I have four porcelain veneers. One of them now has a cavity. My dentist wants to remove the porcelain veneer and replace it with a dental crown. Is this absolutely necessary?

Catina

Dear Catina,

I am glad you wrote. My suggestion is that you get a second opinion before going through with what your dentist is suggesting. In practical terms, only about 2% of dentists are able to match a dental crown to a porcelain veneer. In addition to that, the decay would have to be quite significant for your tooth to need a dental crown. I would say at least 20% of your tooth would need to be decayed to necesitate a crown.

When you have a porcelain veneer, the most susceptible part of the tooth to decay is the edge of the porcelain veneer. Your dentist may either not have the comfort level or skills to do a porcelain veneer or he doesn’t have the tools to do a composite filling on the edge where you likely have the decay. This may be why he is suggesting a crown which is a less specialized treatment. But, this would require grinding down a significant amount of your tooth strucutre. You do not want to do that unless it is absolutely necessary.

Get a second opinion by a skilled cosmetic dentist. When you do, make sure it is a blind opinion. By that I mean do not tell them who your dentist is and what they suggested. Just tell them you want a second opinion on the tooth. If they ask for the dentist or the diagnosis, explain that you want a blind, unbiased opinion. They should understand that. The reason for this is because the dental community is small and they probably know each other. You don’t want him feeling pressured not to say anything negative about a friend’s diagnosis.

This blog is brought to you by East Cobb Dentist Dr. Susan Dennis.