I don’t know what to do. I’ve never had a dental crown before and this one is on my very front tooth after a nasty fall. My dentist said that my teeth are so white that there is not a color to match a crown to it. He’s done the whitest shade available and it is still several shades darker than my teeth. He’s a new dentist for me because we just relocated. I just had to go to a dentist who saw new patients quickly for emergencies, so I don’t know much about him. I’m having my doubts about what he is saying, though. Is there no way to match white teeth?

Brianna

Dear Brianna,

I think what you are facing here is a dentist who may be a decent bread and butter type dentist but has no clue when it comes to dental aesthetics or cosmetic work. You are not going to have a beautiful, or even natural looking, dental crown done by him.

Here is where part of his confusion lies. Based on what you’ve said, he is still using the standard shade guide (pictured left). Before teeth whitening became both popular and affordable, this was the shade guide dentists turned to when they needed to match a dental crown to existing teeth.

A patient’s teeth would always fall somewhere close to one of these shades. Then, in the 1990s, teeth whitening skyrocketed. Dentists started seeing patients come in with teeth whiter than anything on their shade guides. This is because bleaching your teeth, doesn’t just whiten the stains. It can whiten your natural tooth structure as well. That means your teeth can actually become whiter than their natural white.

Eventually, a new shade guide addition came out that added some whiter shades to meet the demand for whiter teeth (pictured below).

Your dentist is facing an additional problem that he won’t know what to do with as well. Front teeth are harder to match. This is because the light hits them more directly revealing all the subtleties and variations in the shades and translucency. He will need to understand color theory and tinting in order to get a perfect match. That would have required extensive post-doctoral training in cosmetic dentistry, which I sincerely doubt he’s done.

In your place, I would either look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top 1% of cosmetic dentists in the world. If there isn’t one in a reasonable distance to you, then another good resource for finding excellent cosmetic dentists is the mynewsmile.com “Find a cosmetic dentist” link.  They prescreen all dentists who want to be listed there for their technical knowledge and training, as well as the artistry of their results.

This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.