I have porcelain veneers and one of my teeth has a cavity. My dentist wants to remove the porcelain veneer, treat the cavity, and then replace the veneer with a dental crown. I am not too keen on this idea and wondered if it was the standard operating procedure for someone in my situation? It is a front tooth, so it is important to me it looks good.
Malorie
Dear Malorie,
If I were in your place, I would recommend you get a second opinion. A crown is a much more aggressive treatment than I think you need. Your cavity would have to be rather substantial in order to justify it. I would think you would need about 1/3 of the tooth to be overrun with decay in order to make it a valid treatment option. If it is just some small decay, why would he recommend a dental crown instead of a porcelain veneer?
Generally, when a dentist is suggesting a less than ideal treatment, it is because they are not comfortable doing the better option. Unfortunately, this does not directly translate to them being able to provide you with a beautiful dental crown that matches your porcelain veneers. In fact, I would estimate that only 1-2% of dentists are actually able to match a single crown to the adjacent teeth in a way that looks attractive and blends naturally.
Getting a Second Opinion
When you go to get that second opinion, you want make certain of two things. The first is that the dentist you go to for your second opinion is in that 1-2% category of dentists who can provide a beautiful result and have the skills to do things well. In order to find a qualified cosmetic dentist, I would look for someone who is accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the best cosmetic dentists in the world.
The second consideration is that it is a blind second opinion. Many dentists know each other. They are peers. You don’t want the dentist who is giving you the second opinion feel conflicted because telling you the truth would mean saying his friend is wrong.
Because of that complication, I always recommend you ask for their opinion without them knowing who it was that did the work to begin with or what their diagnosis was. Be open with them about wanting an unbiased opinion if they ask who your dentist is. They should not have a problem with that.
This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael Weiss.