I’m trying to figure out what to do to improve my smile. I have one crown and three porcelain veneers on my front teeth, and I’ve had them for decades. Now, I’ve noticed that the gum tissue seems to be receding around the crown and one of the veneers is chipped. So, it’s time to do something. I have also been dealing with dry mouth, which has seemed to get worse over the last couple years.
When I talked to my dentist about what was going on, he is recommending I get a full-mouth reconstruction which would mean all of my teeth would be crowns. He said that this will help them all be white. I was originally thinking I’d get the five front teeth done with crowns, and that would be enogh. However, I am wondering if my dry mouth is getting worse and that if getting all those crowns would only make it worse. So, I was wondering if porcelain veneers would work better to help prevent the dry mouth. Then, I’d only need to replace the one crown where the gums are receding around it.
I am no expert, so I am hoping to get some more input. I am wondering if porcelain crowns are indeed the best option for me.
– Dave in Michigan
Thank you so much for reaching out before you moved forward with any of this dentist’s recommendations. Let me first say that it is difficult to give you specific, individualized recommendations without having seen you in person. However, the treatment plan this dentist is proposing is quite alarming! A full-mouth reconstruction (crowns on all your teeth) is an extremely aggressive treatment plan. Also, it sounds like your primary goal is to get whiter teeth. There are other options to improve the appearance of your teeth. As you know, there is a lot of preparation required to place crowns, which sit over top of the prepared tooth. If your teeth are otherwise healthy, than you would not want to get crowns on them, especially for the purpose of making them whiter. Unfortunately, it does not sound like it is in your best interest to stay with this dentist. It may simply be that he is not comfortable with other cosmetic dentistry techniques, and knows how to do crowns, so that is what he is recommending.
It would wise to seek another opinion or two from reputable cosmetic dentists in your area. Typically, teeth whitening should be considered when a patient is requesting whiter teeth. Sadly, teeth whitening is a few hundred dollars at most and crowns on all your teeth has the potential to be in upward of $30-60,000! Please let us emphasize that we are not accusing this dentist of trying to turn a profit. But, it is something worth considering. Maybe there is additional clinical information that is going on with your case that would actually warrant such am extreme plan.
Another thing to consider is that it takes a very high skill level to successfully perform a full-mouth reconstruction. There are all types of issues to consider since the dentist is essentially rebuilding your entire set of teeth. This will affect your speech, how you eat, your bite and also your appearance. There are many complications that are possible if it isn’t done properly including TMJ disorder, lip incompetence or facial pain.
Another indicator that it would be wise to keep looking for the right dentist is that he wants to replace your porcelain veneers with porcelain crowns. When a dentist makes a recommendation like that, it is likely that he isn’t comfortable doing porcelain veneers. When porcelain veneers are done by an expert cosmetic dentist, they can be made to blend in perfectly with your natural teeth, as well as porcelain crowns.
It takes extensive training beyond dental school to do beautiful cosmetic dentistry work. Cosmetic dentistry techniques are not taught in dental school and require extensive training beyond that. There is a fundamental mindset difference between general dentists and cosmetic dentists too. A general dentist is trained to fix a certain problem. Whereas an excellent cosmetic dentist is passionate about how it will look. They want you to love your new smile and want nothing less than for you to love it. The hard part for patients is that there is not a designated specialty area within dentistry for cosmetic dentistry. So, it is difficult for a patient to know when a dentist may be pushed out of their comfort zone. Virtually, any dentist can make the claim to be a cosmetic dentist.
Most ethical dentists will want to sustain as much of your natural tooth structure as possible when making treatment recommendations. So, for discoloration, the first logical treatment to consider is whitening the teeth with bleaching. If the discoloration is severe, or is from tetracycline stains, than porcelain veneers may be an option. But, to recommend grinding down all your natural tooth structure for crowns is definitely an extreme.
You mentioned that you are also dealing with dry mouth. Moving forward with a mouth full of crowns may open your bite improperly and cause lip incompetence, which will in turn further the problems with dry mouth. Since you currently only have one crown, it is possible that there is another issue causing the dry mouth. That is difficult to diagnose since it could be from an underlying medical condition or even from stress. It is unlikely that the increase in your dry mouth is from a chipped porcelain veneer.
Thank you for reaching out. Please consider getting multiple independent opinions from experienced cosmetic dentists in your area before moving forward with any type of treatment.
This post is sponsored by Barrington cosmetic dentist James T. Gavrilos, DDS.