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Advanced cosmetic and general dentistry

Should My Dentist Replace a Cracked Porcelain Veneer for Free?

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In March 2021, my dentist placed ten veneers on my top front teeth. I agreed to ten veneers because I have a broad smile. My dentist did beautiful work, and I have recommended several friends to her. I wore a nightguard before I got the veneers because I grind my teeth. And I have never stopped wearing a nightguard. Two nights ago, I forgot to wear my night guard, and in just that one incident, my right lateral incisor veneer cracked. Should forgetting to wear my nightguard one night cause a veneer to crack? Can a dentist repair a cracked veneer? And should I ask my dentist to replace it for free? I was planning on getting a dental implant for a lower first molar, but this setback might delay my plans. Thank you. Lyzelle from ME

Lyzelle,

Thank you for your question.

Can a Dentist Repair a Cracked Porcelain Veneer?

If a porcelain veneer cracked into two pieces that fit together perfectly, a cosmetic dentist could bond the veneer onto the tooth. The crack will be virtually invisible.

Should Your Dentist Replace Your Cracked Veneer at No Cost?

If your porcelain veneer cracked because you failed to wear your nightguard, your dentist is not responsible for replacing the veneer at no cost. But your veneers are only three months old, so some dentists would replace the cracked one and charge you for the lab fee or another portion. But you can expect to pay the full cost if it happens again.

Dental implant diagram of component, implant fixture in bone, and crown placement

Dental implants are highly effective for tooth replacement

Another factor is whether your dentist gave you specific instructions about wearing your nightguard to avoid damaging your veneers. If your dentist explained the risk, she might not be inclined to replace your cracked veneer at no cost. And you mentioned wearing a nightguard even before your dentist placed the veneers, so unless there are factors that you have not mentioned to us, be prepared to pay the total cost of replacing the veneer.

We understand that you have been anticipating getting a dental implant. But if you have found an excellent dentist, be reasonable if she is willing to negotiate with you on the cost of replacing the veneer.

 

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

My dentist recommended crowns instead of bonding and ruined my teeth

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I asked my long-time dentist to replace the old bonding on my tetracycline-stained teeth. My dentist convinced me that I would like the results if he removed the bonding, whitened my teeth, and placed crowns on my six front teeth. He explained that crowns are a better option because they last long and would help with my gummy smile. I listened to my dentist without knowing what was involved with crowns. Before the procedure, my dentist told me that he would have to grind my teeth a little, but my teeth looked like pegs when he finished.

My crowns look big and pasty, and in fluorescent light, you can see undertones of gray. Although my dentist said he would get the lab to correct it free of charge, the only thing different about my crown is that they look a little less gray. I got crowns at his recommendation, and he messed up my teeth! Now that I see what crowns did to my teeth, I prefer dental bonding, but I guess it is too late now. Is there anything a dentist can do with the crowns to make them look less bright and pasty? – Thank you. Bianca from RI

 

Bianca,

We are sorry to hear about your experience. No doubt, you trusted your dentist because you are a long-time patient.

We will review your dentist’s mistakes to help you understand how selective you must be before choosing another dentist—which we highly recommend.

Pasty-Looking Dental Crowns

Your dental crowns look pasty or chalky because your dentist does not understand how to manipulate porcelain for natural-looking translucence.

Based on your description, Bianca, at least three things went wrong:

  • Aggressive treatment – Your dentist recommended porcelain crowns because he was uncomfortable with porcelain veneers—a more conservative treatment than crowns. Porcelain veneers can last up to 20 years and are a beautiful alternative to dental bonding.
  • Limiting treatment to six teeth – At least eight front teeth—sometimes ten to twelve—show when you smile. Unfortunately, your dentist’s recommendation to treat only six teeth leaves untreated teeth exposed. And it makes it evident that you have dental crowns.
  • Not enough coverage – When a dentist does not understand the color issues related to tetracycline stains, crowns or veneers will not hide the stains. The dark color will show through. And it seems that your dentist’s attempt to lighten your teeth by bleaching them did not work at all.

Schedule a Cosmetic Dentistry Consultation

Photo of a woman's mouch with custom teeth whitening trays being placed on her teeth; from Lowell MA accredited cosmetic dentist Michael Szarek, DMD.

