James Powell, DDS (retired)

Zoom whitening should not affect your front teeth that are bonded, but be aware that the color of your surrounding teeth may become whiter than your bonded teeth. Your teeth over time become lighter and less white but the bonding material color will always stay the same (although the margins of the bonding may turn darker). Therefore, if you do have the whitening done and the colors do not completely match (esthetically), you might opt to have the composite bonding redone, or try to get your natural teeth color as close to the bonding as possible.

In my experience I have seen greater results when braces are done before the implant is actually placed. There is a lot of bone movement when teeth are being shifted with braces so it would be a good idea to let all the shifting be complete before and implant is placed in the bone, for maximum stability. The braces could even give more space for the implant if it is necessary. Hopefully this makes sense, it would be easier for you to visually see how your jaw bone is specifically with a panoramic xray also.

Some dentists recommend not to have veneers put on if you're a grinder because if the actual teeth are being worn, then that means that the veneers would also suffer damage- whether they become worn or even popped off. Some dentists, such as myself, go through specialized training considered neuromuscular dentistry to where they can use TENS units to get the bite where it should be (this has to do with the way the muscles, joints, and bones fit together), then veneers can be placed without being popped off by past grinding habits. You could even consult with a specially trained orthodontist to align your teeth in the right position (to make a larger space between the front top and bottom teeth) so then veneers can be placed. I hope you found this answer helpful, if you would like information on a specially trained dentist who could talk to you more about this, try looking on the Las Vegas Institute website for a dentist in your area.

An implant could be an option for just about anyone. You may not have enough bone in that area due to the infection, but a bone graft could be an option for you. A bone graft could be completed, then an implant could be placed after the bone heals. You would have to have an xray that shows 3D images so the bone level in all aspects could be evaluated-a referral to an oral surgeon or a periodontist may be necessary. If an implant is placed, keep in mind that good oral hygiene must be maintained because implants could suffer from infections just like regular teeth. 

The chipped tooth could definitely be fixed, with options such as a composite filling or a porcelain veneer. The only problem is that if it is chipping now, a placed restoration could chip also. You could possibly be grinding or clenching your teeth (during the day or even at night) so the teeth are hitting each other abnormally. It might be a good idea that you have your bite evaluated when the tooth is restored, or maybe you can have a night guard made so it would protect your teeth at night.

A couple options to fix your gum contours would be either gingival grafting (taking tissues from elsewhere in the mouth and placing/modeling the gums to where it gives you new contours) or porcelain veneers (placing porcelain over your natural teeth and using the porcelain to fit to your gums-this could also contain some kind of gum surgery). With either option, it would be best to discuss the options with your dentist and/or periodontist so they can design options to your specific needs.

Yes, the bleach provided by your new dentist is ok to use and has the ability to provide the same result as the Zoom Whitening Treatment. Most likely your new dentist will provide you with professional in-home bleach, such as 15% or 10% Carbamide Peroxide. The in-office Zoom Whitening treatment uses a high concentration of peroxide in order to quickly lift the shade of the teeth, wheras the 15% and10% Carbamide Peroxide is a lower concentration. Lower concentrations can provide the same results as the Zoom whitening treatment but will take more time. Keep in mind that teeth sensitivity can increase with the higher concentrations, and some people's teeth are only able to lift a few shades.

Having a cleaning with your hygienist before whitening is definitely a good idea. The plaque, tarter, and/or debris will cause a build-up on your teeth that may not allow the teeth to whiten in certain areas, resulting in uneven coloring on your teeth. The same is true for the inflamation of the gums. If the whitening is done when your gums are inflamed you may have left over yellowing close to the gums after the inflimation is taken care of.

Some patients are concerned about the possible sensitivity when having a cleaning before the whitening. However, this can usually be combated by using tooth paste made for sensitivity (such as fluoridex) 1-2 weeks before and after treatment, with the combination of ibuprophen on the day of treatment. 

If you want the best possible result from your Zoom Whitening treatment then have it done within a week of your cleaning.

What I have found is that teeth will relapse (darken) in their shade over time following whitening. That is why we recommend doing touch-ups periodically. Veneers are thin translucent pieces of porcelain that are color stable and when placed over a tooth let the natural coloring of the tooth show through. That is why they look so natural. I have found that if the teeth are whitened prior to veneer placement that the teeth under the veneer will relapse (darken) over time and the veneer will become darker and will be unable to be touched-up with whitening because of the porcelain covering. This will cause the veneered teeth to no longer match the crowns or other teeth. I prefer to build the desired shade in the color stable porcelain veneer and not whiten prior to placing the veneers. Thus achieving a long lasting esthetic result. You will want to whiten any teeth in your smile that will not be crowned or veneered prior so as to match the porcelain to your desired whitened shade of your natural teeth.