My all-porcelain crowns look fake

Dr. Hall,
Recently, I have had 6 front teeth crowned. I asked my dentist after some of my own research, to use only “bonded all porcelain” crowns as I wanted the most natural look possible. It is my understanding that it takes a true cosmetic dentist with extensive training to do this type of crown and so, when the dentist agreed with me, that this was the best thing for front teeth, I went ahead. I do not like the results as they look like false teeth and also do not feel comfortable. Naturally this has been an upsetting experience.

He told me that he would re-do the work. He suggested that I visit the lab person and tell him what I want. I do not have any relationship with this lab person at all but have been going to this dentist for 17 years.

What can I do? I truly appreciate your help.
– Leslie in North Carolina

Leslie,
You unknowingly put your dentist in an awkward position. It’s not just that were you asking for a specific type of crown, which generally isn’t a good idea, but you were expecting your dentist to become an artist and do a beautiful smile for you. Yes, it does take specialized extra training to place a bonded all-porcelain crown. But it sounds like the crowns are WORKING ok. It’s just that you don’t like how they look. So it’s the artistry, mostly, that you have a problem with. You want these to look beautiful and natural, and your dentist is not an artist, it seems to me, and doesn’t know how to create that “look.” People who are attracted to the dental profession become dentists, almost always, because they like to fix things, and they have a strong tendency toward a technician mindset and aren’t very artistic at all.

So it looks to me like he doesn’t know what to do. And it sounds like he’s hoping that the laboratory technician will be able to translate your desires into a beautiful smile, but I think that’s just because he’s at a loss as to how to create a beautiful smile. I don’t think it will help for you to go directly to the lab technician.

And your dentist is being really nice to you–to offer to re-do them. He doesn’t have to do that, but he wants you to be happy, so you must have a good relationship. This will be expensive for him.

Here’s what I’d suggest. I’d get some help from a real cosmetic dentist by getting a second opinion. I know Dr. Jan Kraska in Greensboro, NC, really well, and besides being a very artistic cosmetic dentist, he is a really nice guy, too. Now that will be a bit of a drive for you, but if you really want a beautiful smile, I think you’re going to have to do this. I’d call and talk to Shelley, his wife, who usually answers the phone, and explain that Dr. Dave Hall suggested this, and that you’d like to get your dentist some help with re-doing these crowns so that you like how they look. And offer to pay for a consultation fee, for whatever time it takes for Dr. Kraska. Then ask Dr. Kraska to help direct the lab to making a beautiful set of crowns for you, or even see if your dentist needs to go to a different lab, or see if he would suggest something else.

I’d let your dentist know that you want to do this. I think if you explain it nicely he will cooperate as much as he can. He sounds like a very honest man who wants what is best for you, so I’d hang on to him for all your long-term care. But I think that he was put in an uncomfortable position since he isn’t an artist, and that’s how you could explain it to him, or however you want to put it.

I hope this is helpful.
– Dr. Hall