Archive for the ‘Porcelain crowns’ Category

Broken front tooth on 10 year old

Tuesday, August 31st, 2010

Is it common protocol to wait more than three weeks to fix a broken tooth? My youngest child fell and smashed her two front teeth yesterday afternoon, and our family dentist said this morning that he can’t fix it until early next month! I don’t know anyone who has had this happen to a younger child (she is 10), but that just seems like a really long time to wait.

One of the teeth was broken in half diagonally, and the other is cracked all the way across. We could not locate the part of the tooth that broke off, and I wondered if that was part of the reason he felt he could delay treatment. He told us the root has to “desensitize”. I don’t want to demand treatment right now if it will hurt her down the road, but I do NOT want to wait almost a month to get this fixed.

What should we do? Thanks very much for your help and advice.

Katie in Michigan

Dear Katie,

There is no medical reason to delay treatment. Your dentist’s full schedule may actually be a bit of a boon – unless your general dentist is also an expert, experienced cosmetic dentist, you don’t want him taking care of this for you. In a situation like this, our office strongly recommends choosing an expert cosmetic dentist to make the repairs.

Becuase of your daughter’s age, you probably won’t want to go with a porcelain crown at this time, though she may need one later. Direct dental bonding would be the recommended treatment for the broken tooth, but that is an artistically and technically demanding technique that only the most talented cosmetic dentists can do well. These are the most visible teeth in her mouth, and you want them to look good. When she gets older, she can be fitted with a porcelain crown (or two, depending on the degree of damage to the other tooth), but in the meantime, you do not want her to be embarrassed every time she smiles.

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Should I get porcelain crowns or veneers?

Tuesday, December 1st, 2009

Hi,
A few years ago I saw one of those extreme makeover shows and it really inspired me to do something about my awful teeth. I’ve been self-conscious about my smile for most of my life. My teeth are stained and crooked and shaped wrong, and I am missing one of my lateral incisors (it just never came in).

I’ve been saving for a long time for this, and I want to make sure I get what I really want. I’ve been looking for information on the Internet about different treatments, and I am kind of confused about when you would use porcelain crowns, and when you would use veneers. Based on what I told you, what do you think would be best for me? I don’t want to ask my dentist for the wrong thing and then regret it forever.

Thanks very much for your help,
–Alex in Santa Fe

Dear Alex,

First of all, congratulations to you on deciding to take this very important, life-changing step, and on your determination in working towards making your dream a reality. You really deserve to have an amazing smile!

The most important advice I can offer you for your future dental care is to find an expert cosmetic dentist that you can really trust. The decision to go with porcelain crowns or porcelain veneers should be made with the guidance of an experienced, preferably accredited cosmetic dentist. Many factors will help determine which option—or combination of options—is best for you.

To answer your question about using crowns or veneers, it will really depend on the condition of your existing teeth. In most cases, a dentist will strive to maintain as much of your natural tooth structure as possible. Porcelain veneers require just a small amount of preparation on the front of the teeth, while porcelain crowns generally require more of the tooth structure to be removed all the way around the tooth.

If one or several of your teeth are structurally weak or have large existing fillings, your dentist might chose to protect what remains with a crown.

Another consideration for you is that missing lateral incisor. You should seek an expert cosmetic dentist who also does dental implants.

The most important decision you have to make in this situation is who is going to do the work for you. Anyone can say they do cosmetic dentistry. It is up to you to check their credentials and education, and to view their case studies to make sure you really believe they have both the technical skills and the artistic sense to make your smile everything you could hope for.

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Crown has dark line at the gumline

Friday, November 14th, 2008

My son got a crown on a front tooth, but the crown shows a dark line of metal near his gum. He asked the dentist to cover the line with porcelain, but the dentist said if they will do that he maybe will get gum disease in a few years.

What kind gum disease can he get from a crown, if the porcelain will be covering the metal all the way to the edge of the crown? Should the dentist do the crown deeper and the porcelain will cover the tooth to all way to the gum?
- Gail from California

Gail,
I’m not sure I understand exactly what’s happening here, but I’ll try to be helpful.

