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Dentist Said I Cannot Get White Crowns

I am a bit frustrated. I had a full set of dental crowns done years ago. At the time, they said they didn’t make them very white. I was a bit disappointed, but you can’t do more than what is available. Now that I am replacing them, I felt sure I could finally get the white crowns I have always wanted because they do make them that white now. Unfortunately my dentist said that because I have posts in my crowns that the whitest colors will show the posts. I don’t want that. He told me to do a B1 color with the temporaries and see what I think. We did that, but I wasn’t too thrilled with the color. Do you think it would be possible for me to get an M4 or a BL4 without the post showing through and making them look fake?

Chris

Dear Chris,

I am glad you wrote. I think your dentist may be in a bit over his head when it comes to cosmetic dentistry. He is confusing two very basic concepts: color and opacity. The posts won’t show through because the porcelain crowns are too white, just if they are too translucent. If he does not understand the difference between them, you can almost guarantee you will not get the results you are hoping for. If the posts do not show through the B1, they won’t show through a whiter color either.

This is a very doable smile makeover for you as long as you have the right dentist. Here is my advice. First, ask your dentist if he has done a smile makeover with the bleached shades, which is what you’re looking for. Then, ask to see the before and after images. If he doesn’t have that experience or the results aren’t that great you have a choice. You can allow him to try giving certain conditions I’ll go over shortly or you can go to a dentist with more cosmetic training and expertise.

If you decide to give him a chance, he needs to do the color you want. Insist on that, no matter how white it is. He should also be asking you about the shape and size you want. Then, when the crowns come in, he should place them with a temporary try in paste. Bring someone with you to help you get a good look at them and give you some support if you need to tell him that you don’t like them and they need to be redone. He should not do any permanent bonding until you are thrilled with how they look, even if it means sending them back to the lab.

This blog is brought to you by Douglas, AZ Dentist Dr. Gilberto Tostado.

Tooth bonding near my gum line looks terrible. Can it be redone?

I developed these sensitive yellow notches near the gum line on several of my teeth, so my dentist put small fillings in them to prevent sensitivity.

Although the sensitivity is resolved, the problem now is that my teeth now look worse than when they had the yellow notches. The filling material color is just so off, and the filled spots look rough and opaque.

What can I do? Can I get these redone or am I stuck with this color? Could the dentist just patch a better color over them?

– Greg

Hello Greg,

We’re very sorry to hear about what you’ve gone through. Although we would normally encourage folks to see an expert cosmetic dentist to ensure they get natural-looking cosmetic dental work done, any good general dentist should be able to get the color right for the kind of restorations you had done.

So it does sound like you might want to try visiting a new dentist to get a better color match for your bonding.

On that note, let’s discuss your options for improving the look of your restorations. Keep in mind that these recommendations are based solely upon the information you have shared with us. You will need to seek a second opinion by visiting a cosmetic dentist near you in person to find out which treatment option is best for you.

Option #1: Resurfacing your fillings.

It’s possible that another dentist could simply ‘refinish’ your fillings by grinding down the surface a bit and then covering them with a composite material that matches your teeth better.

Option #2: Replacing your fillings.

There would probably be no issues with simply replacing your fillings altogether if your new dentist sees fit to do so. This shouldn’t harm your teeth at all. If the color of your current fillings makes them stand out from your teeth, then a dentist can easily see how far to drill to remove them. Even if the color was such a good match that the fillings couldn’t be easily distinguished from the teeth, a dentist would use a special drill tip that only removes composite material without harming the tooth.

An Important Note About Abfraction Lesions

Abfraction lesions are notches that develop near the gum line on teeth. These notches can become very sensitive as the enamel wears away over time, and dental bonding is a popular way to protect these sensitive notches. In previous years, dentists believed these notches were caused by aggressive tooth brushing, but now we understand that the main factor is excessive tooth clenching. Biting the teeth together causes them to flex slightly right at the point where they meet the gums. This flexing action weakens the teeth and creates that notch.

If you have a subconscious habit of clenching your teeth, then that could be the reason you developed those sensitive notches at the gum line.

Why does this matter?

The best material for restoring those notches in your teeth depends on what caused them in the first place. A stiff and inflexible material will eventually pop out when the tooth flexes. So if the lesions on your teeth were caused by clenching, then a dentist will probably select a softer and more flexible material that can move with your teeth when they flex under pressure.

This post has been published on behalf of Dr. Gilberto Tostado, a cosmetic dentist near Douglas, AZ.