broken front tooth Archives

I am starting to doubt my dentist that placed a CEREC crown on my front tooth. I was sold when I heard that by choosing CEREC, I wouldn’t have to deal with the inconvenience of a temporary crown. Having the crown done in only one office visit was very appealing. Well, I left town the day after I had the crown placed. I was shocked when the crown came off the next day. I was freaking out and so my friend referred me to her personal dentist. Her dentist seemed comfortable with CEREC and reattached the crown for me. I don’t love the look of the new crown. The color doesn’t look quite right and I think it appears a little longer than the neighboring tooth. The following week when I returned home, I called my dentist to explain what had happened. My dentist offered to have the crown redone. But now I’m starting to wonder if CEREC was a bad choice to replace a broken front tooth? Maybe I should move forward with the traditional crown placement method and go through with the temporary and permanent crown. And I’m even beginning to doubt that having my dentist redo it is the right call either. I’m feeling overwhelmed and don’t know what to do. Can you give me some advice?

-Jen in New York

It is always difficult to provide specific recommendations without having seen your case in person. That said, I’m sorry that you are having to go through this. The bottom line is that a front tooth, single crown is very difficult to get right. Not just any dentist can pull this off. Cosmetic dentistry is an art. Most dentists come from a functional mindset of fixing a problem. Very few (less than two percent) actually have the artistic beauty to deliver beautiful, natural-looking results, especially on a front tooth.

The color may not be right because of the milling machine that was used to fabricate the CEREC crown. Typically, there is a lot of communicator and collaboration on the color of a crown between the cosmetic dentist and the ceramist. But the machine short cuts that process and the CEREC machine will result in a factory color for the crown. A CEREC crown is milled form a single ceramic block, which is provided from the factory. Often times, dentists like using CEREC technology, but agree that they may not be the best fit for a front tooth crown. But there are some highly skilled cosmetic dentists that may be able to deliver a beautiful front tooth CEREC crown. Most excellent cosmetic dentists would choose a traditional porcelain crown so they could perfectly match the surrounding translucency, color and exact shape.

Another cautionary sign is that the crown should not have come off in the first place. So, it is quite possible that the dental bonding wasn’t done properly to begin with. Therefore, you may be correct in questioning your dentist’s ability with cosmetic dentistry. It is nice that he is offering to redo the crown, but you have to wonder if he will successful bond it in place this time around. This may be beyond his personal skill set.

All this to be said, it may be time to seek a second opinion from an expert cosmetic dentist before moving forward with the crown replacement. Meet with another dentist, one that has experience and training in cosmetic dentistry. Specifically ask if they have done front tooth crowns and ask to see examples of the work. Then, you can better assess what may be the best way to go.

Again, it is hard to tell you exactly what to do without having seen your case. Hopefully this gives you some things to consider before moving forward in getting the porcelain crown replaced.

I hit an icy patch when I left my house a week or so ago. I literally fell on my face. I was so embarrassed when I looked in the mirror to discover one of my front teeth had chipped. I couldn’t get into my normal dentist so I had an emergency dentist take a look. From a structural perspective, the tooth should be fine which is a relief. He patched it with dental bonding. But he recommended I get into my normal dentist to have him check it out too. Do I really need to go into my regular dentist? How long with the dental bonding last? If I’m okay with the patch job the original dentist did, do I really need to have it re-checked?

-Mike in Michigan

Mike,

In the winter, dentists see many patients with similar accidents. It’s good to hear that you weren’t more seriously hurt. The emergency dentist likely used a dental bonding material used for filling a cavity. So, it should last for many years, even decades in some cases.

But since the tooth was traumatized, you really should go into your normal dentist. First, if your regular dentist is a cosmetic dentist, he can evaluate the work from an aesthetic viewpoint. Also, sometimes a tooth that is traumatized may not exhibit symptoms right away. The nerves inside the tooth may gradually fail over time. If that occurs, the tooth will need a root canal. So definitely be on the lookout for any kind of abscess, discoloration, or increase in pain. Those are all symptoms. It’s pretty typical that when a patient sees an emergency dentist that they are referred back to their regualar dentist to evaluate any long-term issues.

It is also possible that the break may require a porcelain crown because the dental bonding may not be the ideal fix for the long run. It may have been more of a temporary fix. So, it would be in your best interest to schedule your follow-up visit with your regular dentist just to make sure all looks okay.

Was CEREC the wrong choice for a front tooth?

Will this dental bonding last?