porcelain crowns Archives - Dr. Duane Delaune's Blog

Why Did I Need Root Canal Treatments After Porcelain Veneers

Posted on June 4, 2021 by writeradmin.

I had ten veneers placed on my upper teeth and the same number placed on my bottom. During the diagnostic stage, I was told everything was fine and there were no real risks involved. Since the procedure, I’ve had a lot of pain. My dentist made a few height adjustments, but that did not seem to help. Then, two of the teeth developed an abscess and, when he did the x-rays, it showed my nerves have died, even though they were fine before. Now I have had to have root canal treatments. I’m still in pain and worried more of my nerves will die. My dentist said he’s never had this happen with veneer crowns. What is going on?

Jayla

Dear Jayla,

The first thing I am wondering about is whether you actually received dental crowns instead of porcelain veneers. There are a couple of things that make me things this. First, you called them veneer crowns. That is not a thing. Either you have porcelain veneers or you have dental crowns. There is not a combination. A second inconsistency here is the height adjustments that were made. That is something done with dental crowns. Finally, it is the damage to the nerves.

The Difference in Preparation between Crowns and Veneers

Tooth preparation for porcelain veneers

When a tooth is prepared for porcelain veneers, there is hardly any of the tooth structure removed. Here is an example in the image above. Notice only the surface is affected. Now contrast this with the image below.

Preparation for a Dental Crown

Notice with this tooth, much of the tooth structure had to be removed. It is a much more aggressive preparation and your nerves are at a greater risk as a result. I think this is the treatment you received.

One way to tell is by how far around the tooth your restoration is. With porcelain veneers, it just covers the very front of your teeth and will hug the sides slightly. But, with porcelain crowns, the restoration goes around your entire tooth, including the back.

If your dentist told you that you were getting porcelain veneers, but then gave you porcelain crowns, that is unethical. Plus, if the only reason for the restorations was a smile makeover, porcelain veneers are what you would do— not dental crowns. To be honest, I would tell your dentist he needs to cover the cost of the root canal treatments. I’m sorry this happened to you.

This blog is brought to you by New Orleans Cosmetic Dentist Dr. Duane Delaune.
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Retouching up Teeth Whitening

Posted on December 23, 2020 by writeradmin.

I need to get a dental crown on a front tooth. I know the color will be permanent so I want to retouch up my teeth whitening before settling on the color of the crown. Do you have any tips about how to go about this? Specifically, I am looking at how long I should whiten every day and for how many days.

Caroline

Dear Caroline,

Teeth whitening trays

I’m glad you wrote. I am curious though if your dentist was unable to advise you of this. The reason I ask is because placing a dental crown on a front tooth is much trickier than other dental crowns. It takes some expertise in cosmetic dentistry to do a crown properly on a front tooth. If he wasn’t able to answer the questions about teeth whitening, which does not require expertise, I am going to advise you to find a different dentist at least for the crown.

If it turns out that you do need to switch dentists in order to get a beautiful porcelain crown to match your other front teeth, I recommend you see someone who is recommended on the mynewsmile.com website. These dentists have all been prescreened and are among the top cosmetic dentists in the country.

Touching Up Teeth Whitening

In practice, it is up to you how long each day you leave on your teeth whitening trays. The longer you can leave them on each day, the faster they will whiten. But, if your teeth are sensitive and you can only do them a little bit each day, that is okay too. You will just have to do more days. The fastest would be to sleep in the trays if you can.

While there is no cut and dried rule for how many hours per day or days in general to whiten, there is a standard for how long to wait between the time you stop whitening and you go in for your dental crown. I would recommend giving it one week for the color to settle on your teeth before having the dentist create your dental crown.

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

Getting an Implant Crown to Match

Posted on November 28, 2020 by writeradmin.

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.

Gum Disease From Dental Crowns

Posted on November 3, 2020 by writeradmin.

