Technologically advanced, beautiful, long-lasting dentistry

Crown Too Dark

I needed a crown on my lateral incisor. My dentist gave me the whitest crown possible, but it is too dark for the rest of my teeth. My dentist says it is because I whiten too much and that I can either have one tooth a little darker or I can whiten less. I know that porcelain veneers can be made very white. Is it possible for me to have a porcelain veneer placed over a crown?

Mazie

Dear Mazie,

I’m guessing your dentist does not do a lot of cosmetic dentistry. It sounds like he is working with the old shade guide, which I have above. This is designed to help dentists find the right shade for a dental crown to match the tooth color. This worked fine for decades. Then teeth whitening became more popular. Suddenly, more and more patients had teeth that were so white they were too white for the brightest shade available.

Fortunately, this problem was recognized so the companies came up with an updated shade guide (see directly above). Dentists who do a lot of cosmetic work, will have it. You won’t need to put a porcelain veneer over the crown. In fact, you wouldn’t want to. A veneer bonds well with natural tooth structure, but not with more porcelain, such as on a porcelain crown.

The good news is you won’t have to. You can go to a dentist who has a lot of cosmetic training. They will have the adjusted shade guide. You can continue teeth whitening to your heart’s content and get the dental crown you need.

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

Diabetes and Dental Implants

I have a tooth that is going to need to be extracted due to a car accident. I was in the hospital and couldn’t get to the tooth right away. I have never lost a tooth and was hoping to replace it with a dental implant. Unfortunately, my dentist said that my diabetes disqualifies me from dental implants. I’m disappointed, but what can I do? Is there a second best option for me?

Michael

Dear Michael,

While diabetes is a complicating factor when it comes to dental implants, it does not actually disqualify you from getting them. However, do not pressure your dentist to do them. His statement tells me more about his comfort level with dental implants than it does your situation. This is an unregulated segment of the dental industry and training in dental school (alone) is inadequate.

If you decide you want the dental implant you will want a dentist with significant post-doctoral training as well as experience. Do not be afraid to ask them where they did their post-doctoral training as well as how many cases they’ve done along with their success rate. These are important details that will have a big impact on your outcome.

While pre-procedural diagnostics are always important when it comes to dental implants, they are even more important in your case. Make sure whoever you go to gives you 3-dimensional diagnostics too, such as a CT scan. Though if they don’t suggest that on their own, that would be a bit of a red flag for me. You will also need to be monitored more closely throughout the procedure.

If you go to a dentist who needs to use an oral surgeon for the placement, make sure it is the dentist who determines the placement–not the surgeon. This is important, whether you have diabetes or not.

If you decide not to go with dental implants, then your second best option would be a dental bridge. This puts a dental crown on each of the adjacent teeth and then suspends a false tooth between them.

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