The Ultimate Guide to Teeth Whitening

Teeth whitening is one of the most sought-after cosmetic dentistry procedures, promising us a brighter, more confident smile. In the quest for whiter teeth, many people turn to over-the-counter treatments for a convenient solution. However, the allure of these readily available options often masks their limitations and potential drawbacks.

Over-the-counter products may lack the potency to address stains effectively compared to more customized solutions. The one-size-fits-all approach can lead to uneven results, causing some teeth to whiten more than others. Additionally, these products may not account for individual oral health conditions, potentially exacerbating existing issues such as tooth sensitivity or gum irritation.

At Geach Dental, we aim to equip you with the knowledge to make informed decisions, steer clear of the pitfalls of generic solutions, and guide you toward a brighter, healthier smile. In this comprehensive guide, we will explain everything you need to know about the intricacies of teeth whitening.

Understanding Teeth Discoloration

Teeth are composed of two main components, enamel and dentin. Enamel is the outer part of the tooth and is made of hydroxyapatite. Pure hydroxyapatite is colorless/white and natural enamel has a white color with some translucency. Dentin is the inner part of the tooth and is composed of 70% hydroxyapatite with proteins and water representing the other 30%. Dentin naturally has a more yellowish hue. Over time, the youthful brightness of our smile can fade. With continuous chemical and mechanical wear of enamel over time, the enamel becomes thinner and more translucent making the inner dentin more visible, resulting in a darker tooth color. Furthermore, the natural white color of teeth can be compromised due to stains from pigmented foods, wine, tea, coffee, smoking, etc.

Types of Teeth Stains

Extrinsic Stains:

Extrinsic stains present on the outer surface of the tooth – on enamel or exposed dentin. These stains are often caused by organic chromophores such as tannins from pigmented fruits, coffee, tea or red wine. Regular consumption of these foods and beverages or habitual smoking can contribute to the gradual accumulation of extrinsic stains on the tooth surface.

Intrinsic Stains:

Intrinsic Stains, on the other hand, occur within the tooth structure, affecting the enamel or underlying dentin. These stains may result from factors during tooth formation such as excessive fluoride intake, medications such as tetracycline and metabolic diseases during tooth development. Intrinsic staining can also happen after tooth eruption. Trauma can cause hemorrhage in the tooth leading to discoloration by blood penetrating into the dentin. Certain procedures such as amalgam or root canal fillings can also produce intrinsic stains.

The Most Common Causes of Discoloration

Environmental Factors:

Over time, teeth naturally change color due to environmental influences. Highly acidic beverages erode the surface of the enamel. Thinning of the white enamel leads to more yellowish coloration due the appearance of the underlying dentin. Mechanical grinding of teeth will flatten the enamel on the cusps of teeth also leading to yellowish shades.

Food and Beverages:

Certain foods and beverages contain pigments that can stain teeth over time. Colored fruits, berries, and beverages such as tea, coffee and red wine are common culprits. Regular consumption of these items can contribute to accumulating extrinsic stains on the tooth surface.

Tobacco Use:

Smoking or using tobacco products introduces harmful chemicals to the oral environment, leading to stubborn extrinsic stains. The tar and nicotine in tobacco can discolor teeth, affecting the enamel and underlying dentin.

Medications:

Medications such as tetracycline, can cause intrinsic stains during tooth development. These stains may present as gray or brown discolorations, emphasizing the need for awareness and professional guidance when considering teeth whitening options.

Understanding the diverse nature of teeth stains and their underlying causes is crucial in formulating effective teeth whitening strategies. So, in the following sections, we will explore professional and at-home whitening options, considering individual needs and the nature of discoloration.

In-Office vs. At-Home Teeth Whitening

Options for Professional Teeth Whitening

A smile makeover is a meticulous and personalized process, with each step designed to achieve a stunning and confidence-boosting result. Here’s an in-depth look at the step-by-step process involved in a smile makeover:

In-office Treatments:

In-office teeth whitening procedures administered in the dental office are performed with concentrated solutions of 35% hydrogen peroxide for about 20-30 minutes. These high concentrations of hydrogen peroxide are oxidizing and can harm the soft tissues. In addition, In-office whitening can also cause irritation of the dental pulp in some individuals (1). A heat lamp or blue light is often used to enhance the oxidative action of the peroxide. Based on clinical studies, addition of a blue light has not been proven to enhance the whitening effect or the persistence of the whitening treatment (2). We do not offer in-office treatments in our practice because of the risk of gum irritation and extreme tooth sensitivity.

