I practice general and cosmetic dentistry in North Palm Beach, but we serve Jupiter and Palm Beach Gardens. Frequently we get requests for replacement of old crowns. Up until 20 years ago, a cosmetic approach to unsightly front teeth was to place porcelain and metal crowns. The result was usually an improvement but it didn’t look natural. You could usually tell they were caps.
Take this week’s case for example. These are photos of a woman who had her teeth capped about 22 years ago. To top it off they were not all done at the same time. You probably notice that the 2 front teeth are different shapes. That can be very disconcerting. You see the brain senses when something doesn’t look right. The 2 front teeth are supposed to be mirror images of each other.
You’ll probably notice that the teeth are darker in the first photo. At the time these crowns were done that was the whitest shade that we had available. That was before people started bleaching their teeth. In fact if someone bleached their teeth and they broke one of their front teeth, the laboratories didn’t even have porcelain white enough to match bleached teeth. The manufacturers had to blend whiter shades.
Essentially the bar has been raised as far as what is an acceptable shade for front teeth.
She was unhappy with the shade and the shape of the crowns. After taking appropriate photos and xrays we decided on a course of treatment. We recommended that all 10 caps on the top be replaced with Empress all porcelain crowns. That way we could control the entire smile and make sure that all the teeth were the same color and shape.
Empress is a new type of porcelain that is stronger than the older traditional porcelain. In fact it was the material of choice when the ABC show ‘Extreme Makeover’ aired several years ago. We always preferred porcelain to porcelain and metal crowns but they were subject to fracture. With the advent of Empress, we are now able to offer natural looking crowns that are also as strong as porcelain and metal crowns.
We like all porcelain crowns because they reflect light like a natural tooth. You also may have noticed crowns with a black line at the gumline. This happens when gums recede and expose the metal collar under the the porcelain of a metal and porcelain crown.
Once we agreed on a plan of action, we were able to finish her case in 2 weeks. In fact, she looked this good at the end of her first appointment. We have new materials that help us provisionalize the teeth while we are waiting for the lab to finish the crowns. Incidentally, I only use dental labs that are local and in the United States. What most people don’t realize is that a lot of the cheaper crowns are being outsourced to China.
If you have a dental cosmetic question, please call my office for a complimentary consultation including digital photos. My office number is 694-1740. My website is www.drbilldentistry.com.