than it normally would on anyone else. A few other big culprits are coffee, tea, and wine. Once the material is on there, it’s on there, and it doesn’t respond to whitening. Moreover, if you try to use abrasives to get rid of the stains, you actually put lots of microscopic scratches on the surface, making it even more vulnerable to staining, so you can’t even use whitening toothpaste on them.

Full porcelain might be a better choice because that is not as porous, but it’s also a bit more expensive and requires a couple of visits because the restorations are made in a lab. Ultimately, the best thing for your teeth and health is to stop smoking, but you already know that. Your habit shouldn’t preclude you from an in-office option, but it sounds like your dentist expects you to be unhappy with the results because the stains will show up eventually, and he doesn’t want to have to keep redoing the work. You could make it clear to him that you’re willing to foot the bill when they stain, but he still might not be willing to do them. In that case, your only option is to find someone who will. That doesn’t mean they’ll do it better or differently, only that they feel you understand the risk and are willing to assume it.

 

This blog is sponsored by Uveneer, a chairside veneer template system for dentists.