I had to have two dental crowns on my front teeth because of an accident. Before this, my smile looked fine. These crowns not only look chunky and fake, but the gums have been inflamed for months. My dentist said he has no idea why they are inflamed and wondered if I’m brushing properly. I’ve been brushing my teeth for 45 years. I know how to do it. I visited a periodontist who thinks the crowns went too deep whatever that means. But, either way I have gum disease and need to have some surgery to make this right. What do I do?

Cade

Dear Cade,

You are facing a two-fold problem. The first one is fairly common. Ugly dental crowns is the result of a dentist who did not invest enough in developing their cosmetic dentistry skills. There isn’t a recognized specialty in cosmetic dentistry. As a result, it is up to the dentist how much training they get beyond dental school. Unfortunately, hardly any cosmetic work is taught in dental school, which focuses on the engineering side of things.

In most cases, this is where the problem ends. You have ugly dental crowns, but they are well made and well placed so they function well. Your issue goes one step further. Your dentist blew the general dentistry portion too. He violated the biological width, which means the crowns went too deep under the gums.

Because this has caused functional problems, this will work in your favor. Gum disease is serious and can cost you your teeth. I would like for you to ask for a refund on these crowns. From there, ask for them to pay for the repairs to your gums. They did this and should make it right. If you need gum surgery, you may want to look for a dentist who knows the pinhole technique which is suture free.

Now, when it comes to replacing these porcelain crowns, I want you to look on the mynewsmile.com website. They have a “Find a cosmetic dentist” link where you can input your zip code and how far you are willing to travel. They only recommend cosmetic dentists of the highest caliber. Any one of them will be able to provide you with beautiful, natural-looking crowns.

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

Porcelain Veneer Fell Off Twice

Posted on September 26, 2020 by writeradmin.

I had six porcelain veneers placed by Dr. [name redacted]. After four days, the left incisor fell off. I was only eating bread. The tooth was super sensitive from the moment the veneer fell off so I got an appointment at his office as soon as possible. He said it fell off because my bite was off so he shortened the veneer and the tooth beneath it. Less than a week later it fell off again, this time when I ate a banana. I was none too pleased, and again he said the bite was off so he wants to do a porcelain crown instead. I’m having serious doubts about this. Do you have an alternate recommendation?

Patrice

Dear Patrice,

My first suggestion is not to allow this dentist anywhere near your teeth. He is in over his head and doesn’t have the integrity to admit it. First, he says your porcelain veneer fell off because your bite was off. As the dentist, it was his responsibility to notice things like that before he bonds them on and make sure the veneers are crafted in a way the helps that.

However, I don’t buy that excuse. When a porcelain veneer is properly bonded on, the result will be a chipped porcelain veneer if there is a problem with the bite. It wouldn’t just fall off.

Doing smile makeovers isn’t taught in dental school. Compound that problem with cosmetic dentistry not being a recognized specialty and it puts patients in a real quandary. Any dentist can call themselves a cosmetic dentist regardless of the training they received. To do it well requires significant post-doctoral training. I don’t think your dentist has that training.

Now the second bonding falling off he’s also blaming on your bite being off. But, didn’t he already adjust that? Now he wants to destroy healthy tooth structure to place a dental crown? I don’t think so. That is a massive overtreatment.

I’m going to recommend you look on the mynewsmile.com website. The dentists listed there are prescreened for their technical training, skill, as well as the artistry of their work. Any one of them can properly bond on the veneer that keeps falling off.

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

type 1 diabetes & dental implants

Posted on December 14, 2019 by writeradmin.

If I have type 1 diabetes, is it still possible for me to get dental implants or am I not a candidate?

Ben

Dear Ben,

With diabetes, you can still get dental implants as long as your diabetes is under control. While it is not a contraindicator, it is a risk factor. A significant one, in fact.

One thing I highly suggest is you research your implant dentist very carefully. You need someone who has had significant post-doctoral training in dental implants. For instance, Dr. Delaune received the following training in dental implants.

