Replacing all Crowns because of One?

I had crowns placed on all my front teeth about 17 years ago. Since then, my dentist passed away. I’ve been happy with his replacement, up until now. One of my porcelain crowns started to feel loose. I looked at it closely and there’s a dark spot on the top edge. I went to see the dentist. He said there’s decay at the edge and the crown needs to be replaced. But, (and here’s the catch) he says I have to replace all of them if I want them to match. That’s a LOT of money. Is that really necessary or can I wait until they need replacing individually?

Mara Lynn

Dear Mara Lynn,

Side by Side images of dental crowns done by two different cosmetic dentists on the same smile. One is ugly. One is beautiful

Believe it or not, the images above are of the same smile. In both pictures the patient had dental crowns placed. The only difference was the quality of the cosmetic dentist she used. I’m guessing your current dentist is more like the one on the left. He’s not a cosmetic-oriented practice, therefore his skill is limited.

It sounds like the margins on your porcelain crown opened, leaving a little ledge ideal for the development of decay. At the very least, the one with the decay needs to be replaced.

When your current dentist says your crowns won’t match if he doesn’t re-do all of them at the same time, he not lying to you. He’s admitting the limitations of his skill. In this case, you have two choices.

Choosing a Cosmetic Dentist to Re-do Your Smile

  • Just replace the crowns as needed to save money.

You’ll definitely need a new cosmetic dentist in order to do it this way. A good cosmetic dentist CAN just match one crown to the rest of your teeth. They won’t need to do the entire arch. The first thing I’d do, though, is check all the crowns for suspicious marks and open margins. You’ll want to replace any of those at this go-round before they turn into decay. After that, it’s fine to just change them as you need to.

  • Replace them all at once to save time

Even though this is what your dentist suggested, he did it for the wrong reasons— to cover his lack of cosmetic skill. Because of that, I’m not sure you’d be happy with his results. I believe you’d be better served with another dentist in this case as well.

The top cosmetic dentists in the country are those who’ve reached the accreditation level of the American Academy of Cosmetic Dentistry (AACD). AACD accredited dentists create beautiful smiles. In fact, most of them even have a beautiful smile guarantee.

On a side note, you’ll be much more comfortable using sedation dentistry to have that much work done in one sitting. You can simply go to sleep (if you want to) and when you wake up all the work is done.

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