I recently got a porcelain veneer crown on a tooth that I chipped when I was 10 years old. The first permanent crown that was put on did not match my other teeth, so I had to get it redone. I just got my 2nd one put on and after everyone in the office said it looked great, the color is still off and it is darker than my other teeth. I know a perfect match is difficult, but I would rather it be whiter than darker because that would be less noticeable. I was wondering if I were to get the crown redone again, if this would have any long term side effects on what is left of my tooth underneath my crown? Please let me know what advice you can offer and if it would be safe for me to try to get another crown remade.
– Kyle in Ohio
I’m not sure what you mean by a porcelain veneer crown. I think you may be referring to a porcelain fused to metal crown – because that has a metal foundation and has porcelain veneered over the metal. To get the best match to a natural tooth, it’s best to use an all-porcelain crown, because that can be made to have the same translucency as a natural tooth. But if your dentist hasn’t brought up doing an all-porcelain crown, then I wouldn’t mention it. That’s a recipe for trouble if you start pushing a dentist out of his or her comfort zone – rarely will they admit to a patient that they’re uncomfortable with a newer technology.
And yes, it is possible to get a perfect match on a single front tooth, so that you couldn’t tell, even at very close range, any difference between the crown and the other natural tooth. But this requires extra training and talent that most dentists don’t have. This is why I publish this website – to help people find excellent cosmetic dentists that can do this work.
Dentists generally choose that field because they like to work with their hands and they like to fix things. So they approach things from an engineering mentality. They aren’t good at subtleties of color. And tooth color is very complex. There is a lot of variation in all the colors that are within a single tooth – from the gumline to the biting edge there is a color gradient, plus there are spots where the color is slightly different. Add to this that tooth enamel is fairly translucent and the dentin underneath it is only partially translucent. So matching a tooth gets very complex.
When everyone in the dental office was trying to tell you that this tooth matches so great, that to me is a big red flag. Really good cosmetic dentists don’t act that way – they listen to the patient. So when we would try on a crown, we would ask the patient what they thought. I would pay close attention if there was any hesitation on the part of the patient, and I would insist that they be happy with the result. I would never tell a patient that a tooth or a smile looked great if they didn’t think so. And for a single front tooth, even for an excellent cosmetic dentist, it may be three or four try-ins before the lab would nail the color exactly.
On the other part of your question, it shouldn’t hurt the tooth at all to do this again, as long as the dentist knows what they are doing and is reasonably careful. But don’t try this with a general or family dentist. I would say that about one dentist in maybe fifty or a hundred could do this well.
– Dr. Hall