In December last year I had 24 teeth fitted with either Procera crowns or porcelain veneers. I have severe tetracycling staining that goes right through my teeth. I met a friend who had similar work done – and was astonished at the difference in appearance of the work. Her teeth looked totally natural and were very translucent. Mine on the other hand looked totally opaque and quite false in comparison. I am so upset. I have been reading on your web-site about the Procera crowns – and I now realise why my teeth look opaque. It is the opaque white core. I had no idea there were different types of porcelain crown! My dentist led me to believe that my teeth would look like natural teeth. And they don’t. Obviously my friend has a different type of porcelain crown. My question is – to cover the dark tetracycling staining – would Procera be my only option? Could I have a more translucent Feldspathic crown/veneer?
– Joanne from London
You’re making the mistake of blaming the material, but what happened is that you went to the wrong dentist. It’s the DENTIST who is supposed to know these things. But most dentists went into dentistry because they like to fix things, and 98 to 99%% of them aren’t artists. Your dentist did Procera because to him or her, this was good enough. Think about it–your dentist is the professional and attends courses and reads journals. Why did he or she choose to do Procera crowns? Don’t you think your dentist, if he or she cared enough, could find out that Procera is opaque, and that being opaque isn’t as beautiful as being translucent? My guess is that your dentist KNEW that Procera is opaque. But your friend went to a dentist who had a better sense of beauty and was more artistic.
To your dentist, I’m sure your teeth look fine. They’re white, and look like natural teeth. That’s why we are trying to set up this network of cosmetic dentists/artists who know how to do beautiful work. Dentists typically are technicians and not artists.
What I’m worried about is that you think that you can just go into a regular general dentist and this time tell them to use feldspathic porcelain instead of Procera and everything will be fine. No, that won’t work. You need to find a dentist who has a passion for beautiful cosmetic dentistry and he or she will take care of all those decisions and will choose a material that will look wonderful. So, as to your question about being able to have feldspathic porcelain, I hesitate to answer, because it is much more complicated than that. My technique with tetracycline stains was to do porcelain veneers, and I would do a deep preparation, and then use a composite opaquer directly on the dentin until the dark color was fully blocked out. Then I would take an impression and send it to the lab, and have them do beautiful, translucent feldspathic porcelain veneers. But there are other techniques that work well and newer porcelains that diffuse the light in such a way as to block color while still maintaining the appearance of translucency. But don’t try to figure this out for yourself and then tell the dentist how to do it. That just doesn’t work.
But you are actually better off than most of those who have written to me after having tetracycline stains masked. Most of them end up with gray teeth because the dentist erred in the other direction and made them too translucent. Tetracycline stains are difficult to cover. The darker color has to be masked. And there are very few dentists who know how to do that well. There are very few dentists who care enough to strive for that level of beauty.
– Dr. Hall
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