Dr. Hall,
In 2005 I chipped my front tooth (#9) and had to have a root canal done with a tooth-colored post. I then had an all-porcelain crown placed on the tooth and it looked perfect. Over the past 3 years, my tooth has slowly turned gray. I’ve been told it is the original, underlying tooth that is slowly decaying and shining through the all-porcelain crown. I wanted to have the root canal redone to completely eliminate the gray, but my dentist said that it’s not a good idea since I have a post in that tooth. She said the only alternative is to go with a Lava crown, which would mask the gray somewhat but not perfectly. I desperately want the gray completely gone – is there any alternative besides a dental implant?
– Danielle in Florida
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Danielle,
This is kind of a tough question, but there is an answer.
First, I want to comment on the tooth turning gray underneath your crown. A lot of dentists don’t realize that root canal filling materials, when left in the visible part of the tooth, are strong contributors to this graying of your tooth. I’m not absolutely sure of this, but my guess would be that your tooth wasn’t cleaned out thoroughly when the tooth-colored post was placed.
Yes, one solution could be to mask the darkening color. But it doesn’t need to be a Lava crown. Even regular feldspathic porcelain can be made opaque. But it is a less-than-ideal result.
My response to a problem like yours would be to take a little extra time and care and get this done right. Yes, a post is difficult to remove. But if it is tooth-colored, it is probably fiberglass or some similar material and they can be removed safely. Get it out, clean out the tooth thoroughly, bleach it if necessary, and put on a new crown that is naturally translucent, giving you your beautiful smile back.
If this dentist is the same one that first put the post in, then as I see it, she gets a grade of about “C” for her cosmetic dentistry skills. Yes, she did a lovely crown, but she missed cleaning out the tooth and her understanding of esthetic dental materials and opacity is a little lacking. You need an excellent cosmetic dentist with “A” skills for this job. Check our list for someone in your part of the country. Then go back to your regular dentist for the rest of your care, because it does sound like she has some good skills. Not great on the cosmetic dentistry, but very few dentists excel at that.
– Dr. Hall
Links:
See our page on all-porcelain crowns for some comments about Lava crowns.
About David A. Hall
Dr. David A. 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 advanced internet marketing for dentists.
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