Custom take-home whitening kits:

Take-home whitening kits use 10-20% carbamide peroxide gel that is applied to the teeth using a patient-specific mouthguard. A 10% carbamide gel has been approved by the American Dental Association for home whitening. The lower concentration of the gel requires multiple applications to achieve visible effects. In our practice, we recommend a 16% carbamide peroxide gel to be applied to the teeth using a custom mouthguard for 1-2 hours per day for 10 days. This combination provides a blend of professional-grade efficacy and the convenience of home application. The lower concentration gel also reduces gum irritation and tooth sensitivity. Some patients have teeth that are very sensitive to the 16% gel and this can be substituted with a 10% gel.

Are Over-The-Counter White Strips a Cost-Effective Alternative?

A common question that is asked in our practice is: Does the use of over-the-counter whitening strips exhibit similar whitening results compared to custom take-home kits?

Manufacturers claim that whitening strips show good whitening results at a lower cost and can be easily found online, in markets and pharmacies. Independent clinical studies show that over-the-counter whitening strips can perform about as well as dentist supervised custom take-home kits for whitening teeth (3).

Benefits of OTC whitening strips:

Lower cost and easy, quick application of the strips. In our practice, we recommend Venus white strips. These strips contain 15% hydrogen peroxide with potassium nitrate, which helps to decrease sensitivity. These strips are applied for 20 minutes per day for 7 days.

Benefits of custom take-home kits:

Custom trays are fitted for an even distribution of the gel for all of the teeth. For our take-home kit, we recommend Philips Zoom Nite White. This gel contains 16% carbamide peroxide with amorphous calcium phosphate, fluoride and potassium nitrate. Calcium phosphate and fluoride help to restore the enamel. Potassium nitrate helps to decrease sensitivity.

The expertise of a prosthodontist ensures a guided and effective teeth whitening journey, minimizing the risk of complications and enhancing the overall success of the process.

Consultation and Evaluation

Why It’s Important to Consult With a Prosthodontist

When pursuing a whiter and brighter smile, professional guidance is crucial to navigating the complexities of teeth whitening, ensuring a safe and effective outcome. A prosthodontist brings expertise in restorative dentistry, uniquely positioning them to assess and address the nuances of each patient’s oral condition.

The Initial Assessment and Examination

Oral Health Evaluation:

The first step in the consultation process involves a comprehensive oral health evaluation. Your prosthodontist will assess the overall health of your teeth and gums, identifying any existing issues that may impact the whitening process. This evaluation ensures that the chosen whitening method aligns with your oral health, mitigating potential complications.

Assessment of Existing Restorations:

We will also consider existing dental restorations, such as crowns or veneers. Unlike natural teeth, these restorations do not respond to whitening treatments. Understanding the presence and condition of restorations enables the prosthodontist to tailor your whitening plan, ensuring uniformity in the final tooth color.

Identification of Contraindications:

The consultation will include a thorough review of your medical history to identify any contraindications to teeth whitening. Certain conditions may impact the whitening process or harm oral health. Your prosthodontist will use this information to devise a safe and effective treatment plan, minimizing potential adverse effects.

Customized Treatment Plans

Tailoring Treatments to Your Needs

Severity of Discoloration:

The first step in creating your personalized treatment plan involves assessing the severity of discoloration. We will consider the nature and extent of stains on your teeth, allowing us to tailor the whitening approach effectively to address specific concerns. This individualized assessment ensures that the chosen treatment aligns with the unique characteristics of your teeth.

Your Preferences:

Understanding your preferences is integral to the customization of your treatment. When teeth are severely discolored, a combination of composite resin bonding and/or veneers may be used with a whitening treatment to achieve the desired result. In these situations, your input guides the selection of the most suitable treatment. This personalized approach enhances efficacy and ensures that you are comfortable and confident in your chosen path to a brighter smile.

Discussion of Potential Risks and Side Effects

As part of the comprehensive consultation, your prosthodontist will engage in a transparent discussion about potential risks and side effects associated with teeth whitening. This open dialogue allows you to make informed decisions, considering anything related to tooth sensitivity or gum irritation.

Custom Take-Home Teeth Whitening Kits

What Are Custom Take-Home Kits?

