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Advanced cosmetic and general dentistry

If a Porcelain Veneer Falls Off, Should It Be Replaced with a Crown?

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Last December, my dentist placed 6 porcelain veneers on my front teeth. Two weeks after my dentist bonded the veneers, one of the incisor veneers fell off and broke while I was eating. The tooth was quite sensitive. My dentist said that he needed to adjust my bite. He shortened the opposite bottom tooth and the porcelain veneer. My dentist applied chemicals to my tooth that hurt so bad because it was already sensitive, despite his claims that the fix would be painless.

Last week, the same veneer fell off while I was eating. I feel the same sensitivity in my tooth. I called my dentist’s office to report the problem, and he returned my call and asked me to schedule an appointment for a porcelain crown because my bite must still be off. My dentist hasn’t looked at my tooth, and he wants me to get a crown. I’m suffering from sensitivity in the tooth, and I’m very skeptical about returning to my dentist. Is it normal for a cosmetic dentist to replace a veneer with a crown that keeps falling off?  – Omar from CT

Omar,

Two things aren’t normal about your situation. Porcelain veneers don’t commonly fall off, and it isn’t reasonable to grind down your tooth to replace the veneer with a dental crown.

Your dentist’s explanation about why your porcelain veneer is falling off doesn’t sound logical—especially since your dentist adjusted your bite, and the veneer fell off again. When a dentist properly bonds a porcelain veneer, it might chip or crack—but not fall off.

Why Do Porcelain Veneers Fall Off?

Improper bonding – Porcelain veneers require skill and proper bonding techniques. A dentist needs post-graduated cosmetic dentistry training to understand which tools and materials are needed for successful bonding. We are skeptical that your dentist has received the proper training to give you a long-lasting smile makeover.

Aggressive tooth preparation – If your dentist aggressively prepared your tooth and removed too much enamel, it would cause sensitivity in your tooth and make it a challenge for the veneer to stay in place.

Switch to an Advanced Cosmetic Dentist

If you take the veneer to an advanced cosmetic dentist—preferably accredited— he or she will ensure your tooth is prepared correctly and bond the veneer back in place. A cosmetic dentist who can save your tooth from a crown and ensure your veneer is secure.

Michael Szarek, DMD, an accredited cosmetic dentist in Lowell, MA, sponsors this post. Dr. Szarek’s office is conveniently located near Dracut, Chelmsford, Tewksbury, Billerica, Westford, Andover, Lawrence, Wilmington, Bedford, and Burlington.
Below are porcelain veneers photos of one of Dr. Szarek’s patients.

Three Causes of Root Canal Failure and How Your Dentist Might Treat It

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My top right upper molar is sore. I had a root canal on the tooth in 2002. I first noticed slight pain about two months ago, but now the pain is more frequent and is intense sometimes. Yesterday I saw a small sore on my gum. Pus was coming out of it in the afternoon, and at the same time, the pain was more intense than usual. I’m afraid that I’m going to lose this tooth and need a dental implant. I’m hesitant about going to the dentist in the middle of a pandemic. Is there anything I can do at home to help the tooth until I’m comfortable going to the dentist? Thanks. Jordan from Richmond, VA

Jordan,

The root canal you received in 2002 failed. And that’s not normal. Root canal treatment doesn’t fail over time. Something caused it to fail.

Causes of Root Canal Failure

  • Tooth not completely sealed – If the dentist who completed the root canal treatment didn’t fully seal your tooth, bacteria can leak in, infect the tooth, and cause significant pain.
  • Untreated canals – Some teeth have canals that, without careful observation, go unnoticed. If the dentist doesn’t remove the infection from all the canals, it can linger and cause future problems.
  • Cracked root – A cracked tooth root is painful. If a dentist can save your tooth, you’ll need some form of endodontic treatment, and the tooth will be protected with a new dental crown.
Diagram of three phases of dental implants, for information on implants and diabetes from the office of Lowell, MA dentist Dr. Michael Szarek.

Dental implants fuse with the bone to provide stability.

We recommend that you schedule an appointment with an endodontist or specialist. After an examination and digital x-rays, an endodontist is skilled at accurate diagnosis or treatment options, including another root canal treatment or root canal surgery. The specialist will also explain the risks and success rates.

If there is a chance of saving your tooth, let the endodontist try to save it. If keeping the tooth isn’t an option, a dental implant is the tooth replacement option that’s closest to mimicking the look and function of your natural tooth.

Accredited cosmetic dentist Dr. Michael Szarek of Lowell, MA, sponsors this post.

What to Expect With Porcelain Veneers on Front Teeth With Fillings

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I’ve decided to get veneers this summer, but I wonder what to expect on my two front teeth, which have fillings in them. Will veneers hold to teeth that have extensive fillings? Or should I consider another treatment? Thanks. Nadia from Bridgeport, CT

 

Nadia,

Photo of dental forceps holding a single porcelain veneers, from the office of accredited cosmetic dentist Dr. Szarek of Lowell, MA.

A veneer only covers the front and sides of a tooth

Your cosmetic dentist will use bonding that chemically compatible with the material in the fillings on your front teeth. The bonding material and the fillings in your teeth will unite and form a solid piece. But your before bonding veneers to your teeth, a cosmetic dentist will ensure that your fillings are stable and your teeth are healthy. Any issues with the health of your teeth will be resolved first.

Select an Advanced Cosmetic Dentist

A cosmetic dentist’s skill determines how well he or she bonds your porcelain veneers to your teeth.

  • Look for a dentist with advanced post-graduate training in esthetics.
  • Ask the dentist how many porcelain veneers he or she has completed.
  • Try to find an accredited cosmetic dentist. To achieve accreditation, a dentist must complete rigorous exams and submit successful patient cases that represent the dentist’s skill.

