Botched Tetracycline Case

I’ve had tetracycline stains most of my life. Originally, I had some work done by having dental bonding done over them, but it was time to replace them. I’d since moved to another city and couldn’t see the original dentist. My new dentist suggested we do six dental crowns because it would “hide the stains better.” I did not do adequate research and just trusted what the dentist told me. Now I regret it. The crowns show the stains underneath, especially in fluorescent lighting. Plus, you can tell these are crowns because they look so different from the adjacent teeth.

What do I do here? He’s offered to send them back to the lab, but I’m not sure the results will get any better. Is it okay to ask for a refund?

Lannette

Dear Lannette,

Tetracycline stains are among the most difficlut cosmetic procedures to do. The stains are so dark and so deep, it takes real skill to get the repair opaque enough to cover the stains while still having that natural translucent look. Your dentist likely had good intentions but was in over his head.

Warning Signs He Didn’t Know What He Was Doing

First, he suggested porcelain crowns instead of porcelain veneers. This automatically shows he is not comfortable with cosmetic dentistry. Dental crowns, for this type of procedure, means unnecessarily grinding down healthy tooth structure.

Second, he suggested only six teeth. When we study in dental school we learn about front and back teeth. The first six are considered the front teeth. However, dentists who study cosmetic dentistry, do not divide things into anterior and posterior teeth. Instead, we talk about the aesthetic zone. This is the number of teeth visible when you smile. For most patients, that is eight to ten teeth. Not six.

With those adjacent teeth showing with the dark stains, it makes it obvious your front teeth are crowns.

I agree with you that this dentist is not going to be able to make it any better. I suggest you just ask for a refund. Then go to an experienced cosmetic dentist to do this. The best cosmetic dentists are AACD accredited, so I would look there. Unfortunately, once you have dental crowns placed you are stuck wtih crowns. The good news is an excellent cosmetic dentist can make them look natural and beautiful.

This blog is brought to you by Salam, MA Dentist Dr. Randall Burba.

I Need Root Canals after Porcelain Veneers

I had twelve upper and ten lower veneer crowns. My dentist told me there weren’t any risks in getting a smile makeover. I was fine during the temporaries, but when the permanent veneer crowns were placed, I started having pain. My dentist adjusted it at least five times before it stopped hurting. But, then a few weeks later I ended up with one of them abscessed. I had to have a root canal on the tooth. I asked him about this and he said that he doesn’t know what happened and I am just an unlucky one. Since then, this unlucky one has had to have five more root canal treatments on these teeth. What do I do? I am in complete agony.

Melissa

Dear Melissa,

I am glad you wrote. I want to clarify something first. There are porcelain veneers and there are porcelain crowns, but there is not something called veneer crowns. Unfortunately, there are some unethical dentists who place dental crowns and just call them veneers. One way to tell which one you received is by the tooth preparation your dentist did.

Tooth Preparation for Porcelain Veneers

When your teeth are prepared for porcelain veneers, there is very little tooth preparation necessary. Generally, your dentist will just remove the depth of a fingernail. The veneers themselves only cover the front of the tooth. It would be extremely rare for teeth prepared for veneers to need a root canal treatment, let alone the number you have had to have. My suspicion is that you have had dental crowns placed.

Tooth preparation for dental crowns

On the other hand, when a tooth is prepared for a dental crown, there is a great deal more tooth structure that is removed, as you can see from the image directly above. The crown will surround the entire tooth. It sounds like your dentist went even deeper than this based on your experiences.

If he told you that you received porcelain veneers but gave you porcelain crowns, he either lied or does not know his field well enough. Neither of those are great choices.

When a dentist is overly aggressive with tooth preparation it can lead to problems such as you are having. He needs to pay for the damage he caused. This is especially true because he told her there weren’t risks, when obviously there were.

Whenever possible, a smile makeover should be done with porcelain veneers instead of crowns because of the very risks you encountered, plus it is always better to save as much natural tooth structure as possible.

You’ll have to get any root canals done that are necessary in order to save your teeth.

I’m sorry this happened to you.

This blog is brought to you by Salem, MA Dentist Dr. Randall Burba.