The Cosmetic Dentistry Blog

March 11, 2014

Repairing a porcelain crown

Dr. Hall,
My son has his four front teeth capped with the caps that have a white color in the front and the silver on the back. One of the crown is chipping revealing the silver under the white front. No dentist in or around town says they can help me without replacing the crown. Is there anything that can be done to simply make the front all white again without replacing the whole crown?

- Bobbi from New Mexico

Bobbi,
I have a couple of things to say about your son’s situation.

Yes, there is a way to repair a crown that is chipping and showing the underlying metal, but you’re going to need to go to a dentist with particular expertise in cosmetic dentistry and bonding technology. In Las Cruces that would be Dr. Brian Gilbert. Do a Google search for “Bright Star Dental” and you’ll find him. Over 95% of dentists are not going to know how to do this or have the equipment needed to do this.

The process is very similar to the technique I wrote about several years ago for repairing a porcelain bridge. The underlying metal has to be etched with a small sand blaster and then treated with a metal bonding agent like Panavia. The fractured edges of the porcelain have to also be etched either with the same sand blaster or hydrofluoric acid or both and then my preference is to treat it with a silane coupling agent. Then the metal has to be coated with an opaquer. The crown is then ready for bonding with composite restoratives, to match the color and surface luster of the porcelain.

But there is more to this situation than just repairing the crown. The question that comes to my mind is, Why is this crown chipping? You are writing on behalf of your son, which suggests to me that he is still young, meaning these crowns haven’t been on him for that long. The crowns are porcelain fused to metal, which is pretty strong. When they chip, it is usually because of some flaw in the making of the crown. And you say, “is chipping.” I’m going on sketchy details from you here, but your putting it that way suggests that this is a process that is occurring over time, not a single event. Is it going to chip some more? Something is either wrong with this crown, that it would do this, or there is something happening with your son that is particularly abusive to this crown.

And then I have the question, why were porcelain fused to metal crowns placed on your son’s front teeth in the first place? Dentists who care much about the appearance of their work will put all-porcelain crowns on front teeth almost exclusively, not porcelain fused to metal. I’m really questioning the dentist who did this work.

I’m admitting that my advice here is based on my trying to fill in the blanks with things that you haven’t told me explicitly. If I am filling in the blanks correctly, then here is what I would advise doing. First, I would go back to the dentist who did this and see if he or she will make this right by replacing this one crown for free. If that doesn’t work, then I would go to Dr. Gilbert and have him repair the crown. Then, when your son is college age, if he isn’t that age yet, I would replace all of these crowns with natural-looking all-porcelain crowns.

I’d be interested in hearing more about your case, if you care to write back.
- Dr. Hall

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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.

April 11, 2013

Finding a cosmetic dentist in the Cayman Islands

Hi there Dr Hall,
Many thanks for such helpful information on your website. Your support is greatly appreciated! I currently reside in the Cayman Islands, my front right tooth slightly overlaps my front left tooth. Is there anyone you could recommend in Grand Cayman, so many cosmetic dentists I don’t know where to start. I have visited one, whom suggested getting all my teeth whitened, then 2 zirconia crowns on both front teeth as sister teeth. Are there any other options to compare, or does that sound wise. I am 34 with 2 young kids and finally want not to be too embarrassed to smile.

Many thanks
- Denise

Denise,
What you’re telling me about what this dentist wants to do makes me nervous. The idea that he or she wants to do zirconia crowns on these front teeth rather than bonded porcelain makes me think that he or she is not comfortable with bonded porcelain. Bonded porcelain would be preferable to zirconia. Zirconia is great for back teeth or bridgework, but I wouldn’t recommend it for an esthetically critical situation on your two front teeth. And I would think the ideal treatment would be porcelain veneers anyway, not crowns at all. Doing two or more crowns on front teeth can put you at risk of breaking them off from lateral stresses.

