dental crown Archives - Coleman Dental

What’s wrong with my porcelain veneer?

September 14, 2021 by Brian Sartin

I ended up getting a porcelain veneer done to fix my damaged front tooth. At first, I really liked it. It blended in perfectly with my surrounding teeth. No one seemed to notice I had any work done. I am wondering what’s wrong with it now? It has only been a couple years and I’m noticing a really dark line along my gums. Should I be concerned? I am starting to feel self conscious when I’m laughing and smiling. Do you know what happened?

-Pam in Missouri

Pam,

From what you have described, it actually doesn’t sound like you have a porcelain veneer. It is more likely that you have a porcelain-fused-to-metal crown. A porcelain veneer is a very thin layer of porcelain that is bonded to the front of a tooth. Typically, a porcelain veneers are used to improve the aesthetics of teeth. For example, minor gaps, discoloration and small chips can be addressed with porcelain veneers. But, a dental crown is used when a tooth is more severely damaged. For example, if a tooth is cracked or chipped, has too large of a cavity to fill or needs to be reinforced structurally, a crown is more effective. A porcelain crown covers the entire tooth, kind of like a cap.

When the framework is made of metal, the gums can recede over time and the metal is visible. That said, a couple years seems like a short time for the metal to be exposed. It is possible you may need to be checked out to rule out any other conditions, like gum disease. That way, the cause can be taken care of before the crown is redone.

Now, this is all based on assumption from what you have explained. It is possible that you did get a porcelain veneer. If so, it doesn’t sound like it was done properly. Or, the cosmetic dentistry may have been done by a dentist that didn’t have the proper expertise and training.

There have been cases where bacteria creeps into the gumline area with porcelain veneers that were not placed seamlessly. If this is indeed the case, you will need to have be seen for a professional exam and cleaning. If bacteria is gathering along the gums, decay will become an issue if it hasn’t already and the bond that holds the veneer in place may be compromised.

Thank you for your question. Hopefully this will give you some guidance as to what your next steps should be.

Crowns keep falling off!

September 13, 2021 by Brian Sartin

I have a couple crowns and have never had any problems with them. Well, I feel really bad for my husband because his dental crowns keep falling off. The dentist re-cements them and then in a week or so, they pop right off. The dentist seems like he’s at a loss at this point. I’m wondering what is going on? Is there a super-strong cement we can try first? Or I have heard of CEREC. Is that a better option?

– Jeffrey in Missouri

Jeffrey,

Sadly, it sounds like it’s time for a second opinion. There shouldn’t be an issue with the porcelain crowns not staying cemented. This is not a common occurrence. Once they are permanently cemented, they should stay in place if they were done properly. Something must be breaking the bond.

The life of a crown is typically dependent upon the tooth preparation that was done by the dentist. If the tooth is in any way tapered, the crown will not have a good fit. It sounds like it may be time for some new crowns or better yet, a new cosmetic dentist. In order to successfully place crowns, the dentist must have had extensive training in the bonding technologies and materials. There really is no excuse for your husband’s crowns not to stay on. It’s time to move on.

Lastly, CEREC crowns really aren’t the answer here. This sounds like it’s an issue with the dentist, not the product. CEREC is a technology enables the tooth to be prepared and placed all in one visit.

Should I be worried about really fast crown preparation?

September 9, 2021 by Brian Sartin

I’ve had a multiple crows done and I’m always amazed how quick my dentist is during the crown preparation. I’ve had a couple done elsewhere and it seemed to drag on for 30-45 minutes. My current dentist is very speedy, like less than 30 seconds for the preparation. That said, I’m wondering if he removes too much natural tooth because two of them I’ve had done by him have come off. Is it possible that there just isn’t enough natural tooth left? I’m wondering if I have a case against him? I need to find a solution that doesn’t involve more expensive treatment or having to pay again for the same treatment. I’m nervous because I know that I can’t afford dental implants. Would you recommend that I find a new dentist? I was interested in looking around to see if there was one that would put a guarantee on their work?

-Paul in Minnesota

Paul,

Unfortunately, you won’t find a guarantee with on a porcelain crown. Although, there is something that is referred to as the “standard of care” in the industry. This means that a crown should provide a minimum standard to patients. Every case is different and sometimes an individual may have difficulty with a crown staying bonded in place. But the main problem with your situation is that the crown falling off seems to be happening on more than one crown and multiple times. This does sound like an issue with adhering to the minimum standard of care.