Implantology training from the Zimmer Institute and Russo Seminars
Advanced dental implant training at the Medical University of South Carolina

You’ll want them to do all the diagnostic work possible and keep a close eye on everything throughout the process. Diabetics often have trouble healing so make sure they do extra checks on you during the healing process.

While some dentists will do the implant surgery themselves, others refer you out to an oral surgeon. Don’t make the mistake of seeing an oral surgeon before the dentist. You’ll want the dentist to have close communication with and surgeon to make sure they only place the implants where the dentist wants them.

If you’re going to have a mixture of your own teeth and dental implants, you’ll be more happy with your smile if you whiten your teeth beforehand.

Your dentist will place porcelain crowns on top of the implants. When he or she does that, the crowns can be matched to your natural teeth. However, once that color is made, it is permanent. You’ll want to make sure your teeth are the color you’ll want your implant crowns for a long time.

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

Overbite and porcelain veneers

Posted on November 14, 2019 by writeradmin.

I have pretty bad tetracycline stains and wanted to get porcelain veneers to help cover them. My dentist said I am not a candidate for porcelain veneers because of my overbite. Instead, he wants to do dental crowns on my top six teeth. Is this a good alternate solution? Do I just bleach the bottom teeth?

Kaitlyn

Dear Katilyn,

A tetracycline case done by Dr. Delaune.

Please don’t let your dentist do dental crowns. This will require him to grind your healthy teeth down to nubs. He is likely saying that because he doesn’t know how to do porcelain veneers. I’ll give him credit for having a creative excuse. I’ve never heard a dentist use an overbite as an excuse. In reality, an overbite is easier with porcelain veneers.

You can see from the image above that a tetracycline case can be made to look stunning. There is a big “HOWEVER” when you’re considering this though. Smile makeovers aren’t taught in dental school. Instead, a dentist has to invest in post-doctoral training in order to truly know how to create a beautiful smile. Now, factor in tetracycline stains. These are among the most difficult type of cosmetic cases to do.

What you need is an expert cosmetic dentist. The images above show a tetracycline case done by Dr. Delaune. You want to find a dentist with his training and skills in artistry.

Finding that Expert Cosmetic Dentist

One thing I will suggest is you look on the mynewsmile.com website. This site is run by a retired dentist who is accredited in cosmetic dentistry. He screens each dentist who wants to be listed for both their technical training as well as looking to see what type of beauty they create in the cases they do.

One thing to be aware of, I”m pretty sure whichever cosmetic dentist you end up with will suggest more than six porcelain veneers. Most of our smiles are at least eight teeth wide.

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

Porcelain veneers or crowns for tetracycline stains?

Posted on July 31, 2019 by writeradmin.

I’ve seen two different cosmetic dentists about dealing with my tetracycline stains. They’ve recommended two very different solutions. The first dentist, who is well within my budget, wants to do porcelain crowns on the visible teeth. The other one, who goes several thousand dollars over my intended budget, wants to do porcelain veneers. Is there anything wrong with doing the crowns?

Cassie

Dear Cassie,

porcelain veneer being held up by dental tool

Before we get into the cost difference, I’d like to talk about the different procedures. With dental crowns, you have to have a great deal of tooth structure removed. If those teeth don’t need that structure removed, you are weakening them unnecessarily.

Ask yourself why a dentist would choose to use a procedure which is unnecessarily aggressive. My guess is, it is the only procedure he’s comfortable with. Every dentist places dental crowns. That doesn’t mean they are skilled in cosmetic work.

With porcelain veneers, you only have to remove a minimum amount of tooth structure, about the thickness of a fingernail. You can always switch from veneers to crowns. But, once you have dental crowns, you will always have to have dental crowns.

Choose the Dentist Carefully

Tetracycline stains are among the most challenging cosmetic cases there are. Whatever is used needs to be opaque enough to cover the stains completely, but still be translucent enough to reflect light and look natural.

I would say only the top 1% of dentists in the country could do it beautifully. You need one of those dentists. I would recommend you look on the mynewsmile.com website. They screen every dentist who wants to be listed on their website.