I don’t understand all these cosmetic dentists you are talking about. I just googled cosmetic dentists in the Cayman Islands and looked at several websites and couldn’t find anyone I would trust with even the simplest cosmetic procedures, much less something as involved as what you are telling me. Even in the United States, fewer than one dentist out of fifty could do a beautiful job on your case. I would be surprised if you could find a dentist in the entire Caribbean area who could do a nice job on this. Quite frankly, I would fly in to Miami and have someone there do this. Dr. Sam Sadati near West Palm Beach is one I know personally who would do beautiful work for you. You could have your teeth whitened there locally and then get the two veneers or whatever your case requires done in Florida.

Why spend money to give you a mediocre cosmetic result and then possibly end up with damaged front teeth besides? Spend a little extra for a couple of trips to Florida and get it done right.
Dr. Hall

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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.

March 11, 2013

Porcelain fused to metal crowns are ugly on front teeth. Why would a dentist do this?

Dr. Hall,
I had 4-front teeth crowned with porcelain over metal. I am VERY upset because I was not informed about the dark line that I now see?? I did go to dentist today & he is replacing 1-tooth w/ dark line, but after just a month of having these crowns, I noticed on the back of THIS PARTICULAR TOOTH a spot of METAL appeared. I think that is why he is replacing it. Is this a rare problem?? I wish that I had known my options!!?? How much does a crown w/ porcelain over metal cost?? I am in a small town near Tampa! I paid about $989 per crown; is that too much?
- Shirley from Tampa

Shirley,
Back in the early 1980s, putting porcelain fused to metal crowns on front teeth was a good idea. But not in 2013. There are now porcelain bonding techniques where porcelain can be bonded directly to the tooth instead of having to be bonded to a metal framework to give it strength. And there are new high-strength ceramics. So there is no longer any need for the metal foundation. All-ceramic crowns are plenty strong enough to serve just fine on front teeth.

In my opinion, a dentist who is serious about the appearance of his or her dental work wouldn’t even dream of putting a porcelain fused to metal crown on a front tooth. Not only does the metal make the crown look opaque, but you will have that awful dark line at the gumline. And if the dentist is successful in hiding that under the gum for now, in a few years the gums will often recede a little and the dark line will become visible.

So what you have is a dentist who doesn’t really care that much about how your smile looks. If you do, then you have a basic disconnect with this office. Now I want to be careful here, because many of these dentists who aren’t very concerned about the appearance of their work are excellent dentists. They are very engineering oriented and careful and thorough. They’re just not artistic. And this is the case with about 98% of dentists, maybe more – they simply aren’t artistically inclined at all.

So then what do you do about the four crowns you have? And my guess is that the dark line isn’t the only appearance-related problem with this work. They will have to be kind of opaque. I doubt they sparkle like natural teeth. And the shapes may not be natural. But replacing them with work from a truly artistic dentist will cost you another $1000 per tooth, and your insurance won’t cover that probably for another five years at least. But that is the only remedy. So when you’re ready to have them replaced, find an expert cosmetic dentist from our list and have this done right.

About the fee you paid – $989 is a typical fee for a crown. (Click here to read about costs of porcelain crowns.) The sad thing is that for that fee, or maybe just a little more, you could have had a beautiful all-ceramic crown that would have enhanced your smile rather than detracting from it. And about the metal on the back – remember that this is a porcelain fused to metal crown. They will often have a metal back. The metal back is actually gentler on the opposing teeth that chew against these teeth than the porcelain would be, and it shouldn’t be visible from the front. If you just have a spot of metal showing, then you probably had a thin layer of porcelain there over the metal. That shouldn’t cause any problem.

- Dr. Hall

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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.

March 2, 2013

Do you need a crown on a front tooth with a root canal treatment?

Just had a root canal on the tooth right next to the front tooth. Is it necessary for a crown to be put on ? Can a post only be put in and if so, repair the discoloration with a porcelain veneer ?
- Ann from New York

Ann,
There’s a simple answer to your question and a more thoughtful answer, and I’ll give you both.