Custom Take-Home kits are comprised of two components:

Custom-Fitted Trays: Take-home teeth whitening kits, prescribed by your prosthodontist, feature custom-fitted trays as a critical component. These trays are made to precisely fit the contours of your teeth, ensuring even application of the professional-grade whitening gel. The custom fit enhances the effectiveness of the whitening process and minimizes the risk of the gel contacting the gum tissues.
Professional-Grade Whitening Gel: The prescribed take-home kits include professional-grade whitening gel. This specialized gel works in synergy with custom-fitted trays to penetrate the enamel effectively and target intrinsic and extrinsic stains. The professional-grade nature of the gel ensures a controlled and safe at-home whitening experience.

Proper Usage Instructions

Duration and Frequency: Your prosthodontist provides clear instructions on the duration and frequency of using the take-home whitening kit. The recommended duration of wear and the frequency of application are tailored to your individual needs, considering factors such as the severity of discoloration and your oral health. Following these instructions diligently is essential to achieving optimal results without compromising safety.
Monitoring Progress: Monitoring the progress of your at-home whitening is a collaborative effort between you and your prosthodontist. Regular follow-up appointments may be scheduled to assess the changes in tooth color and adjust the treatment plan if necessary. This proactive approach ensures that the whitening process aligns with your expectations, allowing for modifications to the treatment plan based on your progress.

Over-The-Counter White Strips

What Are Over-The-Counter White Strips?

Over-the-counter white strips are ultra thin clear strips that mold securely around the teeth. These strips contain pre-filled 15% hydrogen peroxide to eliminate stains and whiten teeth.

Proper Usage Instructions

Duration and Frequency: Your prosthodontist provides clear instructions on the duration and frequency of using the over-the-counter white strips. Each kit includes 7 upper and 7 lower pre-filled trays. Trays are applied once per day for 15-20 minutes, for up to 7 days. After use, the thin trays are disposed of.
Monitoring Progress: Monitoring the progress of your at-home whitening is a collaborative effort between you and your prosthodontist. Follow-up appointments may be scheduled to assess the changes in tooth color and adjust the treatment plan if necessary.

Post-Whitening Maintenance and Care

After the whitening treatment, your prosthodontist will recommend long-term after care strategies for maintaining your white new smile.

Oral Hygiene Practices

Brushing: Maintain a routine of brushing your teeth twice daily with a fluoride containing toothpaste, using a soft-bristled toothbrush to prevent gum recession. The Sonicare electric toothbrush with the Sonicare Sensitive brush heads are an excellent combination for daily use.
Toothpaste: Toothpastes containing baking soda are great for maintaining white teeth. Baking soda is a gentle abrasive, biocompatible, acts as an acid-buffering agent, and possesses antibacterial activity. Baking soda is also compatible with fluoride.
Flossing: Incorporate daily flossing to remove plaque and food particles between teeth. This not only helps to maintain excellent oral hygiene but also helps to maintain the tooth surfaces between your teeth.

Dietary Recommendations

Limit Pigmented Foods and Beverages: Moderation of staining foods like coffee, tea, red wine, and dark berries is advised. Rinse your mouth with water after consumption. You can also use a straw when consuming staining beverages to bypass your teeth!
Increase Water Intake: Drinking water aids in rinsing away staining particles after consumption.

Periodic Follow-up Appointments

Monitoring Oral Health: Regular check-ups with your prosthodontist are necessary for monitoring oral health and assessing the effectiveness of the whitening treatment.
Adjusting Treatment Plans if Necessary: Adapt whitening plans based on changes in oral health. Proactive adjustments, additional in-office treatments, or modifications to at-home regimens may be recommended to maintain results.

Addressing Sensitivity and Side Effects

Teeth whitening procedures, while effective, may lead to specific side effects. Understanding and addressing these potential issues ensures a comfortable and successful teeth-whitening experience.

Potential Side Effects of Teeth Whitening

Tooth Sensitivity: One common side effect is increased tooth sensitivity, especially to temperature variations.
Gum Irritation: Some individuals may experience gum irritation during or after whitening.

Strategies for Minimizing Discomfort

Use of Desensitizing Agents:

Toothpaste: Switch to a toothpaste designed for treating tooth sensitivity. Toothpastes that contain potassium nitrate or biosilicate particles can be used daily to alleviate tooth sensitivity.
Desensitizing Agents: Your prosthodontist may recommend a desensitizing agent that can be applied in the dental office for more moderate to severe tooth sensitivity.

Adjusting Treatment Intensity:

Reduced Treatment Frequency: Space out whitening treatments or reduce the duration to allow teeth to adapt to the whitening treatment. This can minimize sensitivity.
Lowering Whitening Concentration: If sensitivity persists, a lower concentration whitening agent can be used for the treatment.