Only an advanced cosmetic dentist can determine if teeth whitening will help tetracycline stains

Tetracycline stains are challenging for dentists to conceal. It takes advanced cosmetic dentistry training and experience to hide the stains and keep crowns or veneers looking natural.

We recommend that you find an accredited cosmetic dentist to examine your crowns. Unfortunately, you will need new crowns to get natural-looking results. After you see the cosmetic dentist, try asking your current dentist for a partial refund at least.

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

Tetracycline stains and chipped dental bonding

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My dentist covered my tetracycline stains with dental bonding five years ago. Now the bonding is dull and starting to chip. I searched the cost of porcelain veneers and even found some online price ranges on dental websites. But I cannot afford veneers. Is there a way to whiten the bonding, or will I have to replace it all? I’m at a new dentist now (since last year), and I would like to know my options before they try to upsell me. Thank you. Fatu from Boston

Fatu,

Thank you for your inquiry. We will provide some information about tetracycline stains and your cosmetic dentistry options.

What Causes Tetracycline Stains in Teeth?

Tetracycline stains develop if you take the antibiotic as a child while your permanent teeth are forming. As a result, deposits in your tooth dentin (layer beneath the enamel) will show up as brown or gray spots or stripes in your teeth.

Treating Tetracycline Stains

An advanced cosmetic dentist can treat tetracycline stains with bleaching treatment, dental bonding, porcelain veneers, or a combination of treatments. But do not try to treat tetracycline stains at home. It can make the stains look even more noticeable.

Dental Bonding for Tetracycline Stains

If you already have dental bonding on your teeth for tetracycline stains, a skilled cosmetic can improve your teeth with these steps:

  • Use sandpaper discs to remove the old bonding
  • Whiten your teeth with a potent bleaching system
  • Apply dental bonding as needed

Dental bonding lasts several years before it needs to be touched up or replaced.

Teeth Whitening

Depending on the severity of the tetracycline stains in your teeth, a dentist may be able to use teeth whitening only to improve the stains. You must use the product as directed. Over-the-counter teeth whitening is not strong enough to affect tetracycline stains, so don’t waste your money on it.

Porcelain Veneers

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

Advanced cosmetic dentists skillfully use porcelain veneers to hid tetracycline stains

An advanced cosmetic dentist knows how to maintain porcelain’s translucence and hide tetracycline stains. Unfortunately, most general or family dentists do not have advanced cosmetic dentistry training. So although they can give you veneers, they might look chalky or pasty if your dentist doesn’t understand how to provide you with natural-looking results.

What If You Cannot Afford a Cosmetic Dentist?

If you cannot afford a cosmetic dentist, we recommend that you start saving money to get one. An expert cosmetic dentist can replace dental bonding or give you beautiful porcelain veneers. But if you are hasty and get cheap dental bonding, you will need to replace it so often that you will likely wish you had waited until you could afford quality work.

Meanwhile, you can schedule a consultation with an advanced or accredited cosmetic dentist to discuss your options. Then you will have a better idea of how to budget for your smile makeover. And you can learn about payment options to make it affordable.

 

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

 

Can I avoid dental metal issues with ceramic crowns?

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For the past 12 years, I have sought natural remedies whenever possible and limit toxins in my body. I have an old dental crown that I want removed, but I am concerned about what the new crown will contain. I researched ceramic crowns and wonder if any trace of metals or lithium is in the crowns. Although I do not have known metal allergies, I am trying to protect my compromised thyroid. Also, I am considering teeth whitening before I replace the crown. But how do I find out what is in the teeth whitening gel that dentists use? Thanks for your help. – Bianca from ME

 

Biana,

Thank you for your inquiry. We are happy to answer your questions.

Is There Any Metal in All-Ceramic Crowns?

All-ceramic crowns do not contain metal. But it is not possible to avoid metal ions in the crowns. Every dental ceramic we are aware of contains metal ions. What is the difference?

Metal vs. Metal Ions in Dental Crowns

The information below will help you understand that although dental ceramics contain metal ions, they do not contain the type of metals commonly known to provoke reactions.

Iron

  • Iron – Iron is a metal.
  • Rust – Rust is formed when iron combines with oxygen—producing iron oxide. Although rust contains iron ions, it is not a metal.
  • Iron ions – The human body does not iron in metal form, but it does contain iron ions, which are essential to life, and the hemoglobin in our blood.

