Baton Rouge Dentist

Will I Need to Replace a Porcelain Veneer with a Crown?

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Will I need to replace a porcelain veneer with a crown if I have a cavity? My upper left lateral incisor has a cavity, so my dentist wants to replace the porcelain veneer with a crown. He said that since the tooth has a cavity, a crown will provide better protection. – Thanks. Kenji from CA

Kenji,

Achieving a precise match between a new crown and existing porcelain veneers is exceptionally difficult. Only a small percentage of dentists (around 2%) possess the specialized skill set required for such an outcome. We’ve seen numerous cases where patients were dissatisfied with their dentists’ attempts to match a crown to their porcelain veneers.

Does a Cavity Require Replacing a Porcelain Veneer with a Crown?

You didn’t specify the cavity’s size, but dentists usually use crowns on exceptionally large cavities. A porcelain veneer is a minimally invasive treatment that requires only a small amount of enamel to be removed from the front of the tooth. In contrast, a crown on a front tooth is a highly aggressive procedure, as it involves grinding down the tooth to a small stub. A crown would only be justified if a significant portion of the tooth has decayed.

Your dentist may be more comfortable with crowns than with porcelain veneers, which could influence his recommendation. It’s also possible the cavity is located at the edge of your porcelain veneer—a vulnerable spot for decay—and your dentist may lack the specialized training or equipment necessary to properly bond a composite filling to the veneer for long-lasting results.

If a family dentist handles your routine care for porcelain veneers, we advise seeking a dentist with extensive postgraduate training in cosmetic dentistry.

How Can You Reduce the Risks of Getting a Cavity in a Porcelain Veneer Tooth?

picture of a porcelain veneer being placed on a prepared tooth
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You can reduce the risk of getting a cavity in a porcelain veneer tooth by limiting how often you snack. Snacking introduces your teeth to bacteria, which promotes decay. Porcelain veneers are more susceptible to decay at the margin where the porcelain and tooth meet. Floss daily.

Baton Rouge family dentist Dr. Ryan Perry sponsors this post. Please read about how he strives to provide his patients with the best care possible.

 

How to Get a Natural-looking Crown on my Front Tooth?

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Hello,

My dentist suggested a porcelain crown over my front tooth to cover up some discoloration. He redid the first one because it was too white, but I don’t like the second one he cemented in. I noticed when I got home how unnatural it looks. He said he’d redo it but should I go back to him, or go see a cosmetic dentist in the city? The only reason I haven’t is because of cost.

Thanks,

Rebecca, from White Plains, NY

 

Hi Rebecca,

Even an expert cosmetic dentist would have many try-ins for a crown on the front tooth. Your dentist needs a few more tries to get it right, but may lack the cosmetic skills to get it to match perfectly. Most dentists will ask patients to crown both their front teeth in order to get them to match perfectly.

You should be able to find a cosmetic dentist within thirty miles to see. However, if your dentist is offering to fix the color of the tooth for free, you may want to keep working with them in order to save money. Your dentist should try taking a picture of your tooth using an intra-oral digital camera. Pictures taken with natural lighting help the most. Then, temporarily cement the crown, and only get it permanently cemented after seeing it in different types of lighting.

An expert cosmetic dentist can give you the most natural look, but if cost is a factor, continue working with your current dentist for a more affordable option.

This blog post is brought to you by Baton Rouge affordable dentist, Dr. Ryan Perry.

What should I do if my crown broke?

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I have had a crown for a little over a year. Unfortunately, the crown has since given me several problems and, a few months ago, a significant piece of the porcelain broke off. I hated this, obviously, but especially because it was so soon after having it done. I have returned to the dentist multiple times to have things adjusted, but now that it is completely broken, I am not sure what to do. I would rather not return to the same doctor since there have been so many issues since the original crown was placed. Because I am in pain and discomfort, not to mention it looks funny, I called an emergency dentist to see if the crown issues could be addressed and I was seen right away. Unfortunately, the dentist felt the original crown needed to be replaced. This is not something I have the money for, nor do I feel like I should have to pay for another crown that has had issues since the original appointment. I understand that it’s not the responsibility of the emergency dentist to incur the expense of fixing a broken crown, but am incredibly frustrated with the entire situation.

Any suggestions?
Steve

Dear Steve,

My apologies for all of the issues you have experienced with your crown. I know all of this is very frustrating. However, I do want to be sure you know that doctors have varying opinions on how to best proceed or address issues such as this. If the crown is broken, it is possible that it cannot be repaired and will have to be replaced. If this is, in fact, the case, I would suggest returning to the dentist who originally did the crown first. Hopefully, this would decrease the out of pocket expense on your end. Although there are some general rules to follow for the time dental procedure results should last, most dentists have their own ideas on this. For example, crowns, like the one you had placed, should last for at least five years. If an issue arises which requires a repair or replacement prior to that, it would be advisable for the dentist to consider not charging the patient, or at least reducing their portion. Going to a new practice would result in a similar cost unless it would be easier on your peace of mind to go to a new dentist. As a patient, you should expect a dentist to stand behind their treatment and the work they do, just as a dentist would want you to do your part to care for and maintain your teeth and come in for regular visits.