In Conclusion

In conclusion, professional teeth whitening offers a clinically supervised, effective, and tailored approach to achieving a brighter smile. With the expertise of a prosthodontist, the benefits extend beyond cosmetic enhancement to encompass personalized care, minimal side effects, and long-lasting results.

If you’re wondering whether it’s time for a smile makeover, and considering teeth whitening, the advanced knowledge and specialized expertise of our prosthodontic team at Geach Dental, located in Downtown Los Angeles and Laguna Niguel, Orange County, are here to help ensure you get the attractive and confident look you deserve.

You’ll receive the personalized treatment you deserve in a comfortable environment. We’ll make sure you understand your teeth whitening options as well as all of the risks and benefits. Time will be spent to make sure that you are 100% comfortable with the plan we agree on.

To take the first step towards whiter teeth and a brighter smile, simply call us today at (213) 622-3339 or click here to schedule a consultation. Your dental wellness is our top priority and your journey towards a youthful, more attractive smile starts here!

References

Vaz, et al. Inflammatory response of human dental pulp to at-home and in-office tooth bleaching. J Appl Oral Sci. 2016;24:509-517.
Carey, C.M. Tooth whitening: What we now know. J Evid Based Dent Pract. 2014;14:70-76.
da Rosa et al. Effectiveness of Whitening Strips Use Compared With Supervised Dental Bleaching: A Systematic Review and Meta-analysis. Operative Dentistry. 2020;45(6).
Epple et al. A Critical Review of Modern Concepts for Teeth Whitening. Dentistry Journal. 2019;7(79).

ABOUT THE AUTHOR: Meet Dr. Adam Geach, distinguished prosthodontics specialist and owner of Geach Dental. His dental education includes Harvard School of Dental Medicine and the University of Connecticut, where he earned a D.M.D. and M.D.Sc. in Prosthodontics, respectively. Dr. Geach holds Diplomate status with the American Board of Prosthodontics, underscoring his exceptional expertise in dental care.

At his clinics in Los Angeles and Laguna Niguel, Dr. Geach offers a wide range of services, from cosmetic treatments to full-mouth reconstructions, all delivered with a focus on personalized patient care.Take the first step toward your ideal smile and improved oral health by clicking here.

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Meet Dr. Adam Geach, distinguished prosthodontics specialist and owner of Geach Dental.

His dental education includes Harvard School of Dental Medicine and the University of Connecticut, where he earned a D.M.D. and an M.D.Sc. in Prosthodontics, respectively. Dr. Geach holds Diplomate status with the American Board of Prosthodontics, underscoring his exceptional expertise in dental care. At his clinics in Los Angeles and Laguna Niguel, Dr. Geach offers a wide range of services, from cosmetic treatments to full-mouth reconstructions, all delivered with a focus on personalized patient care.Take the first step toward your ideal smile and improved oral health by clicking here.

