Archive for August, 2010

Porcelain crowns for a smile makeover?

Tuesday, August 31st, 2010

This may seem like it is coming after the fact, but I am curious about something. I recently had a smile makeover done. I thought I was going to have all porcelain veneers placed, but when I look at the backs of my teeth, it looks like the porcelain goes all the way around. Is it normal to place porcelain crowns instead of porcelain veneers for purely cosmetic reasons? I thought crowns were just for teeth that were damaged. I guess the reason this concerns me is that maybe my teeth were in worse shape than I though, if they needed crowns.

I’ve since seen my general dentist, and she seemed very impressed with the work, so I am not concerned about the quality of the workmanship. Is this standard, to have crowns instead of veneers for a cosmetic smile makeover?

Thanks for your insight,

Ben in Oregon

Dear Ben,

Porcelain crowns and veneers differ only in degree–there really is no specific line of demarcation where a veneer becomes a crown. The fee for a porcelain veneer is usually the same or nearly the same as that for a porcelain crown, because the effort to place each type of restoration is about the same.

It is actually quite common to see porcelain crowns used on the front teeth for cosmetic reasons rather than protective ones. If your teeth were not weakened or damaged, your dentist might have decided to go with crowns to control your bite.

It is surprising that the dentist did not discuss this in detail with you during the course of your treatment. Typically, smile makeovers involve a great deal of give and take between the dentist and the patient, because the dentist will want to make absolutely sure he or she knows exactly what the patient wants.

The simplest solution is simply to ask your cosmetic dentist why he decided to go with porcelain crowns rather than veneers. Crowns are the more aggressive form of treatment, and require more reduction of the natural tooth structure. Veneers require only a little bit of shaving on the front of the tooth. For that reason alone, I would expect your dentist to have a sound reasoning for choosing the crowns. Most dentists will always pursue the least aggressive form of treatment and strive to preserve as much of the natural tooth structure as possible.

My six year old son’s teeth are in bad shape

Wednesday, August 18th, 2010

My son is six years old. I’ve just started to research dental information to address some serious problems with his teeth.

He has at least four cavities that I can see. Two of them are small in diameter, but seem to be quite deep, and two other teeth have actually started to chip away from the decay. I’m afraid there may be more, but he won’t let me get a really good look in his mouth to tell.

What are my options with these kinds of problems? I really don’t want to have any teeth pulled if we can possibly avoid it. They are all molars, and from what I have read so far that could really screw up the alignment of his teeth later on. Can they do some kind of porcelain crowns or white fillings? I don’t want them to look bad and make him embarrassed, either. I’ve read that with kids they often do some kind of metal crown, but those are so ugly!

I also wanted to ask about sleep dentistry (also called sedation dentistry). I think I am going to have to locate someone who does this kind of dentistry, because my son just will not open his mouth for the dentist or the hygienist. We’ve tried three different dentists with no luck. I was hoping he would mature enough to cooperate, but we just can’t wait any longer.

I appreciate your help,

Maranda in New Brunswick

Dear Maranda,

You’ll want to find a pediatric dentist who also performs sedation dentistry. I think you are correct in saying that you simply cannot put of your son’s dental care any longer.

You are also correct that removing the molars without also putting in some kind of space holder will cause a lot of problems down the road. Those molars are also important in helping him eat, so ideally your dentist will try to salvage the teeth rather than extracting them. In pediatric dentistry, much of the work is often geared toward short term maintenance and temporary fixes, because those teeth will not remain in place forever. Usually they will place a stainless steal crown, but if you are adamantly opposed to the steel, your dentist can work with you to find a suitable material.

Another issue that must be addressed is the eating pattern that probably produced this kind of severe decay in such a young child. The kind of decay you’ve described is caused by constant eating. If you want to put a stop to these kinds of serious dental problems, you’ll have to put a stop to the eating habits that produce them.