Dr. Hall,
I have a similar problem to Mary from Australia in your post about the color of the implant crown, except my crown was done three times. Each of them offered a completely wrong color, but my dentist was fed up and told me to “be grateful” and stop asking for so much.
All I want is for my smile to look uniform, like it did with the flipper I used to have to wear. But she says “my color is complicated” because a1 is too grey/white and a2 is too yellow.
She emphasized that I was lucky my implants were still holding after having the crowns be manipulated. This has made me fearful of approaching someone else for a second opinion.
Is this the case? Am I at risk of losing the whole process if I continue to have them redone?
Thank you for your help!
Isabella
(See Dr. Hall’s answer below.)
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Isabella,
I’m struck by the attitude of your dentist, turning her problem on you, accusing you of asking for too much because you want your crown to match your other teeth. You say you were happy with the color of your flipper tooth, so you don’t sound to me about someone who is that hard to please.
To answer your question, no, you won’t damage the implant if your crown is removed by grinding it off. Go get your second opinion. You don’t say where you are, so I can’t give you any tips about how to find an excellent cosmetic dentist. And I don’t know which tooth you are talking about. It sounds like this might be a front tooth. That takes a certain amount of skill and patience on the part of the dentist to get a perfect match if you have a crown on one of your very front teeth. I will tell you that in my office it was normal to have at least two or three try-ins before we got a perfect match in a situation like that—sometimes considerably more than that.
From what you are saying, your dentist seems to be frustrated because your tooth isn’t a perfect match of one of the standard shade tabs of the Vita shade guide: “A1 is too grey/white and A2 is too yellow.” But while that degree of matching is okay for a back tooth, for a front tooth the dentist needs to customize that standard shade tab.
Here is a color map that is typical of what I would draw out for the ceramist when I did a single crown on a front tooth. In the written instructions, I would specify a basic shade. Let’s assume that is A2 for this tooth. Then, besides the basic shade guide, I had a set of tint tabs with various tints of pink, yellow, blue, etc. I would then draw areas where the ceramist would need to add any of those tints to get an exact match with the natural tooth. And then, like I said, after the crown came back from the ceramist I would do an initial try-in, see what the color discrepancies were, and write about those. Later, with the convenience of digital photographs, I would just snap a photo of the try-in and the ceramist could then see where the color needed to be adjusted to get a perfect match. I wouldn’t even THINK of cementing the crown until we had a successful try-in, which is one of the things that really bugs me about your dentist—that she would cement a crown when you didn’t like the color. In fact, my appointments for front tooth crowns were always scheduled as a try-in, and not until we had a successful try-in would we actually cement it.
So it sounds to me like you are in the wrong dental office. While the vast majority of dentists aren’t concerned enough about aesthetics for the appearance-conscious patient, from what you’re telling me, your dentist seems to be at the extreme level of not caring about this issue. Your average dentist won’t ordinarily go past just finding the right shade tab to match your tooth and maybe go to fractions to communicate with the ceramist. For example, the dentist could tell the ceramist, “try a shade A1 1/2 – halfway between A1 and A2.” But if the crown has the right value (the degree of brightness), it will generally be an acceptable match for many people, even if all the right tints aren’t there. But your dentist doesn’t seem to even want to go through that trouble.
– 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.