The simple answer is that dentists were taught in dental school that if a tooth has a root canal treatment, it is weakened, and thus it needs a crown to strengthen it and prevent tooth fracture. Plus, after a root canal treatment, a tooth will turn dark, so a front tooth should have a crown to preserve its appearance.

The more thoughtful answer differs from this approach in two ways. First, on the “likelihood to break” issue:
- Yes, a tooth is weaker after it has had a root canal treatment. But there is a difference between back teeth and front teeth. Back teeth, because they have a flat chewing surface and cusps are prone to splitting – the chewing force comes down between the cusps and this pressure tends to force the cusps apart. A crown will prevent splitting of the tooth. A front tooth, however, doesn’t have these forces. The risk with a front tooth is that chewing creates a horizontal force that may break off the tooth. A crown, since it requires removing 1-2 millimeters all around the circumference of the tooth, will actually weaken it against these horizontal shear forces and make it MORE likely to fracture.

On the discoloration issue, yes, teeth with root canal treatments will discolor. However, if the root canal cement and the root canal filling material are carefully cleaned out of the inside of the crown of the treated tooth, that discoloration will take years to occur and will be mild.

My preference for a front tooth would depend on the amount of healthy tooth structure remaining in the tooth. If, say, 70-80% of the tooth is healthy tooth structure, I would recommend restoring the tooth simply with a translucent or white fiberglass post and composite. Then, when the tooth begins to discolor, that could be corrected with a porcelain veneer or a crown at that point. If substantial amounts of tooth structure are missing, I would use the same white or translucent post with an all-ceramic crown.

Dr. Hall

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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.

March 1, 2013

Is she allergic to the metal in her crowns?

Dr. Hall,
I am 64 years old…had metal fused porcelain crowns (5 upper front teeth) placed 4 years ago. After countless dentist visits, a nightguard, a guard for my bottom teeth, tensing of the jaw, etc., I cannot stop grinding my teeth. I am constantly aware of these crowns with the sensations I feel in the roof of my mouth. Do you think that maybe I cannot tolerate the metal? Previous to these crowns, I had gold backed crowns for 42 years which I never had a grinding problem. I have no peace and I am ruining my bottom teeth. Could I be allergic to the metal? (only because it actually feels “itchy” at the roof of my mouth.)

- Mae in Pennsylvania

Mae,

I need a disclaimer because of not being able to examine you myself, but just going from what you are telling me, it sounds to me like you have two separate problems.

The itchy feeling around the metal backings to your new teeth could well be from a metal allergy. Here’s what I would do: Ask your dental office for information on the composition of the alloy used in the metal of your porcelain fused to metal crowns. The laboratory would have sent them what is called a “Identalloy” certificate, which lists all the metals in the alloy. If you see “Ni” among the metals listed – this stands for nickel, and nickel allergies are fairly common.

Are you sensitive to any metals in earrings, for example? Women who have nickel allergies need to wear hypoallergenic earrings, and they have to be careful with what metals are put in their mouth.

Let me explain these dental metal allergies. In the medical history that the dentist took before starting any treatment, he or she should have asked if you have any history of metal sensitivities, and if you have anything like that in your history, the dentist should have prescribed metals for use in your mouth that have no nickel in them. The problem is, those metals are more expensive than ones that do have nickel. There are three expense classifications of metals used in crown and bridge work. The highest is called “high noble.” The gold backing you used to have would be in this category. Other alloys have high platinum. This type of metal makes a finer margin and is more malleable, meaning that it can be made to fit the tooth the best. The second highest is called “noble.” These will have a higher silver content, but will have no nickel or beryllium, which are metals that can cause sensitivities in some patients. They are somewhat malleable and make a very nice fit to the tooth, but not as high quality as the high noble.

