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Advanced cosmetic and general dentistry

My porcelain crowns don’t match my natural teeth

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Last October I got 3 porcelain crowns for upper teeth in the front of my mouth. One of the crowns matches the color of my natural teeth but the other 2 don’t match. Twice my dentist attempted to make the color match. He keeps saying the lab didn’t get it right. Through the whole process I have not pretended to be pleased, so with my last visit he said that he could try it again or if I want to leave the teeth as they are, he will give me a discount. 3 attempts? I have no confidence in his ability to get the match correct. I am disappointed and frustrated. What next? – Jane H.

Jane – Unfortunately, your experience shows how different an outcome can be, depending on the dentist who does the work. An artistically inclined cosmetic dentist beautifully restores teeth with porcelain crowns.

Although your dentist says attributes the color-match issue to the laboratory, it is the dentist who supplies the technician with notes and instructions to create your dental crowns. Color-match photography is available to take a color-accurate photograph of your teeth. The photograph can be sent to the technician, along with the dentist’s notes to get an accurate match.

You must decide whether or not you want your dentist to try the color match again. You have the option of making an appointment with a skilled and credentialed cosmetic dentist who can provide you with crowns to perfectly match the color and translucency of your natural teeth.

Since your dentist offered a discount because you are displeased with the work, perhaps he will be willing to provide you with some sort of compensation if you decide to let a cosmetic dentist do the work.

This post is sponsored by Lowell cosmetic dentist Dr. Michael Szarek.

Is it possible to get a cavity beneath a crown?

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I have a tooth that has been crowned for 4 years or so. It’s been hurting consistently, so I went to my dentist. She says there is a cavity beneath the crown. I thought crowns protected teeth, so how could there be a cavity in the tooth? – Shelli

Shelli – It is possible to get a cavity beneath crown, but it’s unusual to get the cavity beneath a crown that is only four year sold.

When a crown is placed, the margin—where the crown meets your tooth—should have no gaps. The smallest gap will leave room for plaque. Plaque will attract decay.

Insurance companies usually require that a crown be in place five years before it is replaced. Dentists expect crowns to last much longer than that.

We recommend that you have the crown examined by a skilled cosmetic dentist.

This post is sponsored by Lowell cosmetic dentist Dr. Michael Szarek.

Bulimia and Your Teeth

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More than 10 million Americans suffer from eating disorders, such as anorexia or bulimia.

Bulimia is characterized by excessive over-eating in a short amount of time. Excessive eating is often followed by self-induced vomiting.

In time, the vomiting—whether it’s caused by bulimia or another condition—will affect your teeth. The acid from vomiting will cause teeth to become discolored, thin and weak, and they may begin to crumble.

There are some things you can do to protect your teeth. Immediately after vomiting, your teeth are weak, so avoid brushing them at that time. Instead, thoroughly rinse your mouth with warm baking-soda water to neutralize the acid in your mouth. If baking soda is not available, rinsing your mouth with just water can help. Sip water throughout the day to keep your mouth moist. A dry mouth can’t fight bacteria and decay.

If you are struggling with, or recovering from, bulimia, tell your dentist. He or she will take steps to help you preserve your teeth. Fluoride treatments can help strengthen your teeth and protect them from decay.

If you’re recovering from bulimia and you want a smile makeover, the treatment varies depending on the extent of the damage to your teeth. Porcelain crowns can be made to completely cover and protect your teeth. They will have the translucency and color of your natural teeth. If you have lost teeth, dental implants are the most natural looking and natural feeling way to replace them. After examining your teeth, your dentist will discuss your options with you.

You will get the most natural-looking restoration from an experienced cosmetic dentist who is skilled in designed smile makeovers.

This post is sponsored by Lowell dentist Dr. Michael Szarek.

I am allergic to nickel and concerned about a porcelain fused to metal crown

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I’m highly allergic to nickel. My dentist is recommending 2 porcelain fused to metal crowns for back teeth. I am concerned about having a reaction to the metal. My dentist said that I don’t need to worry. Should I be concerned? Can I get a zirconia crown instead? Thanks Rachel C. from Delaware

Rachel,

About ten percent of women have nickel allergies. The allergic reaction is more common in women than men. An allergic reaction to cheap jewelry or needing hypoallergenic earrings indicates a nickel allergy. In their medical history questionnaire, many dentists ask if you have metal allergies.

Base metal (non-precious), noble metal (semi-precious), and high-noble metal (precious) are the three categories of metal used in dental crowns. The metals are either used as the only component of the crown, or as the foundation of the crown.

Base metals are stiff and very likely to contain nickel. Forty percent of the noble metal will contain precious metals—gold, platinum, and palladium. The remaining composition will be silver, tin, copper, and other metals. Noble metals are softer and easier to manipulate than base metals. High-noble metals contain at least sixty percent noble metals, mostly gold and platinum. High-noble metals are the most pliable.

A noble or high-noble metal should present no problem with your nickel allergy. Your dentist can present you with an ldentalloy certificate before the porcelain crown is placed. This certificate is provided by the dental laboratory for every crown that is made. If the crown contains nickel, you can refuse it and find a dentist who is skilled in placing a zirconia crown.

This blog post is sponsored by Lowell cosmetic dentist Dr. Michael Szarek

Can a broken tooth in my bridge be fixed?

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My eight upper front teeth have a bridge. I am trying not to get overly anxious about this, but I just moved from Maine and I don’t have a dentist yet. The second from my left front tooth chipped. Can it be fixed without having to re-do the entire bridge?

The same techniques that repair a porcelain crown can be used to repair the broken tooth in your bridge.

The chipped porcelain must be cleaned and prepared for bonding. If the bridge is porcelain fused to metal, it will then be rinsed and carefully etched with hydrofluoric acid or with a microetcher that is used to blast fine aluminum oxide particles.

The porcelain will be primed with a silane coupling agent and coated with bonding resin. A metal bonding agent and an opaquer will be used to treat any exposed metal. Composite resins that are translucent and that can be highly polished will be layered to match the properties of the porcelain.

You will need to take care of the composite repair. Extensive alcohol consumption softens composite, and smoking and extensive coffee drinking tend to stain it.

We recommend that you find an expert cosmetic dentist to repair the tooth. He or she will have the necessary material and equipment to properly repair and bridge. You won’t be able to tell that the tooth was broken.

The blog post is sponsored by Lowell cosmetic dentist Dr. Michael Szarek.