Although, it probably won’t be worth it to pursue legal recourse, since the dentist likely has liability in place to cover circumstances like this. You can request a refund so that you can have the work redone at a different dentist’s office. The lack of time spent during the crown preparation is concerning, yet it is difficult to give you specific marching orders without having seen your case in person. It is also possible that was a problem with the bonding techniques or materials used, or that the taper was too drastic and that is why the crowns are failing.

Many dentists will work their entire career and not have a crown fall off. The preparation step is imperative to ensure the crown is seated correctly. Your dentist sounds like his priority lies in speed versus being precise.

So, it would be in your best interest to move on. Have a consultation at a new dentist and see if the crowns can be redone. There are techniques that can be done during the preparation, even if there is less than desirable natural tooth structure in tact, that will successfully bond a crown. The new dentist may even work with you to craft a strategy to get refunded, or even a partial refund would go a long way to help you get the care you deserve.

Good luck and thank you for your inquiry.

Why is My CEREC Crown Attracting Stains and How Do I Fix It?

September 5, 2021 by Brian Sartin

I had a CEREC crown done about two years ago, and it attracts stain like crazy. I drink coffee, but not really excessively or anything, and I brush all the time. Despite my efforts, the tooth looks dingy within a few weeks every time I get a cleaning. I always looks nice when I leave, but it never lasts long. I asked my hygienist about it, and she said I’m not cleaning well enough at home. I am scrubbing as best as I can. I really think it’s got something to do with the fact that it’s a CEREC crown. It’s just that one tooth that becomes an eyesore. None of my other friends have this problem, but I’m also the only one who got a CEREC crown instead of a real one. Do I have to have the whole thing replaced? What are my options?

Thank you,

Ellen in New Hampshire

Dear Ellen,

Crowns, in general, can be made out of many materials, and CEREC crowns are no exception. Regardless of whether you have the kind that is created in the office or in a lab, it’s possible to attract stains like you’re getting. Home care is certainly a factor, and your hygienist was right to mention it. It’s not necessarily a matter of scrubbing hard either, as that can hurt your gums, as well as the neighboring teeth. You might have better luck switching to an ultrasonic toothbrush, or at least upgrading to one with a spinning mechanism.

It sounds like your restoration has microscratches on it. Although the material, itself, is incredibly durable, some things are known to cause very small scratches on the surface. When this happens, your coffee, food, and bacteria can gather in the tiny crevices, which makes it very difficult to clean. Sometimes, patients unknowingly cause the scratches by using abrasive toothpastes, like those designed for whitening. Other times, they can be caused by an inexperienced hygienist, who uses a prophy jet incorrectly, or uses an abrasive prophy paste to polish at the end of a cleaning.

It’s not likely that you’ll ever know for sure what caused the defects, but it’s worth mentioning the issue directly to your dentist. If one of his hygienists isn’t familiar with proper protocol, he’ll get to the bottom of it and can make sure other patients don’t have the same issue. If it is indeed scratched, there isn’t a way to repair it. Your dentist may be able to buff it out some, but it won’t look like it did when it was new. Aside from that, your options are to live with it, and change your cleaning routines, or to replace it.

Will bleaching my dental implant change the color?

September 3, 2021 by Brian Sartin

The dental implant on my front tooth doesn’t match the others anymore. I have had it for a couple years now. It used to blend in with my teeth but now that I have been bleaching my teeth, I am not seeing the implant change color. So now the implant appears much darker than the surrounding teeth. Is there a special teeth whitening formula I can use to whiten the implant?

– Margie in Nebraska

Margie,

Sorry to have to inform you that no amount of tooth whitening or bleaching product will change the color of your dental implant. Ideally, you should have done any teeth whitening prior to the implant being placed.

The porcelain crown that is attached to the implant post is highly stain resistant. So the original color will remain in place because of the seal used. A cosmetic dentist may be able to add staining to darken the crown, but lightening it is not an option at this time. The whitening products you used at home, remove surface stains and the oxygen in them penetrates deep into the tooth to whiten them. But on an artificial tooth like the restoration on your dental implant, the oxygen will not be able to penetrate. Therefore, it will not lighten.

Most cosmetic dentists will inform you of this at the time when the dental implant is placed. The only way to have the restoration match the surrounding teeth is to have the porcelain crown replaced. If this is the route you decide to go, whiten your teeth first. Then, let the color stabilize before the crown is placed. That way the cosmetic dentist will be able to successfully make a match so it look natural and blends in perfectly.

