My left front tooth has progressively turned darker after getting a root canal in 2021. I’ve had three crowns on the tooth since the root canal. Each time, the darkness of the tooth is visible despite the crown. My most recent dentist recommended a porcelain veneer on the incisor tooth next to my front tooth to close a gap. The veneer is lighter than my other teeth, and, of course, it makes the dark crowned tooth even more noticeable. I’ve had the crown for six years, and I’m ready to try again. What do you suggest? Thanks. Helena from KS

Helena,

Wanting a crown that not only functions well but also looks great is reasonable. While zirconia is known for its strength, it often requires being layered with porcelain to look like a natural tooth. Your challenge, however, revolves around masking the dark color of the underlying tooth. This isn’t a simple task and depends on collaboration between your dentist and the ceramist who creates the crown. Ideally, this team will have a well-defined process and proven track record of successfully handling similar situations.

How to Match a New Crown Over a Dark Tooth with an Existing Porcelain Veneer

An advanced cosmetic dentist can match a new crown over a dark tooth with an existing veneer by collaborating with a skilled dental ceramist. The dentist’s role extends beyond requesting a final color. Top cosmetic dentists seek specialized dental ceramists. Master ceramists who possess the expertise to correct such aesthetic challenges are rare. For instance, many expert cosmetic dentists would partner with ceramists who, despite being geographically distant, could consistently deliver the high level of aesthetic quality required. This underscores that creating beautiful cosmetic dentistry is a team effort.

Trained cosmetic dentists accurately communicate the initial shade of the underlying tooth, often including photographs for reference. While some dentists prefer to apply the opaquer to the tooth themselves before sending it to the ceramist, others leave this step to the ceramist. Both approaches can work if communication is precise and detailed.

Your upfront commitment to finding a dentist with extensive post-graduate cosmetic dentistry training and experience will yield a highly aesthetic outcome. Your cosmetic dentist and ceramist will adhere to guidelines similar to these:

• Strategic Communication: The dentist must precisely communicate the desired final shade and the underlying tooth color to the ceramist, often using visual aids.
• Mastering Opaquing: Whether applied by the dentist or ceramist, the opaquer should be used carefully and deeply within the crown to prevent an overly opaque, unnatural look.
• Layering for Depth: Building the crown with inner opaquing and outer translucent porcelain layers is key to achieving a natural, varied appearance.

A common misstep in aesthetic crown fabrication is applying too much opaquer, which can lead to a stark, unnatural white appearance devoid of natural color variations. To avoid this, the opaquing material should be applied deeply within the crown, allowing for more translucent porcelain layers to be placed on top. This technique helps to develop a deep, lifelike translucency in the final crown.

Why Choose a Skilled Cosmetic Dentist?

It’s excellent that your dentist suggested a porcelain veneer for your other front tooth because the treatment is far more conservative than getting a dental crown. However, concealing a dark tooth with a dental crown and matching the crown to an existing porcelain veneer is a demanding task. This level of intricate color matching requires a dentist and ceramist who possess exceptional training and proven skills in color theory and application. Schedule a consultation with an advanced cosmetic dentist.