My Gums Are Inflamed and My Front-Tooth Crown Is Still Too Dark

After multiple attempts, my dentist still can’t get the color right for my front tooth. It’s still too dark. I’m concerned because my gums around the crown are inflamed. I want to tell my dentist which materials I prefer for a better match. What should I ask for? Thanks. Bethany from CT

Bethany,

Most dentists are skilled at function and repair, but only a few have the artistic eye needed to create natural-looking results. These dentists are proud of their work and typically showcase it in a smile gallery on their website. When evaluating a dentist, take time to review those photos for their beauty and naturalness.

Why Be Cautious About Affordable Dentistry?

If a dental practice’s website emphasizes affordability or being an insurance-friendly office, proceed with caution. High-quality cosmetic dentists usually avoid discount insurance networks. That’s because creating a beautiful smile requires the best materials, the best labs, and attention to detail that is impossible to achieve with deep insurance discounts. At most, excellent cosmetic dentists will work with one or two insurance plans, and many of the best avoid them altogether.

Which Porcelain Veneer or Crown Materials Are Best?

It’s natural to ask which dental crown or veneer material is best. However, an advanced cosmetic dentist can produce excellent results with a variety of quality materials, including:

• Layered zirconia
• max (lithium disilicate)
• Feldspathic porcelain

A skilled cosmetic dentist and a talented ceramist can make any of these look beautiful. Think of it like choosing an artist. You would judge them by the quality of their work, not the brand of paint used. The same is true here: focus on the artistry, not just the material.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist, sponsors this post.

My Dental Crown Cracked

For the past 12 years, I’ve had porcelain crowns on my front teeth. I’m wearing braces at age 42, and one of the crowns I knew was somewhat defective. It has a horizontal fracture near the bottom that is getting more noticeable. I am concerned that the crown will break. Is it urgent to get it fixed, or can it wait? I’m hoping that it won’t prolong my ortho treatment. Thanks. Viet from San Diego

Viet,

The fracture will likely eventually break, so it’s wise to get the crown replaced before it becomes an emergency. A broken crown will leave your tooth unprotected and susceptible to breaking.

Cracks or Craze Lines in Crowns

Small cracks or craze lines in teeth or ceramic crowns are not usually a significant concern. However, if you can see the crack, it is progressing. A cosmetic dentist will examine your teeth and crowns and decide if only the cracked one—or all your crowns—require replacement.

If only one crown is replaced, expert color-matching is needed for the existing crowns and your natural teeth. An advanced cosmetic who understands how to manipulate ceramic crowns to match your natural tooth shade and clarity won’t unnecessarily recommend replacing all your crowns. Be cautious with a dentist who tells you that replacing all your crowns is the only way to achieve a match. It means that the dentist doesn’t know how to achieve a match.

What Happens If a Crown Breaks While You’re Wearing Braces?

If your crown breaks and you’re in the middle of orthodontic treatment, your treatment will be somewhat interrupted while you get new crowns. Generally, it takes two visits to get new crowns.

• First visit – Your dentist will prepare your tooth and take digital impressions for a custom crown.
• Waiting period – Your dentist will send the impressions and instructions to a dental ceramist to make a custom crown. It takes about two weeks.
• Second visit – You will return to the office for your dentist to cement the crown to your tooth.

The delay should not significantly lengthen your treatment. orthodontist how getting new crowns will affect your treatment.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist and Diplomate of the International Congress of Oral Implantologists, sponsors this post.

My Tooth Crown Fell Off Four Times

Although our family has had the same dentist for over 15 years, I have given up on my dentist because my crown won’t stay on. I first received a crown for my lower left second molar after a root canal in 2009. My dentist replaced the crown in March 2022. Over the past year, the crown has come off four times. The fourth time it came off was two weeks ago, and I decided not to return to my dentist. I knew I couldn’t leave my tooth bare, so I found an emergency dentist who re-cemented it. She wants me to return to her so she can determine why the crown repeatedly falls off. I’m not sure what to ask or what to do. This ordeal is making me nervous. I wish it would go away, but I know better. I would like to know why the crown keeps coming off. – Thanks. Dakota from NJ

Dakota,

Dr. Michalski would need to examine your crown and tooth to determine why the crown keeps falling off.