No one can pay to be listed. They have to provide background on their cosmetic training as well as visual proof of their artistry.

One last thing, price doesn’t always give a good picture of the skill of the dentist. Some really bad dentists have high prices. Some really great dentists have average prices.

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

Teeth Whitening Using Lemons and Baking Soda

Posted on October 16, 2018 by writeradmin.

I’ve been considering whitening my teeth. I got a quote from my dentist. It wasn’t as expensive as I thought it would be, but then my friend told me she whitens her teeth with fresh lemon juice and baking soda. She has pretty teeth so I’m thinking it may actually work. Is there anything I need to be concerned about if I try this?

Lacee

Dear Lacee,

Lemons

I’m glad you wrote before you did this. Your friend may have a beautiful smile, but she won’t for long if she continues with this. Lemons contain citric acid which will eat away at her tooth enamel, leaving her vulnerable to decay. She’ll also start to develop sensitive teeth.

If you think about it, lemons and other citrus fruits are often one of the main ingredients in cleaning solutions. Hopefully, you can warn her and she can see her dentist and forestall as much damage as possible.

It’s great that you want to whiten your teeth, but it’s more important to do it safely. The tooth bleaching gel that a dentist uses is perfectly safe for your teeth. There are two different options for professional teeth whitening.

Professional Teeth Whitening Options

Your first option is to get custom made trays to do at-home teeth whitening. Your dentist will provide you with the trays and the gel you need. You choose when you wear it and for how long, with a minimum of twenty minutes.

Your second option is to have in-office whitening done. This is often done using the Zoom Whitening system. You go in for your appointment and when you come out, your teeth will be as white as possible.

One thing to be aware of is if you have any dental work, such as crowns, bridges, or fillings, they’ll have to be re-done if you want them to match the whitened teeth. Of course, that’s only necessary if they’re visible. If any crowns are on your front teeth, make sure your dentist gives you an all-porcelain crown. These look more natural.

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

Did I Make a Mistake Getting Porcelain Veneers?

Posted on August 15, 2018 by writeradmin.

I’m wondering if I made a mistake getting porcelain veneers. My teeth have been getting shorter and shorter recently and it was really beginning to bug me. My dentist suggested I get porcelain veneers. They were expensive but my dentist said they could make my teeth longer. I was excited about that. I went forward. I wasn’t crazy about how they turned out. While they are longer, they look a bit boxy. Plus, two of them have popped off. My dentist always puts them back on for free, but it does take time off work. I’m wondering if this was a mistake. I kept thinking for that much money they’d be beautiful, not just longer. Did I have unrealistic expectations?

Melanie

Dear Melanie,

Porcelain veneers are a great way to remake your smile. I think the mistake is simply allowing your family dentist to do it instead of an expert cosmetic dentist. I have another concern aside from your dentist’s cosmetic skill. You mentioned your teeth have been getting shorter. That combined with your veneers popping off, makes me think you’ve been grinding your teeth at night. Your dentist should have recognized these signs.

It’s important this is dealt with or your teeth will continue to grind down until they’re nubs. Then, you’ll be forced to get a mouth full of porcelain crowns in order to chew. I’d be lying if I didn’t say I was concerned about your dentist not bringing this up.

There is a simple solution. You just need to wear a night guard and then it will protect your teeth and your porcelain veneers from being damaged any further.

Getting Gorgeous Porcelain Veneers

Getting a smile makeover is a bit like commissioning an artist to do your portrait. You want to research the artist carefully. They need to have post-graduate training. But, like any art, there also has to be some natural skill there. Your dentist needs an artistic eye. So, how is a patient to research all of that? Well, you could check their credentials, research their smile gallery, check their reviews, etc.

Fortunately, the mynewsmile.com website does all of that for you. If you go to their site and click on “Find a cosmetic dentist”, you simply input your zip code along with how far you’re willing to travel to get a beautiful smile and they’ll list all the expert cosmetic dentists within that range.

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