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Dental Crowns on Front Teeth Look Awful

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I had to have two dental crowns placed on front teeth. I wanted something that was metal-free because I didn’t want to deal with that gray line. The ones my dentist did were absolutely horrid. They didn’t match the rest of my teeth in color, shape or size. My dentist felt bad about it and refunded me. He then gave me a referral to a prosthodontist, whom he said was a dental crown specialist. I was grateful to my dentist as well as excited about the opportunity to get a pretty smile. When I went, the dentist suggested we use sedation in order to make the procedure much easier for me. I do have some dental anxiety, which I mentioned, so I agreed with that. I’d always wanted to try dental sedation. This was a mistake. When I was back to myself, the crowns were practically gray, which made the rest of my smile look off, too. I told him how unhappy I was with them and he said that he had me look at them and I approved them. Really? While I was asleep? I have no recollection of even seeing them. He also told me his assistants also looked at them and thought they were gorgeous. I told him I wanted him to redo them to match the color of my other teeth, but he’s saying he’ll have to charge me for an entirely new pair, which would be in the thousands. Do I really have no other options?

Candice

Dear Candice,

Porcelain Crown

I’m so sorry that this happened to you. Normally, you cannot get a refund just because you don’t like the way your cosmetic work looks. I know that sounds insane, but that is where things stand, at least for now. The good news is that your dentist could not have gotten your approval on the dental crowns if you were under the influence of dental sedation. An important part of dentistry is informed consent. He can’t get that when you’re groggy. This will work in your favor.

On the off chance he offers to do them again without charging you, I am going to recommend against that.I don’t think he’s going to be the best dentist for you. Prosthodontists tend to think they are experts in cosmetic dentistry because they get the extra training on dental crowns. However, that does not give them the expertise needed on artistry. In fact, he should have known that zirconia crowns are not a good choice for front teeth. Traditional porcelain crowns would be best.

My recommendation would be to find someone with post-doctoral training in cosmetic work, as well as an artistic eye. Check out their smile gallery to know whether or not they produce beautiful results.

This blog is brought to you by Auburn, AL Dentists Drs. Murphree and Yount.

Family Dentist Messed Up a Tetracycline Case

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I am distraught over how my teeth ended up after I tried to get my tetracycline stains fixed. I went to my family dentist, who I also know socially, and told him how embarrassed I’ve been for years over the stains on my teeth and asked if there was any cosmetic solution for my situation. I mentioned porcelain veneers. He suggested dental crowns because he thought the added thickness would help hide the stains. So, I got six dental crowns. My other teeth show when I smile which makes the crowns look kind of fake. Plus, when I’m in certain lighting, mostly fluorescent like I have at work, then you can still see all the gray. I spoke to my dentist about it and he is willing to redo them, but I’m wondering if I should just get a refund. I get the feeling that he is in over his head.

Candice

Dear Candice,

Dental crowns that don't go into the aesthetic zone
These porcelain crowns don’t go all the way into the aesthetic zone, making them look fake.

Your dentist seems well meaning, and I like the fact that he is willing to repair what he got wrong. However, I agree with you that he is in over his head and don’t think he will be the best dentist to give you the results that you want. Cosmetic dentistry is not a recognized specialty, which means that any general dentist is allowed to do cosmetic dentistry. The problem with that is it takes a significant amount of post-doctoral training as well as an artistic eye to get beautiful results.

Your dentist made two mistakes right off the bat that tells me he doesn’t have the training. One I have illustrated in the image above. Smiles have what is known as the aesthetic zone. These are teeth that are visible when you smile. Most people have an aesthetic zone of eight to ten teeth wide, so giving you just six dental crowns was a mistake. You’ve noticed this yourself.

The second error in judgment was telling you to get crowns because they are thicker instead of referring you to an expert cosmetic dentist. He probably felt some pressure to not look foolish in front of you because you know each other socially. However, many inexperienced cosmetic dentists make the same mistake without that pressure.

Porcelain veneers are the better solution. However, tetracycline stains are one of the most advanced cosmetic cases a dentist can do. You have to get the teeth opaque enough to cover the stains, but still have some of the translucency of your natural teeth.

I’m going to suggest you get a refund and look for a true cosmetic dentist who can fix these. Look at the best dentist link above in the text to get an idea of what kind of training you want your cosmetic dentist to find. Unfortunately, now that you have dental crowns, you’re stuck with them, but a great cosmetic dentist can give you a stunning smile even with the crowns. He’ll probably suggest adding at least two more depending on how wide your smile is.

This blog is brought to you by Auburn, AL Dentists Drs. Murphree and Yount.

Zirconia or Lumineers?

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I’m trying to decide on what type of porcelain veneers to get. I’ve been to two cosmetic dentists. One is suggesting zirconia crowns instead of veneers. The other is suggesting Lumineers which he said are porcelain veneers. I like the idea of porcelain veneers best but I’ve seen some bad reviews of the Lumineers. Should I try something completely different than the two options given to me?

Callie

Dear Callie,

A single porcelain veneer being placed on a tooth

I’m glad you wrote. I actually am going to suggest you change the question a bit. Instead of asking what type of veneer you should get, I’d like you to ask what type of dentist should you look for. Almost all cosmetic dental work is an art form. Like any art form, the artist you choose is way more indicative of the type of results you will get than the materials they use.

For example, let’s say that you were commissioning an oil painting. You gave two artists the same paints, the same type of canvas, and the same subject to paint. One of them is a gifted artist with years of training and experience under their belt. The other dabbles. I’m sure you’d expect the results to be vastly different. The same will be true with your porcelain veneers.