What to Expect with a Porcelain Veneers

Cosmetic dentists who are artists will work closely with you to give you the smile you’ve envisioned.

  • You’ll co-design your smile makeover.
  • Your dentist will show you a virtual version of your smile makeover.
  • You’ll try on a wax model of your new smile and wear temporary veneers.
  • Your dentist will adjust the temporaries to match your smile goals.
  • After you approve your new smile, your dentist will securely bond the veneers to your teeth.

Are Veneers the Right Solution?

Whether or not you should select another form of cosmetic dentistry depends on your teeth’s health and appearance and what you want to accomplish. Sometimes composite bonding is a solution, or a dentist might recommend a combination of treatments. Request a consultation to learn about your options before requesting a specific procedure like porcelain veneers.

Michael Szarek, DMD, an accredited cosmetic dentist in Lowell, MA sponsors this post.

How to Resolve It If Your Dentist Grinds Your Crown Down to the Metal

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In the late 1990s, my cosmetic dentist in NJ gave me a beautiful Maryland bridge. It’s held up well even though I grind my teeth at night and rarely wear my night guard. I’m not bragging about going without my night guard – my former dentist’s work is impressive. Even my current dentist in CT admitted it. In mid-April, I had some dental work completed. I couldn’t delay getting two crowns.

In the process of trying to adjust my bite with the new crowns, my current dentist reduced the Maryland bridge tooth. A few days later when I was looking at my teeth in the mirror, I noticed a silver dot showing through that same tooth. I scheduled an appointment for my dentist to look at the tooth, and he said the metal is finally showing through because I don’t wear a nightguard. He covered the dot with composite filling, but the metal is showing again. Could the metal suddenly show through the Maryland bridge tooth, although I didn’t have any problems before? Thank you – Tamar

Tamar,

Your dentist doesn’t want to admit that grinding down the tooth in your Maryland bridge caused the metal to show through. If he admits it, he’s obligated to replace your bridge. It is possible that after he thinned the bridge that your teeth-grinding habit exposed more of the metal. But the evidence suggests that the problem occurred after your dentist adjusted your bite.

When Your Dentist Grinds Your Crown Down to the Metal

Get a second opinion – Many dentists will give you a second opinion at no charge. How will a second opinion help?

  • Ask the dentist if there are signs of grinding on the porcelain where the metal is showing. A dental bur leaves distinct marks on porcelain, and it will be easy for the second-opinion dentist to see the marks.
  • Return to your dentist with the report form the second-opinion dentist. But don’t accuse your dentist of intentionally grinding down the porcelain. It’s a mistake that many dentists have made in the past.

Below is a photograph of three crowns on back molar teeth. The porcelain was adjusted so much that the metal shows through.

Lower molar teeth with metal showing through the crowns

An advanced cosmetic dentist can try to conceal metal showing through a crown or replace the crowns

Will You Need a New Maryland Bridge?

Your dentist bonded composite over the metal, but you didn’t mention if he prepared the surface of the metal first. Without preparation, the composite won’t hold.

Panavia is a dental cement that bonds to metal if a dentist takes these steps:

  • Grind away a little of the metal to allow room for the cement
  • Etch the metal with a micro-etcher, or small sandblaster
  • Prime the metal, coat it with a thin layer of opaque Panavia, and cure it
  • Place the correct shade of composite would over the cement and shaped and polish the composite

There is no guarantee that the composite will adhere to the metal for an extended time. But perhaps an advanced cosmetic dentist can use composite to resolve the issue with metal showing through on your Maryland bridge Schedule an appointment with an accredited cosmetic dentist to discuss your options.

Lowell, MA, accredited cosmetic dentist Dr. Michael Szarek sponsors this post.

Can a dentist reuse your crown after root canal treatment?

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There is decay beneath three of my five dental crowns. I need another root canal on one of the teeth. I’m wondering if it’s possible to reuse a crown after a root canal. I have a gag reflex and hate the thought of needing dental implants or dentures. I thought that when I got the crowns in 2011, I wouldn’t need another root canal. It’s disappointing that this process keeps repeating itself. Should I switch dentists? Thanks for your advice. – Harleigh from Portland, ME

Harleigh,

Whether or not your dentist can save your crowns depends on the extent of decay beneath them. Your dentist might need to cut off the crowns, which would make them impossible to reuse.

If your dentist can remove the crowns intact, it may be possible to reline them and bond them back in place.

Switching dentists probably won’t resolve the issue with decay beneath your crowns. If you frequently need crowns and get decay beneath them, several factors can help:

  • Reduce your frequency of eating and snacking throughout the day
  • Brush your teeth regularly and floss between them
  • Keep in mind that good oral hygiene isn’t a substitute for a lot of snacking
  • Keep your regularly scheduled appointments for dental cleanings and exams so your dentist can monitor your crowns
After cosmetic dentistry close-up photo of a patient's smile after receiving dental crowns to close a gap and even and brighten her teeth.

Snack less often to prevent decay beneath crowns and the need for dental implants

Neither dentures nor dental implants should be necessary if you get treatment promptly. Untreated decay will progress and eventually cause infection, which can lead to extraction and the need for a dental implant. Unless all your teeth are unhealthy and beyond saving, you shouldn’t consider dentures.

It’s best to pursue good oral health and take care of the decay beneath your crowns. Even if you need new dental crowns, they are less expensive than dental implants. And it’s worth the cost to preserve your natural teeth instead of extracting them in exchange for dentures.

Accredited cosmetic dentist Dr. Michael Szarek of Lowell, MA, sponsors this post.