Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

June 21, 2010

Unhappy with her two crowns.

Filed under: Crowns for front teeth — Tags: — mesasmiles @ 8:56 am

Hi Dr.Hall,
When I first decided to get braces, all I wanted was to get my front lateral incisors (on front) straightened. Instead, my orthodontist gave me 2 options: (1) Two porcelain crowns on the incisors or (2) have my dentist remove the incisors and then close the gap thereafter. When these options were presented, I felt that I did not have my original choice to just straighten the incisors, so I ended up choosing the porcelain crowns. Since this cosmetic change in 2004, I remain unhappy with them because I was never given my first choice–just to straighten my teeth without any additions or removals. And because I was in my 20s and didn’t know much about the differences between Empress or metal or no metal bond, now I regret my decision in having these fake things on me. My questions for you are: (1) How long will these crowns last before I have to replace them? (My dentist at the time said I would have to replace them every 10 years.) (2) Should I reconsider removing these crowns in the future (about 2014);get braces again; and follow through with the 2nd option I was given back in 2004 (where I have the lateral incisors removed and have them remove the gap this way? (I heard that if I do it this way, the muscle memory in my teeth would make it more difficult to maintain the straight teeth.) Is this a common procedure? How would this look? Would my bite get worse if I do it this way? What are the pros & cons of making this change? When I first picked this orthodontist, I chose him because he did not want to perform any surgery and he was COST EFFECTIVE. However, having gone to him is costing me more in the long run bc I was told that I would have to replace these crowns over time. Please help. I don’t want to make the wrong decision again. (Every time I mention my concerns to a dentist, they always say, “You worry too much. Your teeth are fine.” It’s obvious they are not cosmetic dentists bc they don’t understand how the patient feels emotionally and financially about it all. This does not help the situation. So, please don’t say that to me either.)

Thank you.
Sincerely, Alma
PS: At this time, all I know is that I have porcelain crowns and I am not sure if they have metal or not. This may be Empress…these cost me $1450 in 2004. I would have to contact my previous dentist or lab technician who did this and get back to you if this will help. I currently do not have any gray lines showing where the crowns are at this time.
– Alma from California

I don’t know, not having seen your case, but I’m guessing that you had what we call “peg laterals” – where the lateral incisors are malformed. In such a case, crowning or veneering those laterals is by far the best choice. I’m glad you didn’t have them take out the laterals. Some orthodontists recommend that but the results almost always look very unnatural.

The comment you’re getting from your dentist telling you not to worry about how your teeth look shows that he or she is definitely not a cosmetic dentist. This is what most dentists believe – that patients’ appearance concerns are trivial. And I believe that this is the problem with your two crowns. Had you had them done by an excellent cosmetic dentist, you would have been thrilled with how they look.

Your initial choice was reasonable – do the crowns. Where the procedure broke down was in the artistry of your dentist. But once you have crowns on any teeth, you’re committed to having crowns on them forever, so you need to make the best of the situation.

You do not need to wait until 2014 to fix these. Most dental insurance plans provide replacement benefits for crowns that are over five years old, which would have been 2009 for you. And once you have them replaced, they could last 10, 20, or even 30 years – there is no fixed lifespan for crowns.

My recommendation is to go to our list of California cosmetic dentists at and find a dentist who is truly passionate about doing beautiful work, and get these crowns replaced. I’m confident you’ll absolutely love the result if you go to an expert cosmetic dentist such as we recommend.

Good luck,
Dr. Hall

Click here for referral to an expert cosmetic dentist.

Followup: Alma sends her thank-you for our response.

About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

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