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FAQ:  Porcelain Veneers

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    Veneers - Gum Recession: I have had porcelain veneers for about 5 years now.

    My teeth were dead and the roots removed, hence veneers put on to hide the blackness of the teeth as they died.

    The problem is I can now start to see the discoloration through my veneers. Also my gum line seems to have risen on the veneered teeth, which is off-putting.

    Can the gum line be restored at all? And will new veneers hide the discoloration beneath? ...Visitor from Sheffield England UK

    Good question! As I understand it, your teeth were nonvital and you had root canal therapy to remove the necrotic pulp tissue within the roots. What frequently happens is the necrotic tissue within the root breaks down and becomes absorbed into the dentinal tubules that make up the root structure. It is similar to when you get a bruise. The red blood cells break down forming hemosidirin and cause a discoloration of the tissue. The difference is that your skin is constantly perfused with circulating blood that washes away the pigment. In your tooth, once the pulp tissue dies, there is no circulation. Hence the pigment remains and gets absorbed into the tooth structure.

    What can be done? Well, first root canal therapy. However, the inside of the tooth can also be bleached to remove that discoloration. So in your case, opening up the back of the tooth and performing an internal bleaching can quite possibly eliminate a lot of that discoloration. Make certain that the bleach is placed far enough down inside the tooth so as to bleach that area of tooth near the gum line. Doing so may make the receded area less conspicuous. I happen to use the Zoom (Discus Dental) gel to internally bleach root canal teeth with significant results.

    I would try that first. If that does not produce the results that you like then you would have no other recourse but to replace your existing veneers. Be sure that the veneers have enough opacious porcelain built in to block out any remaining discolorizations. You want to have the veneers made by a good lab that knows how to build in vitality to an opaque veneer by layering the porcelain. It also helps if your dentist properly prepares the teeth to allow the ceramist to create the most esthetic veneer.

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