Tag Archives: porcelain veneers versus porcelain crowns

Porcelain veneers with an overbite

I want to get a smile makeover. I asked my dentist about porcelain veneers and he said because my top teeth cover my bottom teeth I’m not a good candidate. Instead, he suggested I have crowns placed on my six front teeth. My teeth have some dark stains because of tetracycline too. Does this mean after the crowns are done, I’d whiten the bottom teeth to match?

Lisa

Dear Lisa,

A single porcelain veneer being placed on a tooth

I want to caution you not to do dental crowns for your smile makeover. I think I know what is going on here. It sounds like your dentist isn’t as comfortable with designing and placing porcelain veneers than he is with dental crowns.

He doesn’t want to tell you this and cause you to think less of him as a practitioner, so instead he suggests the procedure he feels he does better.

Blaming your bite is creative but not valid. Even thinking about it logically, porcelain veneers would be a better fit for your bite. Porcelain crowns surround your entire tooth, but porcelain veneers only are bonded to the front. They would actually be less intrusive.

On top of all of that, with dental crowns, your teeth have to be ground down to nubs. Because of that, you can never have anything but crowns on those teeth for the remainder of your life.

There is another hint to me that your dentist isn’t an advanced cosmetic dentist. He’s suggesting six teeth be treated. Unless you have a narrow smile, that won’t be enough. Most people show between eight to twelve teeth when they smile.

Finding an Advanced Cosmetic Dentist

Your particular case is particularly challenging and requires a top-notch cosmetic dentist. Tetracycline stains are quite tricky to get right. You need the teeth to have the look of natural translucency, but at the same time still be opaque enough to cover the deep stains.

Only the top 2% of dentists can do this well. In your place, I’d look for a dentist who has been accredited by the American Academy of Cosmetic Dentistry. They have both the technical skill and artistry to give you a stunning smile, even with tetracycline stains.

Regarding the teeth whitening you mentioned. Yes, you would whiten the remaining teeth which don’t get veneered. However, you want to do the teeth whitening first. When you get them to the level of whitening you want, it will be time to get your porcelain veneers. The KöR  Teeth Whitening System has been the most effective in whitening tetracycline stains.

This blog is brought to you by Lafayette Cosmetic Dentist Dr. Mike Malone.

Why Does an Overbite Prevent Me From Getting Porcelain Veneers?

Can you help me understand something? I really wanted to have porcelain veneers placed, but my dentist said because I have an overbite, I’d have to get crowns. He wants to place six porcelain crowns on my front teeth. Is there another option? Also, if I go with the crowns, do I whiten my bottom teeth? Both arches have tetracycline stains.

Amanda L.

Dear Amanda,

Lafayette Porcelain Veneers

I’m very glad you wrote before moving forward with this procedure. It sounds like you went to your family dentist instead of someone with expertise in cosmetic work, and he’s not as comfortable with doing advanced cosmetic procedures. Rather than admit that, he came up with a rather creative (though completely untrue) excuse for why you can’t have it. Then recommended porcelain crowns because he is comfortable doing that.

Porcelain veneers are actually a better solution for an overbite. Crowns have to grind down your teeth. Porcelain veneers do not. Why would you want to grind down healthy tooth structure?

In fact, the two pictures below will demonstrate the difference in preparing for the two procedures.

Lafayette Porcelain Veneers
Tooth Preparation for Porcelain Veneers
porcelain crown prep
Preparation for a Porcelain Crown

As you can see, you save much more tooth structure with porcelain veneers.

Another thing to consider is the number of crowns he said to get because it’s equally applicable to porcelain veneers. Six is not enough. Most smiles show between eight and ten teeth. Some wider smile show even more. Take a close look at your teeth when you’re smiling broadly. How many are visible? You want each visible tooth covered.

So, who should you have do this smile makeover? Your particular case is especially advanced. Tetracycline stains are among the most difficult to deal with. You need an expert cosmetic dentist. In your position, I’d look for a dentist who’s accredited with the American Academy of Cosmetic Dentistry (aacd.org). Bear in mind accreditation is very different from membership. Any dentist can be a member. Accreditation requires a great deal of knowledge, skill, and artistry.

Your bottom arch can be whitened. Traditionally, teeth whitening isn’t the ideal for tetracycline stains, but if your dentist uses KöR Whitening, you should get decent results.

This blog is brought to you by Dr. Mike Malone.

Why Is My Porcelain Veneer Staining My Tooth?

I don’t know what’s going on with my porcelain veneer. I had a large chip on a tooth on a front tooth. My dentist fixed it with a porcelain veneer a few years ago. For some reason it’s developed a black stain at the top near the gumline. What can I do to fix that? It’s a little embarrassing.

Wesley C.

Dear Wesley,

There are a couple of possibilities going on here. To determine which, we’ll need to be certain what you have is actually a porcelain veneer. A porcelain veneer is just placed on the front of your tooth. Very little is done to the actual tooth with the exception of some mild shaving. It’s possible your dentist placed a dental crown instead. For these, your teeth need to be ground down quite a bit, to a nub. Then a restoration is made that surrounds the entire tooth.

If you have a dental crown, based on what you’ve said your dentist likely gave you a porcelain-fused-to-metal crown (PFM). Though, for the life of me I can’t fathom why any decent cosmetic dentist would place a metal-based crown on a front tooth. The appropriate crown for a front tooth would be an all-porcelain crown. The metal-based crowns eventually develop a gray line at the gumline. You’ve only had your restoration a few years. That seems a little soon for the gray line to develop unless you have gum disease or possibly if you brush too hard.

If you do have a porcelain veneer, this shouldn’t be happening at all. It’s a sign your dentist didn’t bond it correctly. It should sit flush with your tooth. If your dentist doesn’t properly smooth it out they’ll be a ledge which can trap bacteria. Another possibility is the bond is so week things are getting between the veneer and the tooth. Both of these will lead to staining and, eventually, decay.

The solution to either of these is it needs to be replaced. If the problem is a crown, you’ll want to replace it with an all-porcelain crown. If it’s a veneer, your dentist should replace it free of charge. The mistake was his.

You may have to get a second opinion from someone who isn’t your dentist to get an honest answer.

This blog is brought to you by Dr. Mike Malone.