Archives for March 2021

Why Are My Crowns Gray and How Long Will It Take to Correct Them?

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I fell in January and damaged three front teeth. My dentist did root canals and crowns on all three teeth – my center front teeth and right incisor. Although my dentist is easygoing about redoing the work for me, the crowns are too thick, and the color is off. They do not match my natural teeth. The crowns look gray, and although my dentist is willing to redo them, he says that he cannot guarantee an exact match. He says he will get the core as white as possible. Am I supposed to settle for gray teeth? My anxiety level is increasing over how many more dental visits it will take to get this right. Thank you. Sheron

 

Sheron,

Unfortunately, like many family dentists, your dentist does not know enough about cosmetic dentistry and matching tooth color. It takes post-graduate cosmetic dentistry training and an artistic eye to match crowns to the characteristics and color of your natural teeth.

If Dental Crowns Are Too Thick and the Wrong Color

If your dental crowns are too thick and the color is, you should not settle for your dentist’s skill level. We encourage you to insist on getting what you agreed to—natural-looking crowns. No one should be able to tell that your front teeth are crowns.

Although you did not give us clinical details about the types of crowns your dentist placed, several factors can cause crowns to look gray.

  • Pure ceramic crowns with a metal post – A metal post and core reinforce a tooth, and the color of the metal can show through the ceramic.
  • A skilled cosmetic can provide crowns that are not gray. Either of these methods might work:
  • Fiberglass post – A fiberglass post and a composite core close to the color of your natural teeth will give your crowns natural translucence.
  • Metal core with opaque layer – An opaque layer of composite bonding can be layered over the metal core. It will block the metallic color. Afterward, the dentist can bond the crown over the opaque layer.
  • Incorporate opaquing into the crown – A skilled cosmetic dentist can instruct the ceramist about the crown color and the metal core. The ceramist can opaque the crown to conceal the metal.

Find a Dentist Who Can Reproduce Your Smile

Face of a woman relaxed during dental treatment for information on sedation dentistry from Dr. Brooksher of Baton Rouge

Sedation will help your new dentist complete as much work as possible while you relax

Unfortunately, your dentist does not have enough training to correct your crowns and is not readily going to refer you to a cosmetic dentist who can. Dental schools minimize cosmetic concerns, and many in the dental profession do the same. Although Dr. Brooksher would need to examine your teeth, it seems that your case requires only a moderate level of aesthetic skill.

We recommend that you schedule a consultation with a skilled cosmetic dentist to explain your treatment options. Hopefully, your dentist will refund you or partially compensate you for being unable to give you crowns that reproduce the look of your natural teeth.

Although you will need more dental work, sedation dentistry can help a cosmetic dentist complete as much work as possible while relaxing and giving you quality results.

 

Steven Brooksher, DDS, of Baton Rouge sponsors this post.

I want this stainless-steel post out of my tooth

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I knew my dentist was going to insert a post into my root canal tooth (lower molar), but I didn’t think to ask what the post was made of. I found out today that the post is stainless steel. I am wearing a temporary crown and will get the final crown in about two weeks. My dentist explained that the stainless-steel post will be encased, but can it be removed and replaced with a non-metal post? If there is no other way to save the tooth, I would rather have an extraction. I’m really concerned about getting this post out of my mouth. I think I am having a reaction to it, and it is making my ears ring. – Thank you. Alex from S. Carolina

Alex,

Thank you for submitting your question to our office.

Although a dentist can remove a stainless-steel post from your tooth, there are risks.

Purpose of a post in a tooth

A dentist might insert a post in a root canal to strengthen the tooth or support a crown. The post can be useful in these situations:

  • Front teeth – A post strengthens the tooth against horizontal fracture.
  • Molar and other teeth – The post can serve as the foundation for building up the tooth and retaining the crown.

History of tooth posts

In the 1970s and earlier, prefabricated dental posts were made of stainless steel. In the 1980s, studies confirmed that metal ions can seep out of the tooth and into the bloodstream—even though the post is cemented inside the tooth. The nickel in stainless steel often causes a reaction in people with metal allergies or sensitivities.

Alternative materials for dental posts

Alternative materials for dental posts include titanium, zirconia, carbon fiber, and fiberglass. Titanium is a strong, biocompatible metal that many dental practices used. And in the 1990s, other materials, including carbon fiber and fiberglass were used to make dental posts. Now, the ceramic zirconia is an alternative for a biocompatible, flexible high-strength post.

If you have metal allergies or sensitivities, a dentist can remove your post. But it seems that your dentist is not the one to do it. The complexity of removing the post depends on how deeply your dentist embedded it and how firmly it is cemented. A skilled dentist might use an ultrasonic tip to dislodge it.

Get a second opinion

Diagram of the phases of a dental implant for a comparison to a partial denture.

Get a second opinion to preserve your tooth instead of needing an extraction and implant

You can ask your dentist to postpone your dental crown until the post is removed. If a crown is cemented over the post, it will become more difficult to remove it. Although Dr. Brooksher would need to examine your tooth, your description does not suggest that you might require an extraction and dental implant. We recommend that you schedule an appointment with a skilled dentist for a second opinion. After examining your tooth, the dentist will explain your treatment option.

Best wishes for a prompt resolution.

 

Steven Brooksher, DDS, of Baton Rouge, sponsors this post.

 

My dentist can’t match my crown to my veneers

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I love my dentist, but she can’t seem to get my crown to match my veneers. The crown is whiter than the veneers. Is this a challenging job that I should ask another dentist to complete, or should I let her keep trying? My dentist must sedate me every time she tries to get this right. And I am getting embarrassed because I can’t take a minor procedure without sedation. I just want this to be over. Thank you. Vivian

 

Vivian,

Many family dentists find it a challenge to match crowns and veneers. Some even have trouble matching crown color to natural teeth.

Porcelain is translucent like tooth enamel, so it looks natural. But porcelain crowns are several times thicker than porcelain veneers. If your teeth are dark, the color will show through more on porcelain veneers than with your crown.

A skilled cosmetic dentist and ceramist can achieve a match with the porcelain or by applying opaque to your teeth before sending your case to the lab.

Adding opaquers to porcelain

If your crown is translucent, your veneers must be opaqued to appear equally translucent. This technique requires skill and good communication between your dentist and the laboratory. Your dentist must take photos of your prepared teeth or record details about their color for the lab to produce accurate results. Dental laboratories that specialize in aesthetics can do this well.

Adding opaquers to your tooth

Your dentist can apply opaquers to your tooth and achieve a color match with these steps:

  • Shave the dark teeth a little
  • Apply an opaque layer of composite on each tooth
  • Create a translucent effect with the porcelain
Face of a woman relaxed during dental treatment for information on sedation dentistry from Dr. Brooksher of Baton Rouge

Sedation can decrease your time in the dental chair or help your dentist accomplish more work

The composite and porcelain veneer luting cement will bond chemically for a strong, natural-looking result.

We understand your concerns about anxiety and the need for sedation. But if you cannot relax during the procedure, it can interfere with the cosmetic dentist’s work and lengthen your time in the dental chair. Getting a second opinion from a dentist with post-graduate cosmetic dentistry training is to your advantage. It can minimize the treatment time needed to match your crown and veneers.

Steven Brooksher, DDS, is a cosmetic dentist in Baton Rouge, LA. Read about his credentials and visit his smile gallery.