February 2020 | Dr. Currie's Dentistry Blog

I am sharing my story in hopes that others will learn from me, and I really don’t know what to do now. Since I was 24, I have had four porcelain-fused-to-metal crowns on my front teeth. They looked OK at first. But, they began to look worse over time. The first thing I did to freshen up my smile was get Kör whitening. Big mistake! The whitening ended up making my crowns look worse. After the fact, I learned it was because teeth whitening treatments will not whiten crowns. They will whiten only natural tooth material, which ended up making my crowns look darker.

Next, I visited a cosmetic dentist and he was simply too expensive for me. He showed me countless beautiful smile makeovers and presented a plan to me that made sense. I just couldn’t justify the cost.

So, I went to another cosmetic dentist who recommended doing eight teeth in the treatment plan, which was even more expensive. He explained that I just wouldn’t like the end result if we only did the four crowns over again. In hindsight, he was right. But, I wouldn’t even listen to their payment options because I was so shocked at the price of the work.

Sadly, I settled with going back to the original general dentist who did my crowns in the first place. I somehow justified to myself that I he would somehow do better than the big, long crowns I’ve had all my life. I settled for the cheap option. Please don’t follow my footsteps. It won’t be worth it. But, here is what happened.

First mistake – I picked a shade that looked almost green in color. Isn’t that his job? Anyway, he promised that he would make sure I liked my smile. But, in the long run he couldn’t handle my requests. They look short now. I think he was overcompensating from my complaint of the originals being too long. And the color – green. Need I say more. I drove him crazy with details and he turned me over to his dental assistant. When it was all said and done the said, “Don’t look on the internet at those perfect teeth. Your smile looks fine.”

Well, there you have it. Fine. It has been three years since me choosing cheap dentistry over the best cosmetic dentist. I don’t know what to do. I honestly just wanted to vent in hopes it may help someone else avoid making the same mistakes I did.

-Sandy from California

Sandy,

Wow – thank you for sharing your story. Unfortunately, it sounds like you’ve learned your lesson the hard way. Hopefully, your transparency with your story will encourage others to not settle for the least expensive treatment option. Cosmetic dentistry is expensive. But, the right cosmetic dentist will hopefully be able to work out payment arrangements or financing options that work for you.

Honestly, if you cannot afford cosmetic dentistry, it may be best to not do anything, save up and go back to the best cosmetic dentist when you can afford it.

There are so many lessons learned in your story. One worth revisiting is about the first dentist who allowed you to whiten your teeth with Kör bleaching. If he knew what he was doing and was honest, he would have never whitened your teeth knowing you have four crowns. There wasn’t a chance that the whitening would end up improving your smile. That left you in a position where the only alternative is to replace the crowns.

One other comment about the second dentist who was recommending doing eight crowns instead of four. Many cosmetic dentists may disagree on their treatment plans. Sometimes an excellent cosmetic dentist won’t accept your case if they aren’t confident that you will end up with a beautiful result. It’s a situation where they care too much, in a way. That is likely what was going on there. He felt that doing four crowns would only look OK. But, in order to give you the result you desperately wanted, eight was the way to go. Again, it’s something for others to look out for. It didn’t necessarily mean he was trying to sell you more, it was likely his intention to give you the absolute best result.

Some cosmetic dentists will still work with you as long as they are clear about setting your expectations for the end result.

Again, thank you for sharing your story. At this point, it may be best to save up for the right treatment plan and best dentist you can afford.

This post is sponsored by York PA dentist Donald H. Currie, DMD.

I thought I had a sinus infection and that is would eventually go away. So, I didn’t think too much of it. But, when I started to experience some swelling and pain in my face by my nose, I decided I should get it checked out. I’m glad I finally did something about it because it turns out I have a periapical abscess. The next step is to see an endodontist to get a root canal.

I’m worried about how my porcelain veneer will hold up because the tooth that requires treatment has a porcelain veneer on it. I’m nervous that the root canal will mean I have to lose my porcelain veneer, or that it will become discolored. This bums me out because I like the way my smile looks with eight porcelain veneers as it is now.

Do you have any recommendations?

-Paula in Indiana

Paula,

Well, first thing first – you need to get the root canal treatment done to take care of the tooth infection. An infected tooth is serious and you should not put it off any longer. If it is left too long, it can spread into your bone and cause complications if it’s not treated.

The unanswered question is why you require a root canal on a tooth with a porcelain veneer. That is difficult since we haven’t seen your case in person.

tool that is used for the preparation of a porcelain veneer

This is an example of the tool used to prepare a tooth for a porcelain veneer.

When a tooth is prepared for a porcelain veneer, a tiny amount of the natural tooth structure is removed. It ends up being about the same thickness as a fingernail or about a half of a millimeter. This usually doesn’t cause any damage to the tooth. It is rare to end up needing a root canal on a tooth that has been prepared for a porcelain veneer, unless the dentist is inexperienced or too aggressive in preparing the tooth.

In the photograph you can see how little of the tooth enamel is removed, using a diamond bur tool. It simply roughs up the surface of the tooth by forming grooves in the tooth. Then, the ridges are smoothed out so the transition from the porcelain veneer to the natural tooth is seamless and looks lifelike, when it’s placed over top.

Not every dentist prepares the tooth in the same way and some tend to be more aggressive in tooth preparation for porcelain veneers. It is possible that this step may have removed too much of the enamel and may have caused damage to the underlying dentin. Some dentists end up doing porcelain crowns and call them porcelain veneers. But, that there is a big difference. For a crown, the preparation process is a much more invasive tooth preparation so the crown fits over the top of the tooth. There ends up being a small portion of the natural tooth left. Hopefully, this isn’t what is going on with your case.

Whether that is the case or not, the bigger issue is that you now require a root canal treatment. The tooth will then turn dark because it is dead. And since you have a porcelain veneer (or crown) on the tooth that requires treatment, it will show through.

This doesn’t mean that all hope is lost. Here’s what should be done. The main part of the dark tooth is from remnants of the filling material and cement that is left after the root canal is done. Many family dentists don’t realize that is the main cause of the darkening of the tooth. So, be sure that your dentist is meticulous at cleaning the materials away after the porcelain crown on the tooth is done, which is the area that is showing above your gums.

Then, a white fiberglass post should be put down into the root to fill the rest of the space in the crown with light-colored composite. The result will not show much darkening of the tooth for years to come.

If you are using an endodontist, they should be more familiar with how to avoid any darkening.

Also, if the porcelain veneer was placed properly to begin with, it should be fine. But, you will likely end up with a crown if you don’t already have one.

Thank you for your question. Hopefully, this information was helpful and didn’t raise more questions for you.

This post is sponsored by York PA dentist Donald H. Currie, DMD.

Choose the best dentist vs a cheap dentist!

I need a root canal on a tooth with a porcelain veneer. Is that OK?

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