Call Us: 267-763-1500

261 Old York Rd, Ste 517, Jenkintown, PA 19046

Banner image on site front page
Cosmetic and
restorative
dentistry

Dental Crown Disaster

Posted on by .

I needed a crown on a front tooth. My dentist suggested a CEREC crown because it could be done in one day, but I’d heard that they don’t look good on front teeth, so I asked for a traditional crown. The temporary crown didn’t really match, but he assured me that the temporary crowns would always be worse than the permanent crowns and when they came in it would be a perfect match. When the crown came in, I never really got to see it before it was bonded in. Once I got to look at it I realized (to my horror) that it didn’t really match the tooth next to it. I mentioned that and he said it “looked fine to him” plus it was already bonded so it couldn’t be removed. Then, a few weeks later the permanent crown, that “couldn’t be removed” fell out. I went back to my dentist suggesting that this would be a good time to improve the appearance. He then said that, “While he could redo it, he would have to charge me for it because I have a functional crown.” Otherwise, he could just bond this back on for free. I was so frustrated. Now it has fallen out again. I’m sure he is going to give me the same choice again. Do you have any recommendations for me?

Greta

Dear Greta,

Porcealin crown being placed on a tooth

The one good thing you have going for you is that the dental crown is not staying in. The dental board considers the standard of care functional. While you, unfortunately, would not have any recourse because the crown does not match your teeth, you do have the right to ask for a refund when it does not stay in. Despite what your dentist said, you do not have a functioning crown if it does not stay in your mouth. That is exactly what I think you should do.

Not only has this dentist shown himself to be unethical in how he misinformed you about the temporary versus permanent crown, he also cannot get the dental crown to stay. Do not allow them to do any more work on you. Instead, tell him you want a complete refund. Your crown is not functional. This is the second time it has fallen out.

When you go to get your crown replaced, I want you to go to an expert cosmetic dentist. Matching a tooth to a front tooth is more challenging than for other teeth because the light hits them directly which reveals all the nuances of the teeth. A truly skilled cosmetic dentist would do a temporary try-in to make sure it perfectly matches the adjacent teeth. If not, they would make notes about what changes need to be made and then send them back to the lab to be redone. He or she would not be satisfied, nor would they bond the crown in, until you are completely satisfied.

My suggestion is that you go to an AACD accredited dentist. These are the top cosemtic dentists in the country. They will give you a gorgeous crown that completely blends in with its adjacent teeth.

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

Dentist Won’t Match Implant Crown

Posted on by .

I have had the dental crown placed on my implant three different times and none of them matched the adjacent teeth. My dentist said I’m being too picky and my tooth color is between A1 and A2 and I will never be satisfied. She’s refusing to do it again. I hinted I will try somewhere else and she said that puts my dental implant in danger of coming loose because she’s already removed the crown two other times. Now I’m worried. Am I stuck with mismatched teeth? I don’t want to risk the implant itself. Could I just whiten everything, crown included?

MaryAnne

Dear MaryAnne,

Using teeth whitening won’t help in this case. It will whiten your natural teeth, but the crown will stay the same shade, making the differences even more obvious. I’m very sorry that your dentist is treating you this way. She seems to be transferring her inability to match the crown for your dental implant to you. This isn’t your fault. Based on what you said, there are probably two problems going on with this. My first guess is this is a front tooth she’s trying to match. Those are trickier than others. Even top cosmetic dentists will do several try-ins before getting an exact match.

Notice I said try-in. There are temporary try-in pastes which allow you and the dentist to see what the dental crown will look like in place without using the permanent bonding materials that require her to grind your crown off every time you request a change. These are inexpensive. There are usually only two reasons a dentist doesn’t carry them. The first would be they don’t care what you think and will only look at it themselves. The second is they don’t know about it because they have not invested in cosmetic training, which has to be done in a post-doctoral setting. I believe your dentist falls into this latter category.

This leads me to her second problem. She’s just going by the standard Vita shade guides and expecting your tooth to be a perfect match. But, your teeth are between an A1 and A2. For back teeth, her method would work fine. However, a front tooth gets all the light when we smile, which shows the color and variations in striking clarity. The standard shade guide isn’t enough.

diagram of a dental color map This is an example of a color map a cosmetic dentist will send to the ceramist. Yes, it will have the basic shade, but there are also instructions for different tints to go in a variety of sections on the tooth, which changes the visual perception of the color. Our natural teeth aren’t one flat color. There are differences in opacity throughout the tooth. This is how you get a tooth to look natural and perfectly match its neighbor.

The truth is your dentist is in over her head. Ask for a partial refund and go elsewhere to get it done. See if you have an AACD accredited dentist in your state. They’re at the top of their field.

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