Why Does a Dental Crown Fall Off?

If a crown repeatedly falls off, the issue is likely with how your dentist prepared your natural tooth for the crown—not the strength of the cement or bonding. If that is the case, you need a new crown.

When a tooth has a root canal and little structure remains to support a crown, a dentist needs a specific technique to ensure the crown is secure. Although a dentist who understands how to resolve the issue might have a slightly different approach, the process generally includes the following:

• Place and cement a semi-flexible fiberglass post deep into the canal, about 2/3 the length of the tooth
• Bond core material to the tooth and the fiberglass post
• Bond the post into the canal with composite.

The composite builds the core for the crown preparation. This method works because some tooth structure remains. But if a tooth breaks off at the gumline, a post alone will not work. Twisting stresses on the post from daily oral function will dislodge the post, and the crown will keep falling off.

If the dentist with whom you had an emergency visit has advanced cosmetic dentistry training, you may check her patient reviews to decide if you want her to complete the work. Otherwise, look for a dentist with advanced cosmetic training. Talk to the dentist about your increasing anxiety and get details on sedation options to calm you during treatment.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist, sponsors this post.

Will I Need a Tooth Implant If My Dental Crown Fractured?

One of my four porcelain crowns cracked, and I would like to know if it is an emergency and whether I will need a tooth implant. The tooth is my left lateral incisor; I’ve had a crown on it since 2002. I do not want to jeopardize my tooth and need a dental implant. The fracture is near the bottom. I took pictures of the crack when I first noticed it, and it’s more noticeable than it was a few months ago.  I do not want it to break while I am out of town visiting my mom for two weeks. The other issue is that I have a new dentist whom I have only seen for cleanings and exams. I’m unsure if I want this practice to do any cosmetic work on my teeth. Is my fractured crown an emergency? – Thank you. Ellis from MI

 

Ellis,

Thank you for your question.

Is a Fractured Dental Crown an Emergency?

A fractured crown is not an emergency that immediately jeopardizes your tooth. Thin fractures (craze lines) in teeth or crowns usually affect only the tooth enamel. However, if you can see the fracture and it is more visible than before, it may worsen. And the crown will eventually break completely.

Do You Need a Tooth Implant if a Crown Breaks?

You do not automatically need a tooth implant if a crown breaks. However, if you leave the tooth unprotected for an extended period, your natural tooth might weaken and break. A cosmetic dentist will examine and x-ray your tooth and look for any signs of damage. Unless you experienced trauma or internal damage to the tooth and the tooth is unsavable, you don’t need a tooth implant.

Get a Dental Crown Second Opinion

You are wise not to trust a dentist whose cosmetic work you haven’t experienced or seen. We recommend scheduling an appointment with an advanced cosmetic dentist to replace the crown. If you are concerned about the crown while out of town, consider seeing a cosmetic dentist as soon as possible. It usually takes about two weeks to get a new crown.

Replacing one crown requires a dentist to have the color-matching skill to ensure the replacement matches your natural teeth and other crowns. Color-matching is a challenge for many dentists, who seldom admit when they do not have the skill.

If you must delay a dental visit and anything happens to your crown while out of town, look for an accredited cosmetic dentist or one with advanced cosmetic dentistry training. Look at dentists’ websites for a smile gallery of before-and-after photos of crowns on front teeth. You can prevent the need for a tooth implant by getting an experienced dentist to examine the condition of your crown and tooth promptly.

 

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist and Diplomate of the International Congress of Oral Implantologist, sponsors this post. Read how Dr. Michalski strives to provide patients with some of the best dental care in Rocky Hill.

How Much Dental Work Can I Get In One Visit?

