I have had the dental crown placed on my implant three different times and none of them matched the adjacent teeth. My dentist said I’m being too picky and my tooth color is between A1 and A2 and I will never be satisfied. She’s refusing to do it again. I hinted I will try somewhere else and she said that puts my dental implant in danger of coming loose because she’s already removed the crown two other times. Now I’m worried. Am I stuck with mismatched teeth? I don’t want to risk the implant itself. Could I just whiten everything, crown included?
MaryAnne
Dear MaryAnne,
Using teeth whitening won’t help in this case. It will whiten your natural teeth, but the crown will stay the same shade, making the differences even more obvious. I’m very sorry that your dentist is treating you this way. She seems to be transferring her inability to match the crown for your dental implant to you. This isn’t your fault. Based on what you said, there are probably two problems going on with this. My first guess is this is a front tooth she’s trying to match. Those are trickier than others. Even top cosmetic dentists will do several try-ins before getting an exact match.
Notice I said try-in. There are temporary try-in pastes which allow you and the dentist to see what the dental crown will look like in place without using the permanent bonding materials that require her to grind your crown off every time you request a change. These are inexpensive. There are usually only two reasons a dentist doesn’t carry them. The first would be they don’t care what you think and will only look at it themselves. The second is they don’t know about it because they have not invested in cosmetic training, which has to be done in a post-doctoral setting. I believe your dentist falls into this latter category.
This leads me to her second problem. She’s just going by the standard Vita shade guides and expecting your tooth to be a perfect match. But, your teeth are between an A1 and A2. For back teeth, her method would work fine. However, a front tooth gets all the light when we smile, which shows the color and variations in striking clarity. The standard shade guide isn’t enough.
This is an example of a color map a cosmetic dentist will send to the ceramist. Yes, it will have the basic shade, but there are also instructions for different tints to go in a variety of sections on the tooth, which changes the visual perception of the color. Our natural teeth aren’t one flat color. There are differences in opacity throughout the tooth. This is how you get a tooth to look natural and perfectly match its neighbor.
The truth is your dentist is in over her head. Ask for a partial refund and go elsewhere to get it done. See if you have an AACD accredited dentist in your state. They’re at the top of their field.
This blog is brought to you by Philadelphia Cosmetic Dentist Dr. Michael WEiss.