The lowest category is called “base metal.” These are very stiff alloys and tend to be cast with small gaps between the metal and the tooth, so they don’t fit quite as well and they aren’t malleable at all. They will have some nickel in them and sometimes some beryllium.

Your new crowns may have also disrupted your bite. The metal sensitivity shouldn’t be causing you to grind your teeth, But if you had crowns on five front teeth, that has a strong impact on your bite and your bite could be thrown off to where it is making you want to grind your teeth. If this is happening to you, I would wear a nightguard every night until the bite is adjusted to where you don’t grind any more.

A particular problem if you have porcelain crowns on your front teeth that don’t have a full metal backing is that the porcelain on the upper teeth is highly abrasive to your lower teeth, and you will gradually wear down your lower front teeth. So I would get this fixed.

Dr. Hall

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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.

June 9, 2012

Why can’t my dentist get this color right on my implant crown?

Dear Dr Hall,
I was not happy with the color of the crown attached to my implant, so I returned to my dentist who said he thought it was fine and sent me away to “think about it.” I returned and he very reluctantly agreed to re-do the color. I recently had the revised crown attached again, but the color is worse – it is now quite noticeably darker. Both times I visited the lab for color assessment. And both times the dentist did not bother to check the color before attaching the crown. I am very disappointed, but do not want to return to this dentist as he obviously is not able to improve. He also had considerable difficulty with attaching the crown which resulted in considerable discomfort and left me wondering whether the attachment to the implant has been damaged. Post-procedure, I cannot eat on that side of the mouth at all. This implant has cost me a considerable sum. I would like to know what my options would be for correcting the color of this crown, and if the attachment has been damaged, would I need to get a whole new crown and implant, and who should pay for this? Is it possible to place a veneer over the crown? Thank you for your help.
- Mary from Australia

Mary,
Your case is a great illustration of the great difference between dentists when it comes to aesthetics. Only about 2% of dentists, from my experience, are very good at aesthetic dentistry, and I have people all of the time having a hard time believing that and wanting to know why. (And that 2% is in the US – probably less in Australia). But dentists become dentists because they like to fix things – they’re just not into works of beauty.

Your dentist clearly has a low degree of interest in the aesthetics of his work, and that is the reason this isn’t working. And you have given clear indication here in your e-mail of his indifference. Any dentist who is seriously trying to do beautiful cosmetic dentistry will be very attentive to your opinion and if you thought the color didn’t match well would not try to tell you that it was fine. Such a dentist would actually make sure the color was right in your eyes before cementing the porcelain crown and would not hesitate to send it back to the lab. But your dentist did not have enough confidence in his own color-matching skills to match the color himself but instead sent you to the laboratory. And then, after being burned once and having to re-do the crown, rather than trying it on and making sure you liked the color this time before permanently cementing it, he just puts it on.

You have figured out that you cannot rely on this dentist to get this right. If you want this done right, you have to find a dentist who actually wants to be good at aesthetic dentistry. I wish you had told me where in Australia you are and I could give you some guidance on that, because good cosmetic dentists are few and far between in Australia.

When a dentist sends you to the laboratory technician for the “color check”, that is a pretty good sign that the dentist knows he or she isn’t very good at tooth color, and those cases often end up looking very poor. All the technician can do is look at the tooth that needs to be matched and take notes about the color. Then he or she dismisses you, goes into the laboratory, and tries to follow the notes that were made. The dentist is supposed to have a higher level of skill than the technician, and should know how to make those notes and instruct the technician. And nowadays, with digital photography, it is very easy for a dentist to hold up a shade guide tooth to your tooth and snap a color-correct photograph and e-mail it to the technician, with notes. The technician can then use that photograph and the notes during the fabrication of your crown, and this is often the best way to get an accurate match.

Do not – absolutely do not try to get a veneer placed over the crown. The crown is difficult enough by itself. Get the crown re-done. If that is done correctly, it will not damage the implant at all. Trying to do a veneer over it and get the color right makes it all the more complicated. Besides which very few dentists know how to properly bond a veneer onto a porcelain crown. That could turn this from a simple bad dream into a true nightmare.