This post is sponsored by Baton Rouge emergency dentist, Dr. Ryan Perry.

Do they do smile makeovers with crowns?

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Not long ago, I decided to have a smile makeover. I thought I received porcelain veneers, but when I look at my teeth, the porcelain appears to go all the way around my teeth. I’m wondering if this was completed like this because my teeth weren’t strong enough before the makeover. Is it normal to have my entire tooth covered even though my procedure was done for cosmetic reasons?
– Anton in Louisiana

Anton,
There isn’t a big difference between porcelain veneers and porcelain crowns. In fact, it’s hard to determine when a porcelain veneer becomes a crown. In terms of fees, most cosmetic dentists have fees that are close to the same for either procedure because both types of dental work take about the same amount of work to finish.

When you receive cosmetic work, it’s quite common to have porcelain crowns done across your front teeth. Your dentist usually has a good reason to have the whole tooth done in the makeover. In fact, there are many reasons your tooth may be crowned.  If your tooth was weak in any way, if there were fillings in the teeth or if your bite needed improvement, you would need more extensive treatment.

It’s important that dentists discuss with you why they might recommend crowns. The majority of cosmetic dentists do their best to be conservative with their work. They do this by trying to preserve as much or your natural tooth structure as possible. They know that crown work is more aggressive and requires a substantial amount of tooth reduction all the way around and they do their best to avoid it whenever possible. However, sometimes the tooth is too weak and needs more stability with crowns. Veneers require only a slight shaving of the front of the tooth.  This is why you need to have a proper explanation for why you might need crowns.

This blog brought to you by Baton Rouge family dentist, Dr. Ryan P. Perry.

How can I fix ugly porcelain-fused-to-metal crowns?

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Over 20 years ago, I decided to get porcelain-fused-to-metal crowns on my front top teeth and now they look bad. When I smile, you see a dark line and I have a large smile. How can I fix this? Would Lumineers be the best solution?
– Cindy from Louisiana
Cindy,
The answer to your challenge is simple – you need new, all-ceramic crowns, with no metal in them. The most important thing you need to know is this work needs to be done by an expert and artistic cosmetic dentist. You don’t want a regular dentist to do this so you need to do a little research to be sure you have a cosmetic dentist who can create beautiful smiles. The right cosmetic dentist will give you a gorgeous smile.

An old injury making my tooth turn dark

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When I was nine I wiped out on my skateboard and put a chip in my left front tooth. My dentist at that time did a nice job fixing it, but now all these years later that tooth is noticeably darker than the others around it. I talked to my current dentist about this, but she says that she would not be comfortable doing a crown because the tooth is dead. She did say that she wants to refer me to a friend of hers that does cosmetic dentistry, but I am a little nervous about the cost. I’ll be paying for this procedure out of pocket, and expect that a cosmetic dentist will be a lot more expensive. I’ve always been really happy with my dentist’s work, and can’t really figure out why she seems to reluctant to do this. I mentioned Lumineers, and she said that I should discuss them with the other dentist, but that she has heard of some issues with them.

Can you shed some light on why she might be dragging her feet on this?

Zachary in South Fork

Dear Zachary,

Your dentist is actually demonstrating extremely ethical behavior. Though any dentist can SAY they do cosmetic dentistry, only about 5% really have the artistic sense and training to do exceptionally beautiful work. Your dentist is telling you that this is not her area of expertise, and referring you to someone she trusts to do superior work.

Lumineers are a brand of porcelain veneers, and there have been some issues with them. The cosmetic dentist you talk to may like to work with them, though, so make sure you chose the dentist with care and let the dentist guide you towards the best solution. A porcelain crown may not be the best solution, as your current dentist suggests but again, the cosmetic dentist you consult will give you all the options and then let you decide what to do.

This blog and post are sponsored by Baton Rouge dentist Dr. Perry.

Son with a broken tooth

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My ten year old son was playing lacrosse and got hit in the mouth with a stick. One of his top front teeth broke off, about 2/3 of the way up, and the other has a diagonal crack in it. I took him to the dentist’s office today, but the dentist wouldn’t even see him. The receptionist says he won’t have time to fix the tooth for 3 more weeks. That is just crazy!

I don’t want to wait for treatment on this. Is it customary to wait this long? Is there some medical reason why it should NOT be treated right away?

Thanks,

Suzy in St. Paul, MN

Dear Suzy,

No medical reason exists to wait. If you still have the piece that broke off, that could help the situation. A talented cosmetic dentist will be able to reattach the piece of tooth.

You should absolutely choose an excellent cosmetic dentist for this procedure, as you want these teeth to look as good as possible.

If you do not have the piece of tooth, direct dental bonding may be an option to repair the broken tooth, or he may need a porcelain crown or two, depending on the severity of the crack in the other tooth. If the roots of the teeth are cracked, he may need root canal treatment. If you consult with an excellent cosmetic dentist, he or she will be able to offer you all of the possible options to get the possible aesthetic result.

Posted courtesy of Baton Rouge dentist Dr. Perry.