The best cosmetic dentists will have extensive post doctoral training in cosmetic dentistry. I would also take the additional precaution of looking at their smile gallery to see the type of results they produce. If they don’t have a smile gallery, don’t bother with that dentist. If they were serious about cosmetic work, they’d have a smile gallery.

All of that being said, I’m not impressed with either suggestion that the two different dentists gave you. If a dentist suggests dental crowns when your teeth are healthy, that is a big red flag. It usually means that they are not comfortable with porcelain veneers and are pointing you toward a procedure they do know how to do rather than sending you somewhere else. I don’t like this because they’re having you remove extra healthy tooth structure rather lose business. Second, even if dental crowns were the right solution, zirconia would not be. These are milled from single blocks of zirconia, which is fine for back teeth, but would make your front teeth look obviously fake.

Lumineers, while they are a brand of porcelain veneers, are highly marketed to inexperienced cosmetic dentists as being easy to place because they don’t require any tooth preparation. While some smiles can get away with this, for most smiles they will look bulky. Plus, the Lumineers company requires dentists to use their lab, which is not known for producing artistic results.

I would focus on looking for a great cosmetic dentist and let them pick the brand. They’ll ask you questions about the type of smile you are wanting and will know which brands will be the right one for that smile.

This blog is brought to you by Auburn, AL Dentists Drs. Murphree and Yount.

Was I Taken In By A “Cosmetic” Dentist?

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I have four crowns on my front teeth that I had done years ago. They were looking pretty dingy so I went to my dentist, who is also a cosmetic dentist, and asked him what to do. He said that KöR Teeth Whitening was stronger than most and would do a good job. Well, they did a good job, but not on my dental crowns. The teeth next to them look great, but the crowns look worse than ever. Now he’s suggesting we replace them. Did he make them worse on purpose so that I’d have to get new crowns?

Brandon

Dear Brandon,

An image of a woman covering her mouth.

I am sorry this happened to you. I could not tell you if your dentist did this on purpose, it’s possible he is just incompetent when it comes to cosmetic dentistry. Either way, this is not going to be the best dentist for you to have the crowns replaced with.

Teeth whitening only works on natural tooth structure. It will have no impact on your dental crowns. Because of that, the teeth get whiter and the crowns stay the same, which has the net effect of making them look even worse. You will definitely need to replace these crowns if you want them to look good. So, if this dentist isn’t the one to do it, who is?

You mentioned your dentist is a cosmetic dentist. Did you know that there is not a recognized specialty in cosmetic dentistry? That means any general dentist can call themselves a cosmetic dentist. Here is the big problem with that. Cosmetic dentistry is barely touched on in dental school. In order for a dentist to develop both the skill and artistry necessary to create beautiful results, they need to invest in post-doctoral training.

Teeth whitening is one of the most basic procedures in the cosmetic world and  your dentist does not have a  grasp of even that. I would not let him near your dental crowns. Instead, look for someone who has invested in that post-doctoral training. Look at their bios to get an idea. For example, here is Dr. Murphree’s bio. This will give you an example of the type of dentist you want to do your porcelain crowns for you.

This blog is brought to you by Auburn, AL Dentists Drs. Murphree and Yount.

The Danger of Yelp! for Smile Makeovers

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I am working on my smile makeover. I am thinking of the BL2 or BL3 color. I’m almost 60 with medium blond hair, blue eyes, and a fair skin tone. I don’t want an over-white smile because of my age. I’ve going with dental bonding because it is less expensive than the porcelain veneers. I’ve looked on Yelp! and have picked the dentist they listed as number one for cosmetic dentists. Quick question, though. Should I have him start with the canines so I can see that I’m getting the right color?

Beverly

Dear Beverly,

A single porcelain veneer being placed on a tooth

 

I am very glad you wrote. I think I can save you from a disaster here. Let’s start with the choice of your cosmetic dentist. While I use Yelp! myself, you have to be careful which services you use it for. For example, it is a fine way to find a good plumber or hair dresser. However, if you are looking at cosmetic work, you have to be more careful. The reason for that is Yelp! does not distinguish between what the ratings are for. A dentist could be getting lots of five stars for being friendly when patients receive their dental cleanings. Yet, he may have no training in cosmetic dentistry.

As an example, I went to Yelp!, picked a random city, and asked for the best cosmetic dentist in that city. I went to the websites of the top five results. The first did not show any links for cosmetic work, not even teeth whitening, which tells me he doesn’t do any cosmetic work. The second through fifth did have cosmetic work on their site, but only two of them had a smile gallery. If a “cosmetic dentist” does not have a smile gallery, that tells me they have zero results that they are proud to display. Any serious cosmetic dentist will have a smile gallery. Of the two that did have a smile gallery, only one of those had any post-doctoral training in cosmetic dentistry.

In order to find the best cosmetic dentist, the first thing you’ll need to do is really make certain the dentist you have in mind has post-doctoral training, but also that their smile gallery shows they achieve beautiful results. If you get a skilled cosmetic dentist, they can help you with the color issue, as well as many other considerations, such as shape and size that will need to be addressed.

As for the choice of dental bonding, I think you may want to reconsider and go for the porcelain veneers. When well cared for the porcelain veneers will last your lifetime. Dental bonding will only give you a few years before you have to replace them. Plus, dental bonding is done free hand, which means there is no testing out the results.

With porcelain veneers, they can place them with a temporary try-in paste. This allows you to look at the comlpleted results and make certain that you really love them before they are permanently bonded on.

This blog is brought to you by Auburn, Al Dentists Drs. Alan Yount and Steve Murphree.