I have severe tetracycline staining that I would like to get fixed. I’ve had consultations with a general dentist who wants to do a complete set of porcelain crowns and a cosmetic dentist who wants to do porcelain veneers (not Lumineers brand). I was quoted a price for veneers that is double the price of crowns. Can I achieve a great result with porcelain crowns or do I have to overspend my budget on the veneers in order to feel good about my smile? The general dentist has done one porcelain crown in my mouth already and I’m quite pleased with the result, although I know that a full set of these crowns will not look as real as the veneers which will have more variation in color to mimic real teeth. Please help me make the best decision regarding crowns vs. veneers. Thank you.
– Michele from Florida
Thank you for your question.
You came to the right place! As I bring out in the website when I talk about tetracycline stains on teeth, this is a very difficult procedure and you absolutely need a talented and well-trained cosmetic dentist. There are so many things that could go wrong in your type of case.
But to get a good result, you need to shift your thinking from thinking about the techniques being used to the artist behind the technique. The reason I would tell you to beware of the porcelain crowns is because of what that says about the dentist. Let me explain.
Crowns are a very aggressive treatment, especially on front teeth. You have to grind away so much of the tooth that you weaken it and run a risk, when you are crowning all the front teeth, of snapping them off later in life. So why would a dentist suggest that when the more conservative porcelain veneers would do? Because he or she is uncomfortable doing porcelain veneers. The take-away here is that the dentist is not an artist. I think you already figured that out. I would absolutely not let him or her try to fix your tetracycline stains. Mediocre results would be the best you could hope for, and you run the risk of real trouble. And one problem you run into with the crowns is that if you need another dentist to come in later and re-do the case, you’re stuck with crowns. You can’t back-pedal to porcelain veneers.
And I’m not impressed with your telling me that you are quite pleased with the one crown this dentist did. There are a lot of dentists who can do a great single crown. A smile makeover, especially when you have severe tetracycline stains, is in a completely different league.
But this doesn’t mean I’m giving a green light to the other dentist. Is he or she a true cosmetic dentist or simply a dentist who claims to be a cosmetic dentist? This is the great peril the patient faces. Cosmetic dentistry is not a recognized specialty. All it takes to be a “cosmetic dentist” is a simple announcement–no extra training, no artistic talent. And you can’t judge them by the fees. Some poor ones charge high fees. Some terrific ones charge very reasonable fees.
You didn’t share any numbers for the fees we are talking about, or any names of dentists. You may have more than two choices here. If you’d like to follow up with any additional questions, feel free to email me back. Tell me the fee and give me the name of the “cosmetic dentist,” and I could tell you more. You have the potential here of getting a really stunning smile if you do the right thing.
– Dr. Hall
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Michele answers these last questions and I respond. Read the follow-up post: Crowns vs veneers for tetracycline-stained teeth.