Archive for January, 2010

Question about using crowns instead of porcelain veneers in a smile makeover

Saturday, January 30th, 2010

I have a question about my recent smile makeover. I thought the dentist would use porcelain veneers, but the porcelain goes all the way around my teeth. Are these actually porcelain crowns? Is it normal to use crowns for a procedure done for purely cosmetic reasons? My teeth were discolored, but otherwise sound. Since the makeover, I’ve seen a couple of the dentists in the office where my kids get their routine care, and they say the use of crowns for this situation is normal, and seem very impressed with the work. What is your opinion?

Bruce in Newark

Dear Bruce,

There is not a rigid definition of when a veneer becomes a crown—the difference between a crown and a veneer is a matter of degree only. Both take about the same amount of work to place, and the fees are often the same or very close to it.

In terms of use in a smile makeover, it is not at all unusual to see crowns used in place of veneers on the front teeth. Your dentist may have had several different reasons for using crowns rather than veneers. You state that your teeth were sound, so it could have been done to control your bite.

I am a little surprised that your dentist did not explain his treatment plan to you before you had the work done. When you ask about this—and I do suggest that you ask, for your own peace of mind—I would expect there to be a good reason for going with a more aggressive form of treatment. Most cosmetic dentists will choose the most conservative treatment plan available to meet their ends, and porcelain veneers are definitely more conservative than crowns. For dental crowns, your natural teeth must be substantially reduced, while for veneers, only a thin shaving of the front surface of your teeth is necessary.

Timing of dental implant after extraction.

Monday, January 18th, 2010

I have to have one of my molars removed, because it has decay that is below my gumline. Both my regular dentist and the specialist he sent me to assure me that the tooth can not be saved, and so we have to remove it. I am on a fixed income, and all of this is very expensive. How long can I stall before I have to get a dental implant?

Augustus in Little Rock

Dear Augustus,

You shouldn’t wait TOO long. Within a couple of weeks, the teeth that surround the empty socket will begin to “drift” into the space. Our teeth move naturally to touch their neighbors, and to meet another tooth when you bite down. This phenomenon will also cause the tooth that should meet the now-missing tooth in the opposite jaw to super-erupt (grow to try and reach the missing tooth). All of this movement can seriously disrupt your bite, which in turn could lead to TMJ problems. All of these problems will add to your costs to correct if you let the situation get out of hand.

You’ve made a good choice to go with a dental implant to replace your tooth, but in the meantime you are going to need some kind of temporary tooth to act as a placeholder. Your dentist should fit you with a temporary partial denture (called a flipper).

Your dentist won’t be able to place the root form for the dental implant until the area is free of infection and fully healed. After that, the root form will need several weeks at least to become fully fused with the bone of your jaw, and only then can the permanent tooth be fixed to the root form.