Sodium

  • Sodium – Sodium as a pure metal is toxic, but as a metal ion combined with chlorine, it becomes sodium chloride—or table salt—which is essential to life.
  • Lithium – In the same family as sodium, lithium is so reactive that it is found only in ionic form when combined with other elements.
    • Lithium disilicate is a strong ceramic that produces dental crowns, including e.max crowns.

Zirconium

  • Zirconium – It is a metal that in ionic form and combined with oxygen becomes zirconia. Zirconia crowns are high strength. Zirconia is used to build dental bridges without a metal framework.

Other Metal Ions

Other metal ions in the human body and essential to life:

  • Calcium
  • Cobalt
  • Copper
  • Magnesium
  • Manganese
  • Molybdenum
  • Potassium
  • Zinc

We are not aware of the ceramics we mentioned provoking sensitivities or an allergic reaction. Most people who are want holistic or biological dental materials choose ceramic crowns.

  • Experienced cosmetic dentists understand which dental ceramics are best for anterior, or front, teeth. And they know which ceramics to use on molar teeth to withstand the forces of chewing and grinding food.
  • Some dental crowns are layered with glass on the outside to increase the aesthetics. Glass is pure silica (silicon dioxide). Leucite glass contains aluminum tectosilicate.

What Does Tooth Bleaching Gel Contain?

Tube of teeth whitening gelIf you are concerned about the contents of bleaching gel for whitening your teeth, ask your dentist which whitening brands they use. You can research the brands online to see the contents of the gel. It will help you determine if the contents will provoke a reaction.

Although you can ask the dental office what the bleaching gel contains, your comfort might increase if you check all the ingredients online.

One popular brand of professional bleaching gel lists these ingredients:

  • 40% hydrogen peroxide
  • 1.1% sodium fluoride
  • 3% potassium nitrate
  • a unique chemical activator

Advanced cosmetic dentists are familiar with the types of ceramic crowns available and will work with you to find a crown that meets your dental needs.

Best wishes for your ceramic crown and a brighter smile!

 

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

 

Should I choose zirconia or titanium implants?

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I have four missing teeth and am gradually replacing them with dental implants. My first two implants are titanium. But I read online that zirconia implants might be better because titanium can cause an allergic reaction or neurological issues. I will receive my next two implants in the fall. Should I ask for zirconia implants this time? Thank you. Oliver from RI

Oliver,

Thank you for submitting your inquiry to our office.

Titanium is one of the most biocompatible materials used for prosthetics in the medical and dental fields. Although people with specific metal allergies or sensitivities might benefit from zirconia implants, titanium is widely used. The human body contains various elements that help it perform essential functions, including zinc, iron, and copper. If a specific metal causes a reaction, it must be determined on an individual basis.

Are Zirconia Dental Implants Better than Titanium?

A December 2016 article, Zirconia Vs. Titanium Implants – Deciding Factors, was published in the Journal of Dentistry, Oral Disorders & Therapy. The report makes the following points:

Zirconia implants

Although zirconia is an ultra-strong ceramic, many implant dentists recognize its limitations:

  • An implant dentist or oral surgeon cannot usually leave zirconia implants to heal beneath the gums
  • Zirconia lacks the flexural strength of titanium and may crack under pressure
  • Adjustments to zirconia can lead to micro-cracks that can spread and result in dental implant failure
  • The small diameter of zirconia implants increases fracture risk
  • The one-piece design of zirconia implants is not conducive to using for full-mouth reconstruction

What If You Have A Titanium Allergy?

Photo of five dental implant screws. On both the left and right side is a single titanium implant, and three zirconia implants are between them.

Titanium (metal) and zirconia (white) dental implants

Although most people are concerned about an allergic reaction to titanium, only 6% of patients have titanium allergies. And some metal reactivity tests are unreliable. But if you have a confirmed titanium allergy—or if you simply prefer zirconia—zirconia dental implants may be an option.

Schedule a Dental Implant Consultation

We recommend that you begin with a consultation with a skilled cosmetic dentist who restores dental implants. He or she will explain your options for crowns or dentures on zirconia vs. titanium implants and the result you can expect.

Dentists who do not have advanced implant surgery training work with a periodontist (implant specialist) or an oral surgeon to plan for and place your dental implants.

 

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