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Hi Dr. Hall,
I have had porcelain crowns on my front teeth for at least 16 yrs. One of them has always had a tiny defect that you could not see with the naked eye. Now I can see it and feel it. I am afraid it will break while I’m in public and I’ll lose it altogether. It is a horizontal fracture line. Near the bottom. I am not opposed to replacing but just wonder if I need to do it as an emergency.
Thanks for your help.
– Ruth from Ohio
Ruth,
I would find an expert cosmetic dentist and get the crown replaced. I wouldn’t call it an emergency, but this is a defect that I suspect will one day in the not-too-distant future result in a complete break.
You say this crown has always had this defect, but you couldn’t see it with the naked eye. Teeth and porcelain can have these lines that we call craze lines, and they are ordinarily of no particular concern. What gets my attention now with your situation is that you say you can now not only see this with the unaided eye, but you can feel it. So there has been some movement here resulting in a palpable discrepancy in the surface.
Depending on what your cosmetic dentist sees when these teeth are examined, he or she may recommend replacing all the front crowns, as they are all old. But if the other crowns look fine, there should be no need for that. See what you are told.
If you replace just one crown, that is going to require excellent color-matching skill on the part of your dentist. Be wary if the dentist tells you that the only way to guarantee a perfect match is to replace more than one crown–that’s a way for them to admit they don’t have the skill to match the new crown to the old ones.
– Dr. Hall
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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.