If you need any more help with this, please write back.
- Dr. Hall

P.S. – I see you found our website by searching on “dental catastrophe.” I had not thought of that search term before, but it is appropriate!

Click here to read my blog posting about how to ask for a refund from your dentist.

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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.

May 29, 2012

Decay on a tooth with a crown after only seven years

Filed under: Porcelain crowns — Tags: , , — mesasmiles @ 11:42 am

Dr. Hall
I have a 7 year old porcelain crown with a cavity underneath. What would cause this to happen? And could you recommend a good cosmetic dentist for me?
Thank you.
Judi from Ohio

Judi,
Seven years isn’t very long for a crown to last. When any crown is done, regardless of the material that is used, the dentist needs to be sure that the margin, which is the place where the crown meets your tooth, has no gaps in it, and that it is smooth. If there is any roughness at the margin or if there is a gap, even a very tiny gap there, it will attract plaque and will be a place that will be extra vulnerable to recurrent decay.

Insurance companies will generally have a standard that they expect a dental crown to last a minimum of five years and won’t pay for a replacement anytime sooner than that. But most dentists would feel that the crown should last much longer than that and would be embarrassed if it got new decay in seven years, unless the patient were particularly prone to cavities.

And I see that we do not have a recommended cosmetic dentist close enough to you. If you are serious about this request and it wasn’t just an offhand question, get back to me, and we will research this and find you a great cosmetic dentist. Please see my separate post, how we choose a cosmetic dentist.

Dr. Hall

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xxx

 

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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.

April 4, 2012

What treatment is needed for a calcified root canal?

Hi Dr Hall,
First of all I appreciate the good work that you are doing.
Regarding my question: my daughter had yellow staining on her right front tooth. The doc did an x-ray and said the root canal is getting calcified and suggested a root canal. After the root canal we suggested to leave it as such but he said the tooth would fracture and a crown is a must.The crown he suggested was LAVA. We were not happy with the finish so we are trying an emax or perhaps a metal free ceramic.To push us to decide fast he frightened us that the gums are falling down.But I am happy I did not go with a badly made crown. I would like to know whether I have been taken for a ride and two which is the best crown to use? My gratitude for your enlightening blog I shall recommend to all my colleagues. My prayers and God Bless
- Bransdon from India

Bransdon,
I’m glad to be able to help.

First of all, I’m not sure why your daughter needs a root canal on this tooth. Just because the canal is getting calcified? As long as it’s not infected, she doesn’t need a root canal treatment. Calcification of a root canal is just the depositing of extra dentin inside the tooth. It  can happen after a traumatic injury – it’s the tooth’s attempt to protect itself against infection of the canal. Also, all teeth tend to have their canals get a little calcified as we get older.

Second, even if she has a root canal, she doesn’t necessarily need a crown on this front tooth. While a back tooth that has had a root canal treatment will be prone to fracture if it doesn’t have a crown, a crown on a front tooth can actually weaken the tooth. A back tooth has a chewing surface. Chewing pressure on this surface will tend to push apart the cusps of the tooth, possibly causing it to split. But if a front tooth breaks, it tends to break around the neck of the tooth, and it just breaks off entirely at that point rather than splitting as back teeth do.

The Lava crown and the e.max crown are very similar to each other. They both have a very strong zirconia base overlaid with a feldspathic porcelain, but they are made by different companies. They are a good crown for dentists who aren’t very good at cosmetic dentistry procedures, but they require aggressive tooth reduction, which will further weaken this tooth.