Hi. I really don’t like going to the dentist. I want to finish dental work without too many dental appointments. I need two crowns and three root canals, and I want to get my teeth whitened. I put off the root canals and crowns for over a year. My dentist wants me to spread the treatment over two months, but I would like this done all at once. I don’t like a dentist who has me return unnecessarily. Can I get all this work done on the same day, or am I not being reasonable? – Ken from Reno, NV

Ken – Thank you for your question. We understand your concerns about minimizing dental visits and maximizing your time in the dental chair.

How Much Dental Work Can You Get in One Visit?

How much dental work you can get in one visit depends on several factors, including:

• The type of procedure
• Procedure complexity
• Extent of the work required
• Condition of your teeth
• Your oral health
• Your physical health
• Your dentist’s experience, skills, and recommendations
• Whether you get dental sedation and the type of sedation

How Does Sedation Dentistry Help a Dentist Accomplish More?

Sedation can help a dentist accomplish more work than without sedation for these reasons:

• You are relaxed – A patient’s anxiety, gag reflex, or inability to relax can limit how much work a dentist completes in one visit. However, dental sedation calms you and allows a dentist to proceed with treatment.
• Your dentist can focus – Your relaxed state allows the dentist to focus on your care while monitoring your vital signs during sedation.
• Decrease pain sensitivity – The American Dental Association confirms that using sedation for complex treatments can ease pain and anxiety.

Can You Get Teeth Whitening and Crowns on the Same Day?

A dentist must complete teeth whitening before placing dental crowns. Your dentist will want to ensure the crowns match your whitened teeth. It can take a week or two for your tooth color to stabilize after whitening.

Speak with your dentist regarding your concerns about minimizing your visits and making your visits as productive as possible. Ask your dentist about sedation for your procedures, too. Consider getting a second opinion from an advanced cosmetic dentist if necessary.

Dr. Thaddeus Michalski, a Rocky Hill, Connecticut dentist and Diplomate of the International Congress of Oral Implantologists, sponsors this post.

 

What Are Treatment Options for a Teen’s Chipped Teeth?

My 14-year-old daughter’s front teeth are chipped from an accident. They are her permanent teeth, so our options are limited. At 14, she may have another growth spurt. Are veneers or bonding the only options for her chipped teeth? Thank you. Danielle

Danielle,

Thank you for your question. You are correct that veneers or bonding are the options for permanent teeth unless the tooth is severely damaged.

What Are the Treatment Options for Chipped Teeth?

For a teenager who is still growing, dental bonding is the preferred option for minor chipped teeth. When a large portion of a tooth is missing, a dentist will x-ray it for internal damage and determine whether the tooth needs a dental crown to protect it. A skilled cosmetic dentist can conceal the chips with these steps:

• Clean the teeth
• Roughen the surfaces
• Etch the teeth and apply a bonding agent
• Select and blend dental composites that match the teeth
• Apply and shape layers of composite on each tooth
• Harden the composite
• Reshape and polish the composite to match the surrounding natural teeth

Cosmetic dentists can restore chipped teeth with dental bonding while patients sit in the dental chair. Bonding strengthens teeth because, according to the American Dental Association, tooth enamel and bonding fuse. The seamless bond will look completely natural.

How Long Will Dental Bonding Last?

Quality dental bonding placed by a cosmetic dentist lasts an average of five years. As the bonding wears, a dentist will eventually need to replace it. If your daughter takes care of the bonding and sees a cosmetic dentist to refresh it and remove stains.

What About Porcelain Veneers for Teenagers?

Porcelain veneers can restore chipped teeth, but dental bonding is more practical for a growing teenager whose jaw is still growing. A dentist would need to replace the veneers when the jaw and tooth are complete, and each veneer costs over $1,000.

Will Dental Insurance Pay to Repair a Chipped Tooth?

Although dental insurance will not cover the entire cost of dental bonding, it may provide some coverage. Contact your dental insurance company to ask about plan benefits.

Schedule a consultation with a cosmetic dentist who treats children.

Rocky Hill, Connecticut, cosmetic dentist Dr. Thaddeus Michalski sponsors this post.