Wrong Shade for My Dental Crowns, and They Are Yellowing

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My natural teeth are quite white, so I asked my dentist for BL1 crowns when I found out that I needed crowns. The crowns are the wrong shade and turning yellow, although I got them in early May. I drink a cup or two of coffee or tea daily, and they make the crowns even darker. I am looking for another dentist and hope you can advise me on what to expect or what another dentist might say is the problem. Thanks. Yadi from Brooklyn

Yadi,

Porcelain crowns with the glaze intact will not attract stains or discolor. Sometimes a patient thinks they got porcelain crowns or veneers when the dentist placed cheap resin on their teeth instead.

If the glaze breaks your crowns, that could also cause them to attract stains. Hydrofluoric acid in acidulated fluoride in the dental office can etch the glaze away and leave your crowns with a rough, porous surface. Also, power polishing equipment in the dental office can damage the glaze on dental crowns. Still, your crowns were not as white as you wanted, and we discuss what may have happened.

When Your Dental Crowns Are Not as White as You Wanted

Requesting BL1 shade for your dental crowns produces whiteness beyond any shade of natural teeth. Your dentist may hesitate to give you super-white dental crowns. Dental ceramists introduced the Ivoclar shade guide on this page in the early 90s after teeth bleaching became popular and people wanted super white teeth. Only teeth bleaching could get your natural teeth to the BL1 shade. A2 is the most common shade of adult teeth.

Whitening your natural teeth before you get porcelain crowns allows a dentist to see how white your teeth could get. Most cosmetic dentists would only give you a BL1 shade for dental crowns if you had bleached your teeth to that shade. Further, an experienced cosmetic dentist would address the teeth behind your front six teeth to avoid a glaring color mismatch. If you insist on crowns lighter than your natural teeth could get, the dentist may recommend porcelain veneers on the teeth that show when you smile. Otherwise, your crowns would look fake, and the dentist’s commitment to aesthetics would cause them to advise you to see another dentist. We wish your dentist had been upfront about the BL1 shade and helped you anticipate what to expect.

See the picture below for A2 (the most common natural shade) versus BL1 after bleaching. Can you see why a dentist would want to see if BL1 crowns were too white for your surrounding natural teeth even after teeth bleaching?

Ivoclar bleaching shade guides, including BL and A-D shades

Getting a Second Opinion for Dental Crowns on Front Teeth

We recommend asking for recommendations or searching online for an expert cosmetic dentist, preferably an accredited dentist. Look at dentists’ websites for a smile gallery of patients’ before and after pictures. Look for dental crown cases and pictures that show the dentist’s artistry. Your crown color and smile design are fundamental to your smile makeover. Schedule at least two consultations to compare the dentist’s credentials, experience, and ability to give you crowns that look real, do not turn yellow, and complement your smile.

 

 

Dr. Steven Brooksher, a Baton Rouge accredited cosmetic dentist, 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.

 

My zirconia crowns don’t match after a second try

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In September, my dentist placed four new zirconia crowns on my upper front teeth. The crowns don’t match the shape of my natural teeth. They look like they would not match the shape of anyone’s natural teeth. My mistake was to ask my dentist to do the work. He said he could do it for $600 – $800 less than other dentists because I am an existing patient.  Thank you, Ada

Ada,

My dentist agrees that my teeth do not look natural, so he referred me to a prosthodontist to correct the issue. Now the shape of my teeth is okay, but the color is off. I made the mistake of asking for sedation before I saw the crowns. The prosthodontist cemented the crowns without me getting a non-sedated look at them. I am angry and frustrated. He said he will change the color if I pay for it. Why should I pay for teeth that look gray? Isn’t a prosthodontist a specialist?

It’s unfortunate to know you’ve had two bad experiences with dentists who can’t give you natural-looking results with crowns.

Your dentist should take responsibility to correct your smile in the best way possible instead of referring you to a prosthodontist. Although prosthodontists have two to three years of training in restoring teeth, few are artists in cosmetic dentistry. They can get the technical details and function correctly, but the aesthetics are often lacking. But an excellent cosmetic dentist is concerned about the details that make your smile look natural. And they don’t bond the work to your teeth unless you love the way it looks.

Zirconia crowns for front teeth

Although a dentist can give you zirconia crowns on your front teeth, it takes advanced cosmetic dentistry training to make the crowns look natural.

  • Zirconia crowns are made from a block – A dental lab tech makes zirconia crowns from blocks and mills them into shape to fit over your tooth. But a zirconia block has one color throughout it. Your natural teeth have variations in color and translucence.
  • Porcelain layers can make zirconia look natural – A zirconia crown cannot recreate the look of your tooth unless a ceramist bakes porcelain onto the surface and manipulates the color.

Sedation for dental crowns

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

Try on temporary crowns before receiving sedation dentistry

If you need sedation when your crowns are cemented, your dentist can create temporary crowns first. If you like the temporary crowns, a dental ceramist can duplicate them when making your permanent restorations. Before you are sedated for the final crowns, at least you know you approved them.

What’s Next?

Our recommendations are below:

  • Discontinue treatment – Don’t let the prosthodontist do any more work on your teeth. He isn’t interested in giving you crowns that you love.
  • Ask for a refund – Depending on the extent of color mismatch in your crowns, you may only receive a partial refund.
  • Look for an advanced cosmetic dentist – Don’t rely on a referral. Look for a dentist with credentials (accreditation, at least) from the American Academy of Cosmetic Dentistry or the American Academy of Dental Aesthetics.

 

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