Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

September 6, 2018

Matching the color on a crown for a front tooth


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Hi Dr. Hall,
I had a root canal done on my front tooth over 10 years ago. In the past few years I had noticed a blue discoloration at the top of the tooth. After trying internal bleaching, my dentist ended up doing a crown.

The first crown that came back from the lab looked very white. He redid it. The next tooth, which is in my mouth now, looks better but doesn’t match the other front tooth. The dentist permanently cemented it in, but when I got home and took some selfies I was unhappy with how unnaturally white it looks.

The dentist will give it another try but my question is — should I let him try again or go to someone else who specializes in cosmetic dentistry? I now live in Princeton, NJ and my dentist is in Brooklyn. Cost is a factor.
Thanks,
Ronnie

Ronnie,
Doing a crown on a single front tooth is a tricky procedure. The slightest variation in color between the two front teeth is usually very noticeable. And it isn’t just the overall color—any tooth has multiple colors in it. Even expert cosmetic dentists will often have multiple try-ins before they get the crown to match perfectly. When I was in practice, I charged about 40% more for crowning a single front tooth because we would typically send it back to the lab three or four times until we got it perfect and I would charge the extra fee because of all the extra appointments. Dentists with poor cosmetic dentistry skills sometimes ask patients to crown both front teeth in order to get the color right.

That your dentist would think that the crown would look right after one or two trips to the lab shows either inexperience or a low level of commitment to excellent cosmetic dentistry. I’m not meaning to imply condemnation with that comment because that is typical of the overwhelming majority of dentists—maybe 98% of them. So yes, if you want this done so that your two front teeth match perfectly, you need to raise your sights and go to an excellent cosmetic dentist such as we recommend. There are several excellent ones within reasonable driving distance of Princeton, say 15-30 miles.

However, depending on how big a factor cost is for you, and if your dentist is willing to work with you to get this right for no extra charge, you may want to stick with this dentist to save the money of having another dentist start over with you. And, I would add, if you are willing to make several more trips back to Brooklyn. To help the process, you or the dentist should get hold of a good digital camera that is capable of taking a clear photograph of the new crown in place next to your natural tooth under outside light, such as right next to a window. That will go a long way toward helping the ceramist pin down the right color. And be sure that the crown is only temporarily cemented until you have seen it under various lighting conditions.

If you want perfection—a crown so natural that you can’t distinguish it from the real tooth next to it—you need the expert cosmetic dentist. But if you are willing to accept some compromise of that ideal in order to save money—try letting your dentist have some more tries to get this closer.
– 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.

June 11, 2018

Another family dentist trying to do cosmetic dentistry


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Dr. Hall,
Last year, I had a tooth with composite bonding chip. My dentist retired and the new dentist suggested veneers. After realizing my teeth had fillings, he said he could only do crowns. Unfortunately, I didn’t question him because I knew nothing about this procedure at all. Now, I have six porcelain crowns on my front teeth that I hate. My front two teeth look gray in pictures and do not blend with the other four crowns. What can I do?
– Anna from a small town in central Georgia

Anna,
So you have another cosmetic dentistry horror story. You have spent a lot of money and probably look worse than before you started.

There isn’t a whole lot you can do except have at least these front two crowns re-done. Hopefully your dentist cares enough about his work that he will take care of this for you without charging you.

In re-doing them, you should insist on a try-in before they are bonded, and you should make sure to get a good look at the crowns before they are bonded or cemented into place. And when they are tried in, that should be done with a clear try-in paste that will help transmit the color of the underlying teeth through the porcelain of the crowns. Since your dentist clearly doesn’t have much expertise in cosmetic dentistry and so is unlikely to have try-in pastes, he can just use clear glycerin or any other clear water-soluble gel which should work just as well. Otherwise, you can get a false reading of what the actual final color will be.

If your dentist won’t do that for you or balks at any part of these instructions, you will have to go somewhere else. If that is the case, I would strongly recommend taking the two-hour drive to Atlanta where you can go to a real cosmetic dentist who knows what he or she is doing. Check our list of recommended cosmetic dentists—any one of them could do a beautiful job of this for you.
– Dr. Hall

Do you have a comment or anything else to add? We’d love to hear from you. Enter your comment below.

Click here to ask Dr. Hall a question of your own.

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.

October 7, 2015

These crowns are not the color they appeared to be when they were tried in

 

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Dr. Hall,

I have just had two all porcelain crowns made for my two front teeth, #s 8 & 9. The crowns were a wonderful color match to adjacent teeth and I unreservedly authorized them to be cemented in. After the cementing procedure, I looked in the mirror and IMMEDIATELY noticed a slight grayish hue to the teeth. I inquired about this, and the dentist stated that the cementing product he used was transparent in color. I have looked at the teeth in different light conditions over the past several days and STILL see this. Is there something in the cement or its curing that could have caused this?
– Sara from Florida

Sara,
Did the dentist try in the crowns dry? Or was there some type of try-in paste used between the crown and the tooth under it?

That is one possibility that could account for a difference in perceived color between the crowns when they were tried in and when they were cemented. If the crowns are dry, they don’t transmit the underlying color of the tooth as well as they would with a bonding medium between the tooth and the crown. Darkness, stain, or metal posts in the teeth underneath could cause a gray tinge to the crowns. What I did in my practice when my bonding cement was going to be transparent was use a clear glycerin to accurately mimic what the resulting color would look like when it was bonded.

If that’s not the case, then the only other explanation I can think of for a discrepancy in the color like this would be color metamerism, which is the property certain materials have to appear one color under one light and another color under another. Some porcelains may match the teeth under a cool fluorescent light but then won’t match in, say, daylight or under incandescent light. But a clear bonding cement made by a reputable manufacturer will not change colors upon curing and won’t impact the color of the final result beyond helping transmit the underlying color.

If the grayness is only very slight, maybe it isn’t really noticeable, and since both very front teeth are the same, it shouldn’t be distracting. However, if the grayness is significant and noticeable to others, I think your dentist should fix this. At his expense. It could be a great learning experience for him.

Dr. Hall

Do you have a comment to add? I’d love to hear from you! Please enter your comment below.

Click here to ask Dr. Hall a question of your own.

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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