Should My Dentist Be Able to Match My Implant Crown?

Posted on by .

I want your advice as to whether I am being too picky. I had a dental implant made for a tooth that could not be saved after an accident. It’s a front tooth so I want it to match the other front tooth. My dentist has tried three different implant crowns, but none of them have matched. She’s frustrated with me and thinks I should just be grateful I have a tooth because “It is not her fault my tooth is between two dental crown shades.” Am I being too picky? Isn’t there a way to blend two shades together to make something closer?

Amy

Dear Amy,

I’m glad you wrote. You are definitely not being too picky. Plus, it was unfair of your dentist to push this off on you as if you were at fault for her lack of skill by not making her job simple enough for her. My suspicion is she does not have much training in cosmetic work, which is absolutely necessary to match a front tooth.

Color map a cosmetic dentist would createWhile the standard shades that your dentist referred to are adequate for back teeth, they do not quite cut it for front teeth as you have discovered. Your front teeth are exposed to direct light, which reveals all the variants in your teeth. The problem isn’t your natural shade color. There isn’t a shade that directly matches any tooth. When your teeth are hidden away toward the back, close is good enough.

For front teeth, your dentist has to pull out any artistry and color theory training he or she has received. Yours hasn’t. When a dentist needs to match a front tooth, they will draw out a “map” of your tooth, similar to the one to the one here, then mark for the ceramist the various tints and stains needed to give the tooth the correct blend.

It’s pretty apparent your dentist does not know how to do this and I don’t think she’s going to invest in the training needed. My suggestion is you pay for the dental implant but ask for a refund on the implant crown, so you can get it done properly somewhere else.

Discuss the procedure with any potential new dentist to make sure they are willing to do this properly. Here are some things to consider. Ask them if they will use a temporary try-in paste for you to approve the look and match of the porcelain crown before bonding. If they say no, move on. If they say yes, ask them how many times they’re willing to re-do it to make sure it is an exact match. The only acceptable answer should be as many times as is necessary.

It would be a miracle for even the best cosmetic dentists to get a perfect match the first time when it comes to a front tooth. Most will require two or three try-ins, so don’t panic when the first one doesn’t necessarily work. Just know you will get a tooth you can be proud to show.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.
Click here to learn more about smile makeovers.

Crown Doesn’t Match

Posted on by .

I don’t know what to do. I had to get a dental crown on front tooth. My dentist can’t seem to get them to match. The first one was way too dark. The next one was way too white. The third one is close. I thought I could live with it and he bonded it one but now every time I look in the mirror I feel like my smile looks fake. Am I being too picky? My dentist said if I really want to do it again he will.

Candace

Dear Candace,

Dr. Cheek looking at computer visuals

The tendency for most patients in your situation is to finally just settle for a crown that doesn’t look quite right. If this is a front tooth, however, even a slight variation in the color between the crown and adjacent teeth will be noticeable to others and will make the crown look fake.

Your dentist seems to be very ethical and is doing everything he can to make this right. I just think he is in over his head. Matching a single dental crown to a front tooth is a highly developed skill. Additionally, the dentist has to have a great working relationship with artistic skill. Their relationship needs to be very communicative where they understand one another the way best friends would.

An expert cosmetic dentist will do try-ins to make sure it matches perfectly. I don’t think your dentist has the expertise necessary and didn’t even know about temporary try-in pastes.

Another method being used very effectively to match crowns on front teeth is photography. Using sophisticated camera equipment designed for taking dental photographs, the dentist will start by taking a photograph of a standard shade tab of a shade that is close to the shade of your natural teeth. The shade tab will be put up against your natural teeth and photographed, and this photograph will be sent to the ceramist as a guide in re-creating the natural color of the tooth. Then, if the crown provided by the ceramist doesn’t match perfectly, that crown is tried in on the tooth and a new photograph is taken. The ceramist then will be able to see, in the lab, exactly what color modifications need to be made to get it to match perfectly. Your typical family dentist won’t have this type of photographic equipment.

So what do you do if your dentist doesn’t have the skills necessary? Your dentist is willing to keep trying. If you are willing to let him, you can. However, it’s likely he’ll never get it quite right. You could have a conversation with him and tell him you think it would be better if he transferred your information to a dentist with more expertise and the tools necessary to do it properly.

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