If the dentist covers the existing line with a white restorative material, that usually doesn’t work too well. It doesn’t block out the color well, and it’s difficult to get everything to look natural. A porcelain fused to metal crown has a lot of opaquer to cover the metal, and getting that to blend with the tooth without looking funny is very difficult.

Depending on the anatomy of this tooth and how it relates to the gums, if the dentist works to cover this line, it is possible that this could irritate the gums and provoke gum disease. It’s also possible that the dentist simply doesn’t want to do this, either because it is very difficult and the dentist isn’t confident he or she could create a satisfactory result, or because it is too much work and too expensive.

Re-doing the crown could work, and the dentist could put the metal margin up under the gum a little. Or, the dentist could use what is called a porcelain butt margin that masks the metal a little bit. But even with these techniques, eventually the gum will recede a little and the dark line will become visible. And both would require completely re-doing the crown, which would be expensive for the dentist. And I wonder why it wasn’t done this way in the first place.

But the best solution is to do an all porcelain crown, with no metal in it. This can be made to look perfectly natural. But I wouldn’t ask your dentist to do this. Few dentists know how to do this type of crown well. If he or she felt comfortable doing all porcelain crowns, this would have been suggested at the beginning. Dentists who know how to do all porcelain crowns will strongly recommend them for front teeth, because there is no comparison with how beautiful they look. Dentists never like to show their discomfort to a patient, so if you press this matter, you may be pushing your dentist out of his or her comfort zone and end up with real problems.

Related links:
Cleveland cosmetic dentist
Cleveland lumineers

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My crown doesn’t go down to the gumline

Saturday, May 17th, 2008

A couple of months ago I had a lot of dental work. One in particular was a crown on my back lower tooth. The dentist made the crown short and it did not reach to my gum lines (I am almost certain the dentist knew she messed up but didn’t tell me). Now that tooth is sensitive, what do you suggest I have done? Should I have a new crown made to go down all the way to my gum line or should I go with a gum graft?
- Luke in California

Dear Luke,
It isn’t necessary for your crown, especially if it is on a back tooth, to go all the way to the gumline. In fact, keeping the margin of the crown away from the gum can be healthier because there is less chance of gum irritation. So I wouldn’t advise getting a new crown.

As far as the sensitivity in the tooth, there are several possibilities. If the front surface of the tooth near the gumline is sensitive to touch, then it could be that this surface needs to be coated with a desensitizer. If the tooth is sensitive to cold, it may just need some time to get used to the crown, especially if the crown has metal in it. Or it could be that the decay or the old fillings in the tooth were especially deep, and the tooth is irritated because of those reasons.

Links to related information:
Cleveland cosmetic dentist
Porcelain crowns
Porcelain veneers
Cost of porcelain veneers
Lumineers

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Can you put a porcelain veneer over dental bonding?

Wednesday, January 16th, 2008

My daugter chipped about 1/2 of her front tooth off when she was 8. It was bonded and still looks very good, but the lower edge is a little transparent. She is now 21 and is considering veneers. Can a veneer be placed over a 1/2 bonded tooth, or will a crown be required first? Would you recomeend veneers for both front teeth to insure a match in color?
- Ray

Ray,
Yes, a porcelain veneer can be placed over a tooth that is half tooth bonding. However, the problem is that the porcelain is much more durable than the bonding, so the lifespan of the veneer would be limited by the bonding. It wouldn’t likely cost any more to get an all-porcelain crown on that tooth–we charge the same for either service. The disadvantage is that a crown requires grinding away more of the tooth. But if half of it is gone already, I wouldn’t consider that an issue. The advantage is that the crown would last much longer.

Many dentists have problem matching the color of a single front tooth. However, we feel confident that we can get a perfect match for you. Color training and an eye for color are an important difference between a general dentist who enjoys doing some cosmetic dentistry and a genuine cosmetic dentist who has an artistic flair and a passion for appearance-related dentistry.

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