I have had crowns on all my front teeth for over a decade. When I stop and think about it, the cosmetic dentist that placed them probably did it closer to 15 years ago now. I think they’ve managed to hold up well over the years. But I noticed that one of them feels like there is some movement when I push my tongue on it. I’ve never experienced this before. So, I made an appointment with a new cosmetic dentist in my area, since I’ve moved after the original treatment was done. He told me that there is some decay on the tooth underneath the crown and that it needs to be redone. Then, he was telling me that I really should just have all my crowns redone so they match well and look uniform. I in now way anticipated spending this kind of money for one wiggly crown! But I don’t want to look funny and have mismatched teeth. Do you think I really need to have the dentist do all of them over?
-Timothy in Nevada
The first question that comes to mind is about the dentist you chose. Is this dentist a true cosmetic dentist, one that focuses on mostly cosmetic dentistry? There is a fundamental difference between a general dentist and a cosmetic dentist, although there is no recognized specialty area for cosmetic dentistry in the field. Think of it like this. A general dentist is trained to fix things, like a fundamental problem. But a cosmetic dentist that has undergone additional cosmetic dentistry training and coursework will go way beyond that. An excellent cosmetic dentist will not only want to achieve the functionality of the problem, but will make your cosmetic dentistry work look natural, beautiful and lifelike. They have an eye for aesthetics that you may not find from a general dentist.
The response you are questioning about having all your porcelain crowns replaced versus the one crown on the tooth that is showing decay, leads me to believe that this new cosmetic dentist may not have the ability and skill set to successfully match it to the surrounding teeth. An expert cosmetic dentist will absolutely be able to blend in the tooth and will not necessarily recommend that the neighboring crowns be redone for aesthetic purposes. Now, if there is a functional problem with another crown, that is a different story. But it doesn’t sound like that is the what is going on here.
So you may want to proceed with caution or possibly seek an opinion from another cosmetic dentist to see if the same recommendations are made. Another thing to consider is that after 15 years, you may be approaching the end of the lifespan for your crowns. Now, you don’t need to have them done all at once for budgetary reasons. But when you find the right cosmetic dentist, it may be in your best interest to have them evaluated to make a plan for possible replacement. If there are issues with the margins or you can start to see edges of the crowns, you may be a candidate to have them replaced.
It sounds like at the very least, you may want to have a conversation with the new dentist about the other crowns. Try to determine if he is concerned about the functionality of your other crowns. Also, ask him about his portfolio of work on other crowns he has done on the front teeth. Take a look and see how you feel about the quality of his work and if the crowns are beautiful and natural-looking.
The moral of the story is that finding the right dentist is of utmost importance. So as long as you aren’t in pain, you may have a little time to explore your options.
Thank you for your question.
This post is sponsored by Barrington cosmetic dentist James T. Gavrilos, DDS.