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Advanced cosmetic and general dentistry

Is Replacing My Veneer with a Crown the Solution for a Cavity?

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My dentist wants to replace my porcelain veneer with a crown because I have a cavity in the veneer tooth. I have eight veneers. Is this my only option? Thank you. Stacie from CT

Stacie,

A porcelain veneer held next to a tooth

A cavity in a porcelain veneer tooth is rare. Consult a cosmetic dentist.

We recommend getting a second opinion before allowing your dentist to replace your porcelain veneer with a crown. A second opinion can help you feel confident about your treatment choice.

Several reasons for concern are:

  • Matching the Crown to Your Veneers – Matching a dental crown to surrounding veneers is challenging for most dentists. Perhaps 2% of dentists have advanced cosmetic dentistry training and experience to do it.
  • Determining Treatment Based on Cavity Size—A dentist should only recommend replacing a porcelain veneer with a crown for a cavity if the cavity is large. In that case, removing the decay may require removing so much tooth structure that the tooth cannot retain a porcelain veneer. If the cavity is on the edge of your tooth, your dentist may not have the training or equipment to fill the cavity. Preparing a tooth for a dental crown will require grinding it on all sides to ensure it fits over it.
  • Your Dentist’s Experience = Most family and general dentists don’t do cosmetic dentistry often enough to skillfully remove a cavity from a porcelain veneer tooth. Often, the dentist will recommend a crown instead because they are more comfortable with crown placement.

We cannot say that your dentist’s treatment recommendation is wrong. However, if you are uncomfortable with replacing your porcelain veneers with a crown, get a second opinion from an advanced cosmetic dentist. Search online for cosmetic dentists, look at their bios on their websites, and check for extensive post-graduate training in cosmetic dentistry.

It is unusual to get a cavity on a porcelain veneer tooth because it covers the front of the tooth. Floss diligently between your teeth and limit snacking. You may also want a cosmetic dentist to check the quality of the bond between your tooth and the porcelain veneer.

Lowell, Massachusetts, accredited cosmetic dentist Dr. Michael Szarek sponsors this post. Read how Dr. Szarek strives to give his patients the best dental care in Lowell.

 

Can I Get Oversized Dental Crowns Replaced with Veneers?

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My new dentist replaced four old crowns on my front teeth in June, but they were too thick and too big. She redid the crowns, but they were still oversized and uncomfortable. The crowns make my lips protrude. Although my dentist says she is willing to try again, I’m done and want to switch dentists. Can I get the oversized crowns replaced with veneers? Thank you. Darlene from Mobile, AL

Darlene,

Thank you for your question. We understand your frustration. Dr. Szarek would need to examine your crowns to determine when they are so bulky, but we will answer your question about switching from dental crowns to veneers.

Can You Replace Oversized Dental Crowns with Veneers?

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

Porcelain veneers bond to fronts of teeth, but dental crowns cover the entire tooth

You are unable to replace dental crowns with porcelain veneers. Preparing a tooth for a crown requires shaving it down every side of the tooth—making it too small to support a porcelain veneer. In contrast, tooth preparation for porcelain veneers is different. Sometimes, veneers do not require any preparation at all. When a skilled dentist must prepare your teeth for veneers, they will only remove a fraction of a millimeter from the front of each affected tooth.

Your teeth are already prepared for dental crowns, and insufficient tooth structure is left to support porcelain veneers. Also, veneers would leave the backs of your shaved-down teeth exposed and susceptible to decay. You can only replace dental crowns with new crowns.

Get a Second Opinion

Although a cosmetic dentist can only replace your existing crowns with new ones, you do not need to repeat an unpleasant experience with another dentist. Please look for dentists with post-graduate training in cosmetic dentistry and years of experience practicing the art.

Tips on selecting a dentist:

  • Read the dentist’s patients’ reviews. If you cannot find any reviews, be cautious.
  • Schedule a consultation with one or two advanced cosmetic dentists to discuss how to resolve your concerns.
  • Ask to see before-and-after patient photos of the dentist’s experience with crowns.

An experienced cosmetic dentist can replace your crowns and make them look natural.

 

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

My dentist is violating my tooth-extraction rights

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I asked my dentist for teeth whitening, but he doesn’t want to do it because he recommends a root canal and crown on a second molar. My point is that teeth whitening is much cheaper. If I can’t afford a root canal and crown, why should I do it? I have dental insurance, but it will only cover half of the cost. And then if the root canal doesn’t work, my dentist will have to extract the tooth anyway? Why not just get rid of the tooth, eliminate the future problems, and whiten my teeth? I’m thinking about switching dentists. – London

London,

Thank you for your question. We understand your concerns about your budget and want to improve your smile without creating debt.

Extracting a second molar tooth

Extracting a second molar tooth causes the least complications. A second molar does not have a tooth behind it that will drift after the extraction.

Some facts to consider:

  • Lower second molar – The upper molar opposite to the tooth you want your dentist to extract will have no tooth to meet it. It will begin to drift, bite into your gum, and eventually require extraction.
  • Chewing efficiency – If you have your premolars and front teeth, you can chew adequately without your upper and lower second molars.
  • First molar – If you later lose a first molar, it will disrupt your bit on that side of your mouth and reduce your chewing efficiency.

It’s Still Best to Save Your Teeth

But we understand your budget is limited. If your dentist is skilled with root canal treatment and crowns, the risk of it failing is minimal.

We recommend that you have another discussion with your dentist about the pros and cons of keeping the tooth or removing it. Ask about the urgency of root canal treatment and determine if you have a little time to save money. Some dentists offer no-interest financing that allows you to pay for care over time.

Photo of teeth whitening trays in a case, for information on DIY teeth whitening from Lowell, MA dentist Dr. Michael Szarek.

Resolve dental issues before whitening your teeth

If you and your dentist cannot reach an agreement, you can get a second opinion on your second molar and teeth whitening options. Some dentists offer free or discounted whitening to patients who keep regular dental cleaning and exam appointments.

 

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