Hi Dr. Hall:
I have eight front porcelain veneers. I thought I had a sinus infection because I had swelling and pain next to my nose. It turns out that I have a periapical abscess and my dentist is going to refer me to an endodontist for a root canal.
I’m worried about my veneers, either losing the veneer or the darkening you mentioned.
What do you recommend?
– Gail D.
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I have a couple of things to say about your case.
Of course you need to go ahead and have the root canal done. You can let that infection around the end of your tooth sit there deep in your bone without being properly treated. I do wonder, however, how you ended up needing a root canal treatment after getting these porcelain veneers.Porcelain veneers should be done with very light tooth preparation—removing maybe half a millimeter—and it is very gentle to the tooth. Of the hundreds of porcelain veneers I prepared and placed while I was practicing, I never had a tooth that needed a root canal treatment. The photo on the right shows the depth-limiting diamond bur that I used for these preparations. It would cut half-millimeter deep grooves in the tooth, after which I would go back and remove the ridges with a conventional diamond. But some dentists do very aggressive preparations, removing all of the enamel of the tooth and deeply into the underlying dentin. Some even do full crowns and call them veneers. This type of preparation has a much greater risk of stressing the tooth to where it needs a root canal treatment. I hope that wasn’t what happened in your case.
But anyway, that’s all water under the bridge. You need to have the root canal treatment and you’re aware that after a root canal a tooth will turn dark, and since a porcelain veneer has some translucency to it, that darkness will show through. Here’s how to keep the root canal from ruining your porcelain veneer. The vast majority of the darkening of a the tooth comes from the remnants of the root canal filling material and cement that is left in the tooth. Most family dentists do not know that. So you need to ask your dentist to carefully clean out any of those materials from the crown of the tooth—that part of the tooth that is above the gumline, the part that you can see. Then he or she should place a white fiberglass post down into the root and fill the rest of the space in the crown with a light-colored composite. When I did this, I would not see any darkening of the tooth for five or ten years. If the tooth is covered by a porcelain veneer, it may even forestall the darkening longer than that.
If your porcelain veneer was placed correctly, you shouldn’t lose the porcelain veneer.
I hope this is helpful.
– 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.