Archives for August 2022

Are Cracks in Porcelain Crowns a Dental Emergency?

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I’ve had four porcelain crowns on my front teeth for a bit over ten years. One of them has always had a slight defect, but you couldn’t see it, just feel it if you rubbed your tongue over it. Now, I can feel it AND see it. It looks like a little line toward the bottom of the crown. Would this be considered a dental emergency? I don’t want it to break when I am out in public.

Carol

Dear Carol,

Woman covering her mouth

I’m glad you wrote. I would not consider this a dental emergency, but I would start making plans to get this replaced. There are a couple of considerations here.

  • Do you just want to replace all of them at the same time, or just one at a time as needed?
  • Are you happy with the color of your teeth?
  • If you choose to do them one at a time as needed, is your dentist an expert cosmetic dentist?

There are some benefits to doing them all at once, but the obvious drawback is that it will cost significantly more money. So, are the benefits worth the cost? First, you won’t have to worry about when they are going to need to be replaced because you have already taken care of them. Second, you won’t have to run to the dentist every time one of them is nearing the end of its life. You can go in and get them all replaced, one appointment and you’re done. Whether that is worth it is dependent on your individual circumstances.

I wouldn’t necessarily recommend replacing them all if they were just a few years old, but you’ve had yours for a while. Just don’t get them all replaced because your dentist says that is the only way to match them. That is an indicator that he or she is not an expert cosmetic dentist and you want front teeth that are beautiful.

I mentioned tooth color earlier. The color the crowns are made with is permanent. If you are happy with the current shade of your teeth then you are good to go. If you are considering teeth whitening then the time to have it done is before you have your crowns made. This way the shade can match the new color. Teeth whitening does not change the color of crowns so if you decide to do it later, you will have to replace the crowns again in order to get them to match.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Tetracycline Stains and No Money

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I have had tetracycline stains on my teeth since childhood. All the research says to put porcelain veneers on your teeth to cover them but my dentist doesn’t do porcelain veneers. He does do crowns, which he has suggested we use. Even that, however, is out of my reach. Are there any other alternatives?

Callie

Dear Callie,

smile with tetracycline stains

I am very glad you wrote. For the benefit of others reading, who may not know what tetracycline stains are (pictured above), I am going to give a brief explanation. Tetracycline is a prescription medication. If you take it before your permanent teeth are formed, which generally happens at the age of twelve, it will deposit in the dentin of your teeth and show up as a dark brown or gray stains.

The best solution to this is porcelain veneers, which would need to be done in the hands of an expert cosmetic dentist. Covering tetracycline stains is one of the most advanced and tricky procedures dentists have to do. They have to make the cover opaque enough to cover the dark stains, but still translucent enough to look sparkling and natural.

Some family dentists who are not skilled in cosmetic dentistry try to make up for this by doing porcelain crowns. I will be honest with you, any dentist that suggests dental crowns for this is a big red flag. They are telling you, “I can’t do porcelain veneers, but I’m totally willing to grind down healthy tooth structure to rake in money for what I do know.” If they don’t do porcelain veneers, they are not skilled enough in cosmetic work to make these crowns look good. Even most dentists who do porcelain veneers don’t have the skills for tetracycline stains.

Tetraycycline Stains and No Money

You have a few options. First, you can leave the teeth as they are while saving up for the high-end (and higher priced) procedure. This obviously would depend on how long it would take you to reach your goal.

Second, you can have teeth whitening done. When you do this, know that it won’t be done in one tube of gel. In fact, you will have to be persistent, but if you are, it will work. One thing to note is I don’t recommend Zoom Whitening for this. It is more expensive than the take-home trays whitening. It is a fantastic whitener, but you will need too many sessions for it to be financially do-able for you. Of course, you could do one zoom appointment to get a jump start and then do the rest with trays. As far as tray teeth whittening goes, see if your dentist offers or is willing to purchase kör whitening for you. This is the most potent gel available.

Your final option is to have the teeth whitening done while saving up. This allows you to make some progress if it is going to take you a long time to get to the cost goal. If you choose this, you may even find you are happy enough with your whitening results that you no longer feel the need for porcelain veneers. Just bear in mind it will take a while for the whitening to really make a difference.

This blog is brought to you by East Cobb Dentist Dr.Cristi Cheek.