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.

While 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.

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