My left front tooth (central incisor) had a root canal treatment several years ago and has since turned a grayish color. My dentist was suggesting a dental crown for it, but I really would rather be more conservative with the tooth structure. He doesn’t think a porcelain veneer is a good idea and so I am wondering about composite bonding. Would that work? One thing I am worried about is that every time it has to be redone that I will lose more structure. I like my dentist but I’m starting to lose confidence in him. He’s just not interested in keeping this tooth as intact as possible. What would your advice be?

Matthew

Dear Matthew,

I’m glad you wrote. Either a porcelain veneer or some direct dental bonding will be fine, with a catch. You have to be careful who does it. If it is done right you won’t have to worry about losing structure during updates. Let’s start with the direct composite bonding. The benefit to this is the dentist can work with the color right there instead of having to go back and forth with the lab. This will last between three to five years. If well cared for, even longer. My suggestion, if you go with the bonding, is to use Supersmile Toothpaste. It is specifically designed for cosmetic work. The porcelain veneer will last longer, but will cost more.

Now for that catch I mentioned earlier. Matching a single tooth is super advanced. If your dentist is suggesting a dental crown on a healthy tooth, it tells me that he is not comfortable with cosmetic dentistry. I honestly think this is beyond the skills of your family dentist. It doesn’t mean that you have to give him up altogether if you like him. He may be a perfectly respectable general dentist. Many cosmetic patients go to one dentist for their general work and another for their specialized cosmetic work.

To match a front tooth, I would only go to an AACD accredited dentist. They are the top 3% of dentists in the country. These are the only dentists I would trust with such a difficult procedure.

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