In India, you have to be very careful with getting crowns or any type of complicated dental care. I’m not all that familiar with their standards there, but I know they aren’t as high as they are here in the United States. But the best thing to do for a front tooth that does not have a large filling, which sounds like it is your daughter’s situation, is to have a root canal treatment, then have a translucent fiberglass post placed to strengthen the tooth. Before placing the post, all of the root canal cement and root canal filling materials should be cleaned out from the inside of the visible part of the tooth – this will help insure against discoloration. If the color is off, I would have that fixed with a thin porcelain veneer. That will help the tooth retain its maximum strength. And I would try to seek out a dentist who is somewhat familiar with cosmetic dentistry procedures. There are dentists in India who are members of the American Academy of Cosmetic Dentistry, and I would seek out one of those. (You can go to the AACD website and pull up a membership list.)

I do not recommend, in the United States, relying on membership in the AACD for any type of assurance that a dentist will do good cosmetic dental work. But in India, it does show a level of commitment to cosmetic dentistry to be willing to fly to the United States to learn these procedures. Plus, I believe, there is only

- Dr. Hall

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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.

January 9, 2012

If I already have two porcelain crowns, how will porcelain veneers work?

Dr. Hall,
I’m really interested of getting a set of veneers for my upper teeth. but two of my front teeth already have a porcelain crowns. I was wondering that if ever I’ll remove those crowns, can a porcelain veneers be placed on the teeth? Hope to hear from you soon.

Thank you very much..
Kate in Bahrain

Kate,

A porcelain crown

A porcelain crown

Porcelain veneers and porcelain crowns are similar in that they are both made out of porcelain, but the crown covers the entire tooth and the porcelain veneer only covers the front.

Once a tooth has been prepared for a crown, you can’t go back to a veneer, because you can’t leave the back and sides of the tooth uncovered.

Here is a diagram of a front tooth prepared for a porcelain crown. The preparation is very aggressive, because in order for the crown to fit over the tooth, the tooth has to be tapered slightly.

A porcelain veneer

A porcelain veneer

And then this is a photograph of a tooth prepared for a porcelain veneer. This preparation is very conservative, because the veneer just has to fit over the front of the tooth.

There are some dentists who will shave back the crown somewhat and put a porcelain veneer over a crown, but I don’t recommend this. You don’t save any money, because it’s the same amount of work to put a veneer over the crown as it is to just do a new crown. And not only does this option not look as nice, but a crown with a veneer bonded over it has many points of vulnerability where it could fail later, where a new crown will last much longer. A good cosmetic dentist will simply replace the crown, and a good cosmetic dental laboratory will have no problem getting the new crown to match the porcelain veneers.

Dr. Hall

We thank our advertisers who help fund this site.

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.

May 19, 2011

My dentist won’t do the crowns unless I do the braces

Hi, I went to dentist today to inquire about replacing the crown on my two front teeth. They were put on about fifteen years ago and are discolored and embarrassing. I was told I need full ortho braces before I can get the crowns replaced. I do not have the money for that and I don’t see why I can’t just get new crowns and do the other stuff later. My front teeth in question are a little crooked and bucked out but not that terrible. What should I do?
- PJ from Wisconsin

Dear PJ,
I don’t like it when dentists put these restrictions on their treatment – they will only do the perfect treatment or nothing. People have budgets and sometimes less than ideal is the only thing within their budget.

You certainly should be able to get these crowns replaced without doing the orthodontic treatment. You could forgo the braces entirely, or you could do it later. The dentist should still be able to do great crowns and get them looking great.

I would find another dentist who is a more sympathetic and understanding type who will work with you and your budget.

And I would be sure to do all-porcelain crowns on your front teeth. Otherwise they will tend to look fake and will end up showing a dark line at the gumline. Make sure your dentist feels comfortable with this type of crown. Don’t press your dentist to do a certain type of crown – but ask what type the dentist recommends, all-porcelain or porcelain fused to metal. And if he recommends porcelain fused to metal, you’re in the wrong office. Just quietly exit and find a dentist who loves doing the all-porcelain.
- Dr. Hall

We thank our advertisers who help fund this site.

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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