What metals are used in a crown?

August 29, 2021 by Brian Sartin

I am a holistically-minded person and am very cautious about anything I put in my body. At my last dentist appointment, I found out I need a crown. As I began researching it looks like ceramic crowns are best. Is this actually made of glass? I haven’t been able to get a straight answer it seems. I want to stay away from any metals or lithium. I am adamant about this because of my thyroid condition. Any insight you could provide would be greatly appreciated.

-Sheila from California

Sheila,

Ceramic crowns do not contain any metals. But, due to the nature of your question, I’m wondering if you are also insistent on avoiding metal ions as well. Unfortunately, this is a near impossible request, since every dental ceramic contains metal ions.

Here’s some background chemistry information to consider. Iron is a metal. Iron oxide is actually iron and oxygen combined, which is rust. Technically, rust is not a metal. But it does have metal ions in it. Now, you do not want to eat metallic iron. But the ions for iron are a key component in our diet and sustain our bodies. For example, our blood contains hemoglobin and also is responsible for it being red in color.

Stay with me. Another relevant example is sodium. It is a metal, which is toxic when ingested. But as a metal ion, when it is combined with chlorine, the product is salt. Other basic essential metal ions include calcium, potassium, zinc and magnesium. And there are a whole host of others.

So, to go back to your initial concern about lithium. It is a metal that is highly reactive. Therefore, doesn’t exist naturally, unless it is combined with the ion form and with other elements. So, lithium disilicate is a ceramic. It is extremely strong and is very successfully when used in a crown.

Another form of ion combined with oxygen is zirconia, which comes from the metal zirconium. A zirconia crown is one of the strongest materials used in dental crowns today.

When you mention Vita crowns. This is just a certain brand of porcelain. Porcelain crowns do contain metal ions. When the porcelain crown is bonded to the tooth, it can end up being stronger than your natural teeth. Kaolin is a clay that contains silica and aluminum oxide. Notice it is another ion, not aluminum metal.

You also asked about if the crowns were comprised of glass. The answer is no. Glass or silicon dioxide, won’t hold up as a dental crown. Some brands of crowns, like Empress crowns, may use glass in them. For example, in the Empress crowns, leucite glass contains aluminum tectosilicate.

So, those are the facts. I know it’s a lot to digest. But you seem to be a researcher. So feel free to use what I have provided here, along with what you have already compiled to best determine which type of crown is best for you.

In closing, considering your slant toward holistic practices, zirconia crowns would likely provide the least biological impact. Thank you for your question. Hopefully this information was helpful.

This post is sponsored by Houston cosmetic dentist Coleman Dental.

Problem after CEREC crown.

August 26, 2021 by Brian Sartin

I had a CEREC crown done about two months ago. The assistant warned me that my gums weren’t very happy around the preparation site and that I should use saltwater rinses a few times a day for about a week. She said that it would help heal the area quicker, but made no note of what to do if it didn’t heal. I did the rinses, but my gums are still incredibly tender and they bleed the instant I brush there. What gives?

-Mark in Georgia

Dear Mark,

The first concern would be infection, but if you’re not in pain and aren’t experiencing any swelling, that’s probably not the culprit. Provided you are healthy, the area should have healed by now. Occasionally people with certain health conditions or those who smoke take longer to recover, though.

More than likely, your gums are irritated either directly or indirectly by the CEREC crown, which can happen with any kind of crown. Sometimes it’s a little more difficult for patients to get between the teeth and floss when there is a restoration. When that happens, bacteria flourish and the gums become irritated, red and inflamed, plus they’re more prone to bleeding. The good news is that it’s an easy fix and correcting it simply requires extra time with hygiene. If you’re using regular floss, try switching to a floss pick or other implement to clean between the teeth and be sure to brush gently. You’re likely to see a lot of red for the first few days you really get in there and clean, but it should taper off in the coming weeks. Keep up with the saltwater rinses while you wok to restore health to the gum tissue. If you’re already cleaning well, it’s also possible that the margins of the CEREC crown are irritating your gums. If this is the case, improving your hygiene further will still help, but the only real fix is to have a new CEREC crown made.

Will this dental bonding last?

August 25, 2021 by Brian Sartin

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.

Will People Be Able to Tell If I Have Lumineers?

