Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

September 21, 2018

Gap between my crown and my bridge


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I have a space between my 2 front teeth, however one of my front teeth is a crown and the other front tooth is part of a bridge. Can the gap between my front teeth be closed with Lumineers or any other procedure or would I have to get a new bridge and crown, possibly all in one structure to close the gap?
– Laura from Nevada

Laura,
Your question prompts me to ask a question of my own: Why did the dentist who made the crown and/or the bridge leave a gap between your front teeth? The easy way to fix this would have been to make them correctly in the first place.

At this point, yes, you pretty much need to have probably both of them re-made—depending on how big the gap is. Both front teeth need to be the same size—you don’t want to close the gap from just one side by making one side larger.

this microetcher has a long nozzle with a button on it, and at one end a small clear plastic bottle as a reservoir

A Micro-Etcher

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But there is a procedure you might want to try before doing that. There are ways to bond composite to porcelain, and you could start with trying that—treating this as a dental bonding case. If the dentist has what is called a micro-etcher, which is a small sand-blasting handpiece, he or she could micro-etch the porcelain surfaces next to the gap. This would be followed by etching with a hydrofluoric acid gel and then priming the surface with a silane coupling agent. A bonding resin would then be applied followed by composite bonding material to match the shade of the crown and the bridge. The composite would be shaped and polished. In theory, this should work. However, my experience with bonding to porcelain was that after a few months, we would see staining along the margin between the composite and the porcelain. But it could be worth a try to try to avoid the expense of a complete re-do of your front teeth.
I would think it goes without saying that you need an expert cosmetic dentist to do this, such as we recommend on this website.

The company that makes Lumineers, a few years ago, tried to promote the idea of bonding Lumineers over the top of porcelain crowns, but I strongly discourage that. You would get the same risk of staining at the margins, and would spend the same amount of money as you would spend just re-doing the case completely. Click the link to read more about the problems with that approach.

– Dr. Hall

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About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

August 14, 2015

My front teeth are darkening under my veneers

My Lumineers are 7-8 years old. Originally I had them on 16 teeth. At the time I had the money….there is no way I could afford this now. Soon after I had them put on by a dentist in Kona, Hawaii, I moved to Austin, Texas and they began to fall off. Two fell off and I paid to have them reinstalled. I told the dentist in Hawaii, and he ended up (after many letters and threats of legal action) sending me a very small refund so I could pay the dentist in Austin. The veneers had also begun to darken/no fit well at the gum line, making me self conscious more and more as time goes on. Since then no further veneers have fallen off, but over the past year I have noticed my front teeth darkening UNDER the veneers, one more than the other. I am afraid that I will need to have them removed and replaced and I definitely don’t have the money to do that. Interestingly, when I first chose the color of my new teeth I nearly chose a darker color to look more natural…as they seemed nearly too WHITE. But now they seem far darker…..I’m not flashing as white as my friends with natural teeth. Anyway….scared and disappointed I guess. Need advice on how to deal with the darkening teeth.
– Debbie from Texas

Debbie,
You’re right that the veneers will now need to be replaced. They are leaking, and the problem isn’t just the color, but when dental work leaks, the next step is that it begins to decay. When stain can leak in, bacteria also leak in.

It doesn’t sound to me like either dentist, the one in Hawaii or the one in Austin, knew enough to do this right. They weren’t bonded right in the first place, as you now understand. But very few dentists know how to re-bond porcelain veneers. The old bonding material would first need to be completely cleaned off, with some type of sand-blasting equipment which few dentists have. Then the inside surface of the porcelain should have been etched with hydrofluoric acid, again something that few dentists would stock. The veneer could then be primed and bonded onto your tooth, where it should remain without leaking for many years.

If your veneers could be just popped off, they could probably be cleaned up and re-bonded properly, and you should be fine. But I’m guessing that the Austin dentist probably bonded them on pretty well, just not well enough to hold up over these years. So they would most likely break in trying to take them off.

Another issue will be getting the new veneers to match your old ones. Make sure you go to an expert cosmetic dentist for this. Don’t look for cheap here–you’ll end up paying more in the long run.

I hope this is helpful.

Dr. Hall

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About David A. Hall

Dr. David 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 complete Internet marketing for dentists.

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