I had to have a dental implant on a front tooth. The dental implant itself is fine. The crown, however, is an entirely different story. We’ve done three different crowns and none of them have matched the teeth next to it. My dentist said I don’t have teeth that go with the dental colors. Apparently, my teeth are between an A1 and A2. I really don’t like how different my two front teeth look. My dentist is frustrated with me and said I should be grateful I have a tooth that is close. She feels I am being unreasonable. Am I? I thought it was possible to match front teeth. When I asked if we could try just one more time, she said I could damage the dental implant if I keep trying. I”m not sure what to do at this point.

Kristin

Dear Kristin,

I do not like that your dentist is pushing her lack of ability onto you as being unreasonable. Of course, you would want your two front teeth to match. While it is very likely your teeth are between two shades, that doesn’t mean you cannot have an exact match of your teeth. Those shade guides she is using will give a very close match. That is good enough if you are doing dental crowns on just about any tooth except the front teeth.

Front teeth are especially tricky. This is because they are completely exposed to the light when you smile. This shows them in much more detail. An exact match is necessary or your front teeth will look strange, which you have, unfortunately, discovered for yourself.

If you look at the image directly left, this is what true cosmetic dentists use to help the lab get an exact match to your teeth. First, they’ll use the basic shade guide, such as the A1 or A2. From there, your dentist will have to map out where to put various tints to create the perfect shade on your porcelain crown. When done with expertise and artistry, no one will be able to tell the implant crown from your natural tooth.

I don’t think you are going to get the result you need from this dentist. Because the implant seems fine, I suggest asking for a refund on the dental crown only. She hasn’t been able to give you a crown that matches your teeth. Then, I want you to go to an expert cosmetic dentist. One way you can find an expert cosmetic dentist in your area is to use the mynewsmile.com website. They have a “Find a Cosmetic Dentist” link. You input your zip code and how far you are willing to travel and they will give you a list of dentists who are true artists. Any one of them will give you a crown that matches your adjacent tooth exactly.

As far as your dental implant being at risk, if your dentist did that correctly, you shouldn’t have any problem. Though, here again, she is showing her lack of knowledge of cosmetic dentistry. The best cosmetic dentists know that the patient needs to see the work and approve it before it is permanently bonded onto the tooth. They do this using a temporary try-in paste. You’d get to see the crown in various lightings in order to be certain you are pleased with the result. Only then will it be bonded on permanently.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.