Dr. Hall,
I have several front teeth that have caps on them. I’ve had them for approximately 30 years. They are not white like I would like them. What would you recommend for whitening my “fake” teeth. I’m assuming they are porcelain, but not 100% sure on the material they’re made up of. They were put in with posts and each one is individual.
—Missy from Pennsylvania

Missy,
If you have caps (crowns) on your front teeth and they are white and they’ve been there for 30 years, I’m pretty sure they have to be porcelain. Nothing else would last that long.

Unfortunately, the only way to whiten crowns is to replace them.

There is a company that is promoting the use of porcelain veneers to cover over old crowns, but that procedure makes no sense for several reasons, one of the biggest of which is cost. With most dentists, the cost of a porcelain veneer is pretty much the same as a new porcelain crown, so why wouldn’t you just replace the crown? Even if the veneer is cheaper, it isn’t cheaper enough to make it worth it.

First of all, if these crowns are 30 years old, there is a decent chance there could be some leakage or even decay under them.

Second, pasting porcelain veneers over old crowns creates some problems. This is a tricky bonding situation, and the bonding between the old porcelain and new porcelain is hard to get very strong, and it tends to be susceptible to stain. And it’s not going to last all that long. If these first crowns have lasted 30 years, why not get new ones and try to get another 30 years out of them? That makes way more sense than bonding some veneers over them that might last another five years.

No, just replace the crowns. It’s time a dentist looked under them to see what is going on there. It’s bound to be at least stained. Have the dentist clean it all up and put on some beautiful all porcelain crowns that can be as white as you want them. Bleach the rest of your teeth first, and then get the new crowns.

But go to an excellent cosmetic dentist. This is a new smile you’re talking about, and you need a dentist/artist to do this right.

—Dr. Hall

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

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