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.

 

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.

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.