Tetracycline Stains Are Showing Through My New Crowns

Posted by AllSmiles

I had bonding on my four front teeth in the early 2000s to cover tetracycline stains. When one of the teeth chipped, I went back to my longtime dentist and asked about getting veneers on my six front teeth.

He recommended six crowns instead because he said they could cover the stains better and help with my gummy smile, so I trusted his advice. Unfortunately, I can see gray showing through a few of the crowns, especially under fluorescent lighting. My dentist has offered to have the lab remake the problem crowns at no charge, but I’m unsure whether I trust him to do the work.

I am also upset that I agreed to crowns because there is no going back to my natural teeth now. I wish I had researched my options more before deciding. I’m considering asking for a refund and having an experienced cosmetic dentist evaluate and possibly redo the crowns instead. Would that make things worse? – Thanks. Evan from Chicago

Evan,

This is a difficult situation, especially because you trusted a dentist you have known for years. We understand why you are now questioning whether you should have the crowns remade or seek another opinion.

Why Is Gray Showing Through Your Crowns?

 

The gray is likely showing through because tetracycline stains can be extremely difficult to mask while still creating natural-looking, translucent crowns.

Your treatment raises several concerns. None necessarily suggest bad intentions. However, they do show why treating severe tetracycline staining requires advanced cosmetic dentistry skills.

• Crowns were used instead of veneers. Preparing six front teeth for crowns requires removing considerably more tooth structure than preparing them for porcelain veneers. Once the teeth are prepared for crowns, you can’t reverse the process.
• Only six teeth were treated. A smile makeover is not necessarily limited to the six front teeth. Depending on the width of your smile, eight, ten, or even twelve teeth may show when you smile and fall within what cosmetic dentists often call the aesthetic zone.
• The tetracycline staining was not completely masked. Dark tetracycline stains create a challenging color problem. The restorations need enough opacity to block the underlying discoloration without becoming flat or artificial-looking.

Do You Need New Crowns?

We would recommend getting an opinion from an experienced cosmetic dentist before having any crowns remade. Your dentist has offered to correct the problem at no charge, which shows a willingness to address your concerns. However, remaking the crowns successfully requires determining why the gray is showing through and developing a plan for the entire smile.

The dentist and dental laboratory both play important roles in cases involving severe tetracycline staining. You want a team with experience masking dark discoloration while maintaining the translucency, color variation, and other characteristics that make porcelain look like natural teeth.

Can You Ask for a Refund?

It’s reasonable to discuss a refund with your dentist before proceeding with additional treatment. Since you have a longstanding relationship and your dentist has already acknowledged the problem, you may be able to reach an agreement that allows you to pursue treatment elsewhere.

You are in the Philadelphia area, where you have access to dentists with extensive cosmetic dentistry experience. We would look for someone who can show you before-and-after photographs of tetracycline cases like yours. An experienced cosmetic dentist can evaluate the existing crowns, determine how many teeth need treatment, and explain what it would take to create a natural-looking smile.

If you’re comfortable with your general dentist for routine care, seeking a cosmetic dentist for this treatment doesn’t mean you need to end that relationship.

Chandler, Arizona, dentists Dr. William Walden and Dr. Tyrel Beavers sponsor this post. Read about their efforts to provide the best dental care in Chandler.