The porcelain crown looks funny.

Dr. Hall,
I just had 4 veneers placed on my top teeth. One is a crown. After having them permanently placed, I noticed (on the crown tooth) an outline, sort of like a patch, underneath the tooth. The doctor said it was my original tooth. It seems there’s more cement concentrated on that tooth which shows through. The doctor said no one would notice it but I do and am unhappy about it. She said if she were to replace it, the new veneer would look different from the other 3 because it wasn’t made at the same time. I don’t know what to do. I signed a form stating I consented to the way they look however had I seen this prior to her placing them on permanently, I would have brought it up. Is there any truth to what she’s saying? Am I taking a chance getting a new one put in and having it not blend in with the others? Should she charge me?
– Janet in New York

Dear Janet,
This is typical of what happens when you go to a general dentist who isn’t expert in cosmetic dentistry, and I’ll see if I can help you.

General dentists are taught in dental school that they know what is best for you, and your job is to just accept that. True cosmetic dentists are different — they are very tuned in to what you think, and if you don’t like how the work looks, then they consider the treatment a failure, and they will stay with you until you love it, as long as you’re reasonable.

My opinion is that this dentist should fix this until you like it. The reason being, and I’m guessing somewhat at this, that you agreed to the porcelain veneers simply for the sake of the appearance. Thus, this dentist was representing to you that she was going to make your smile look great. And it doesn’t. Her response to you is typical of general dentists — she knows how it is supposed to look, and it doesn’t matter that you don’t like it.

And I’m a little confused in what you’re telling me. You said you signed a consent form that you liked how they look. But then you say you didn’t see this prior to her placing them on the teeth permanently. That’s confusing. And then you say this is the crown tooth, but then you’re going to replace the veneer, which is confusing, too. But I’ll guess at what you’re meaning and give you some general direction. True cosmetic dentists will let you get a long, hard look at what things look like before putting them on and will be sure you have examined every detail. General dentists generally give you a quick look in the mirror while you’re upside-down in the chair, and that’s it.

A good cosmetic dentist teamed with a good dental laboratory will be able to duplicate the shade and shape of the crown and match it to the other veneers. That may be beyond the ability of this dentist, but it is routine for a good cosmetic dentist. If it were me, I would ask that she do this, and in my opinion, it should be for no charge. And the way to make sure it looks the same is to insist on getting a complete look when it’s tried in and pin her down — does this look exactly like it’s going to look once it’s on? It isn’t acceptable to have it put on permanently before you see how it looks, to make sure it matches. There are ways to check this, and she should know these. But it shouldn’t be that hard this soon from when the case was first done. She should have a copy of her instructions to the lab on the shade to make this crown. The same instructions to the same lab should produce the same result.

And then, please tell your friends that when they want things done to beautify their smile, to go to a real cosmetic dentist. Only a couple percent of dentists are artistic enough and really care that much about beautiful smiles to do a good job at that. Check our list of recommended cosmetic dentists for help with this.

I hope this is helpful.
– Dr. Hall

Related information:
Porcelain crowns for front teeth.
Porcelain veneers
The difference between a cosmetic dentist and a general dentist
Read about one-visit Cerec crowns
Click here to find a cosmetic dentist