August 23, 2021 by Brian Sartin

I went to my dentist for a consultation on Lumineers. I thought they’d be good for me because I have uneven discoloration and a small chip on one of my teeth. I also really liked the idea of having minimal preparation work done because my teeth are healthy. I don’t want to ruin them. My dentist said that Lumineers, and any other type of veneer, are a bad choice because people will be able to see where the veneer ends and my natural tooth starts when I open my mouth wide or tip my head back. Is this true? He wants me to have “cosmetic crowns” done because they’ll cover the whole tooth and be indistinguishable. I don’t want to remove more tooth than I need to, but I also don’t want to look ridiculous. What should I do?

Sincerely,

Aurora in Illinois

Dear Aurora,

It isn’t true that porcelain veneers will look fake or that people will be able to tell where the veneer ends. Done correctly, porcelain veneers are the most natural-looking and beautiful of all dental restorations. However, with the Lumineers brand, our experience is that they often look fake–not because of seeing where the Lumineer ends, but because the color ends up being too opaque and the shape isn’t natural.

Having said that, I would still listen to your dentist because he is telegraphing to you that he is uncomfortable doing porcelain veneers.

Cosmetic dentistry is like an art and takes extensive training to deliver beautiful results. Although cosmetic dentistry isn’t a designated specialty are within dentistry, you should look for an accredited cosmetic dentist in your area. The American Academy of Cosmetic Dentistry (AACD) has put into place a rigorous accreditation program for dentists that seek the highest level of professionalism and skill in cosmetic dentistry. If you find an accredited cosmetic dentist, you can trust that the dentist has a high standard when it comes to the services offered.

With any kind of cosmetic dental work, the doctor has to have quite a bit of skill. This is true whether you’re getting some form of porcelain veneer, a porcelain crown, or even a tooth-colored filling. The doctor has to be able to make the colors match flawlessly and make sure the joint between the veneer and the tooth is perfectly smooth. If he fails in getting the color or translucency correct, your dental work stands out like a sore thumb. If the restoration is bulky, or not flush with your natural tooth, it will be obvious, plus it will collect debris and plaque.

Also, doing porcelain crowns would be overkill. It would seem a shame to grind down perfectly healthy teeth to do crowns simply because your family dentist doesn’t know how to do veneers well.

If you insisted on having the veneers procedure done by your current dentist, you would probably be unhappy with the results. He knows his limitations and he’s telling you he can’t make it look right, even though he’s blaming the procedure and not his technique. If you want to have porcelain veneers done, see an accredited cosmetic dentist. If you can’t find an accredited cosmetic dentist, the next best thing would be to ask about their cosmetic dentistry credentials, check out their portfolio and ask to see cases similar to yours. But whatever you decide, don’t ask your current dentist to do veneers.

Can I get my dental implants whitened?

August 23, 2021 by Brian Sartin

I have been really happy with my dental implants. They are in place of my two front teeth. They are holding up well and look really natural. Although, I still cringe when I look in the mirror because I don’t love my smile. I’d like to get some cosmetic dentistry done to improve my look. My dental implants show when I smile. So, I’m wondering the best approach.

Is it true that dental implants cannot be whitened? If so, then what are my options? Will placing porcelain veneers over top of the implants work? Then, I could get the rest of the surrounding teeth whitened? Do you have any advice?

-Jena in Connecticut

Jena,

Dental implants cannot be whitened. Teeth bleaching techniques only work on natural teeth. Dental implants are usually made from porcelain or another material. So, they cannot be whitened. The implants are highly stain resistant, so the idea is that they won’t become discolored. Ideally,you should have had your teeth whitened prior to getting the porcelain crowns placed onto the implants.

There are laboratories that may be able to change the color of a crown. But, they are usually made to be darker. It would be very difficult to make the crown appear lighter since the color is baked in. Also, placing a porcelain veneer over the dental implant won’t work. It wouldn’t look right and likely wouldn’t function well either.

Since the crowns are on the two front teeth, your options are limited. Unfortunately, you would have to get the crowns replaced after your natural teeth were whitened to the color you desire. Then, the new crowns could be made to match perfectly. Keep in mind, this wouldn’t mean going through the entire dental implant process over again. You would only need to have the crown replaced. The posts and screws that were surgically implanted into your jaw will be fine.

Thank you for your question. Hopefully, this post will help others that are considering dental implants. It’s always best to do the teeth whitening before getting the permanent crowns placed on the implants.