Replacing missing front teeth with dental implants

How Dental Implants Can Replace Failing Teeth and Create a Natural-Looking, Functional Smile Losing your front teeth—or being told they can no longer be saved—can be overwhelming. Front teeth aren’t only important for your smile. They help you bite into foods, speak clearly, and feel comfortable smiling and interacting with other people. For patients with advanced gum disease, teeth can gradually lose their supporting bone, become loose, and move out of their natural positions. Eventually, saving those teeth may no longer be predictable. That was the situation for this patient. He came to Geach Dental in Los Angeles extremely self-conscious about his front teeth. He had become so uncomfortable with their appearance that he avoided smiling. But his problem wasn’t only cosmetic. A comprehensive evaluation revealed severe periodontal bone loss affecting both the upper and lower four front teeth. Over time, the upper teeth had shifted dramatically, changing his smile and compromising their position. The goal was bigger than replacing missing teeth. We wanted to rebuild his smile and restore his ability to function comfortably again. Why Couldn’t the Front Teeth Be Saved? The foundation of a healthy tooth is the bone and gum tissue surrounding it. When periodontal disease becomes advanced, that supporting bone can be lost. Teeth may become mobile, migrate into different positions, and eventually reach a point where keeping them is no longer predictable. This patient also reported a long history of cigarette smoking, an important factor considered as part of his periodontal evaluation. Before beginning the prosthodontic treatment, we referred him to a periodontist for a complete periodontal evaluation. His treatment plan included periodontal therapy and oral-hygiene instruction, management of his smoking, removal of the eight severely compromised front teeth, placement of dental implants, and fabrication of implant-supported bridges to replace the missing teeth. Dental Implants Are Only Part of the Solution When replacing front teeth, successfully placing dental implants is extremely important—but it’s only part of the treatment. We also have to determine: Where should the new teeth go? This patient had lived with teeth that had shifted significantly because of periodontal bone loss. Simply reproducing their existing positions would reproduce many of the same esthetic problems. Instead, we began by designing the final smile first. Before treatment, we created a digital blueprint showing the planned position, shape, size, and proportions of the future teeth. That blueprint helped guide both implant placement and the design of the final implant bridges. Designing the Smile Before Placing the Final Teeth Our goals were to create teeth that would: This planning is especially important when dental implants are being used in the front of the mouth. Unlike natural teeth, implants cannot simply be moved after they have integrated into the bone. The final restoration therefore needs to be considered from the beginning of treatment. Temporary Implant Teeth Let Us Test the New Smile After the compromised teeth were removed and the implants placed, temporary implant-supported bridges were created from our digital design. These temporary teeth served an important purpose. They allowed us to evaluate the new smile before making the final implant bridges. We could adjust the: Most importantly, the patient could participate. He could see his new smile, live with it, and give us feedback about the appearance before we fabricated the final restorations. The temporary bridges also allowed the surrounding soft tissue to be shaped and refined during healing. Creating Natural-Looking Implant Teeth One of the greatest challenges in implant dentistry is making replacement teeth look natural—particularly in the front of the mouth. Color is only one part of the equation. Natural-looking teeth depend on subtle differences in shape, proportion, translucency, surface texture, and contours. At Geach Dental, we have the advantage of working closely with our in-office laboratory technician. For complex implant cases, the technician can meet directly with the patient and work with Dr. Geach to refine shade, shape, contours, and other details before the final restorations are completed. The objective is simple: People should see your smile—not your dental implants. The Final Result: A New Smile and Restored Function The before-and-after photographs tell an important story. In the original photographs, the severe movement of the front teeth is immediately noticeable. In the final photographs, the upper and lower implant bridges restore a much more harmonious tooth position and smile. But this treatment wasn’t performed for appearance alone. The final implant-supported bridges also restored the patient’s front teeth so that they could once again contribute to normal function. The definitive restorations were fabricated from zirconia, a tooth-colored ceramic material selected for its combination of esthetics, smooth surface, and durability. The result is a dramatic change from where this patient began: fixed replacement teeth designed to restore both his smile and his ability to function. Can Dental Implants Replace Several Missing Front Teeth? Yes. Dental implants don’t necessarily require one implant for every missing tooth. In appropriate situations, strategically positioned implants can support a fixed dental bridge that replaces several missing teeth. This can be particularly useful for patients who are facing the loss of multiple teeth because of: The appropriate number and position of implants depends on each patient’s bone, gum tissue, bite, remaining teeth, health history, and restorative goals. That’s why careful planning before implant placement is so important. Why Choose a Prosthodontist for Complex Dental Implant Treatment? Replacing several missing front teeth requires more than placing implants. The final teeth need to look natural, fit the patient’s face, function with the bite, and integrate with the remaining natural teeth. A prosthodontist receives advanced specialty training in replacing and reconstructing teeth, including complex dental implant treatment. At Geach Dental, our approach combines prosthodontic planning, digital smile design, implant dentistry, provisional restorations, and close collaboration with our in-office dental laboratory. For complex cases, we also coordinate treatment with periodontal and other dental specialists when appropriate. The objective isn’t simply to replace missing teeth. It’s to reconstruct the smile as a whole. Considering Dental Implants in Los Angeles? If you have missing teeth—or

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When Old Veneers Make Your Smile Look Older

