I mentioned to my dentist how much I hate my smile because of my tetracycline stains. He said the best solution is to put crowns on all my visible teeth. While my teeth are ugly, they are also healthy. I hate the idea of grounding them all down. Will they look natural if I do? Would teeth whitening solve the problem instead?

Miranda

Dear Miranda,

 

It is difficult having a smile you are embarrassed by, especially when our smile is the first thing people notice about us. I agree with you that dental crowns is not the way to go for this. If you have healthy teeth, it is always best to keep them as intact as possible. While teeth whitening could help IF you were very persistent. Even then, they would never be completely gone. Because of that, it is not the best solution for tetracycline stains.

My recommendation is that you use porcelain veneers. These remove hardly any tooth structure. Unlike dental crowns, which have to fit around the entire tooth, porcelain veneers go on the front of the tooth. One important word of caution. I am going to recommend you do not go to your dentist for this.

Tetracycline stains are one of the most difficult to address. It takes advanced cosmetic dentistry training to do it properly. Training that is not available in dental school. The trick comes in getting the veneers opaque enough to cover the stains, but still translucent enough to look beautiful and natural.  A dentist has to invest in that instruction post-doctorally. The fact that your dentist is suggesting crowns instead of veneers tells me he does not have the right training for this. Many dentists think they can make up for that lack of training by using dental crowns, which are thicker. But that is not enough to make them look beautiful.

When dealing with tetracycline stains, I would only go to a dentist who is AACD accredited. You can find them on aacd.com. Accreditation is different than membership. Any dentist can join the American Academy of Cosmetic Dentistry. To become accredited, however, requires passing extensive examinations as well as proving your artistry to a board of examiners.

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