A Prosthodontic Approach to Replacing Aging Cosmetic Dentistry with Natural-Looking Restorations If you had veneers or crowns placed 10, 15, or even 20 years ago, you may have loved your smile when they were first completed. But smiles change—and so does cosmetic dentistry. Older veneers can look bulky, square, opaque, worn, or simply outdated compared with today’s more natural-looking ceramic restorations. Sometimes patients don’t want an entirely new smile. They just want their smile to look natural again. That was the goal for this patient. The Problem: Old Veneers That No Longer Looked Natural This patient was referred to Geach Dental because she was unhappy with the appearance of her four upper front teeth. Her existing veneers had several characteristics that made them stand out from her surrounding natural teeth. The front teeth appeared very square, all four restorations slanted slightly to one side, and the porcelain was relatively opaque rather than having the subtle translucency of natural enamel. See picture below. The veneers weren’t simply “old.” They looked like dental work. Our goal was to change that. We wanted to replace the aging restorations with teeth that blended naturally into her smile—without creating an artificial or overly perfect appearance. Good Cosmetic Dentistry Shouldn’t Look Like Dental Work One of the misconceptions about cosmetic dentistry is that improving a smile simply means making teeth whiter. For us, natural-looking cosmetic dentistry is much more about the details. The shape, proportions, contours, translucency, alignment, and color of the teeth all need to work together. For this patient, our goals were to: Ultimately, people should notice your smile—not your dental work. Designing the New Smile Before Making the Final Teeth Before fabricating the final restorations, we created a digital diagnostic design for the four front teeth. This allowed us to establish the new tooth shapes and proportions before completing the final crowns. After removing the existing veneers, the teeth were conservatively prepared and custom temporary crowns were made from our new digital design. This is an important part of our approach to complex cosmetic dentistry. Rather than simply removing the old restorations and hoping the patient likes the final result, the temporary crowns allow us to test-drive the new smile first. The Patient Gets a Say in the Final Smile With the temporary restorations in place, the patient can see the proposed changes directly in her own mouth. We can evaluate: Most importantly, the patient can give us feedback. If we want a tooth slightly shorter, longer, softer, or more rounded, those changes can be made before the final restorations are fabricated. Once the temporary restorations look and feel right, they become the blueprint for the final teeth. That patient feedback and refinement process was an important part of this case. Why Replacing Only Four Front Teeth Can Be So Challenging You might assume that replacing four veneers is easier than restoring an entire smile. Esthetically, the opposite can sometimes be true. When we replace only a few front teeth, the new restorations must blend with the patient’s remaining natural teeth. The shade can’t simply be “white.” Natural teeth have subtle variations in color, translucency, texture, and brightness. Reproducing those characteristics is what helps a ceramic restoration look like a tooth rather than a crown. The goal is not to make four beautiful crowns. The goal is to make it difficult to tell which four teeth are crowns. The Advantage of Our In-Office Dental Laboratory At Geach Dental, we work closely with our in-office laboratory technician when creating highly esthetic restorations. This allows us to carefully control details such as: In this case, the final restorations were designed, milled, characterized, and finished in close collaboration with our technician, using the refined temporary crowns as the guide for the final result. For front teeth, these small details can make an enormous difference. The Result: A More Natural-Looking Smile The objective wasn’t to give this patient a completely different smile. It was to make her existing smile look more natural, balanced, and current. The new front teeth have softer contours, improved alignment, and a more natural relationship with the surrounding teeth. The final crowns were made from zirconia, selected to provide a combination of esthetics and durability. The improvement is noticeable. But ideally, the dentistry isn’t. That’s exactly what we want. Before After Is It Time to Replace Your Old Veneers or Crowns? Many patients assume they should only replace veneers or crowns when something breaks. That’s not necessarily the case. You may want to consider replacing older cosmetic dental work if your restorations have become: You may also simply feel that your dental work makes your smile look older than you feel. In some cases, replacing just a few aging restorations can refresh the appearance of the entire smile. Why See a Prosthodontist for Replacing Old Dental Work? Replacing existing cosmetic dentistry presents different challenges than starting with untouched teeth. The dentist needs to evaluate the existing restorations, the teeth underneath them, the bite, the surrounding natural teeth, and the patient’s overall smile before determining what should—and just as importantly, what should not—be changed. A prosthodontist receives advanced specialty training in restorative, cosmetic, implant, and reconstructive dentistry. At Geach Dental, we routinely treat patients with existing veneers, crowns, dental implants, and complex restorative dentistry. Our approach isn’t simply about making teeth look prettier. We want the final restorations to look natural, function properly, and integrate with the rest of the patient’s smile. Ready to Update Your Smile? If you had cosmetic dentistry completed years ago and your veneers, crowns, or implant restorations no longer look the way you want, you may not need to start over. Sometimes the right approach is simply to replace aging dental work with modern, natural-looking restorations. Dr. Adam Geach, DMD, MDSc, is a prosthodontist providing advanced cosmetic, restorative, and implant dentistry at Geach Dental, serving patients in Downtown Los Angeles and Orange County. If you’re unhappy with old veneers, crowns, or other cosmetic dental work, schedule a consultation

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