porcelain crowns Archives - Drake & Wallace Dentistry

Is a Cracked Porcelain Crown a Dental Emergency?

Posted on March 21, 2025 by writeradmin.

About ten years ago, I had four porcelain crowns placed for a smile makeover. One of them had always had what my dentist called a craze line, but it was never a problem. Now, I can see it as a horizontal crack. I can also feel it with my tongue as well. I am worried this is going to break. Should I get this replaced? Is it a dental emergency or do I just schedule a regular appointment?

Laura

Dear Laura,

I’m glad you wrote. While craze lines are usually harmless, your dental crown has obviously changed. Given that you can feel and see a crack, it is very likely to break at some point. I would not consider it a dental emergency, but I would schedule an appointment. That crown will need to be replaced. While you are there, you can have the dentist check out the other three crowns to see what kind of condition they are in.

If they’re fine, then you have a couple of options. You could just replace all of them at the same time and get it over with. Or, you can simply replace the one with the crack and then leave the others to replace one at a time when they live out their lifespan.

I am curious as to why your dentist suggested porcelain crowns for your smile makeover. The typical procedure for a smile makeover is to have porcelain veneers placed. Was there some structural damage to your teeth or some other reason for your dentist suggesting using crowns instead?

Some dentists who do not have serious training will point patients to a procedure they are comfortable with. Every dentist studies dental crowns. Unfortunately, even though it is a massive overtreatment, you will always have to have crowns on those teeth. There is not enough structure left for your dentist to place porcelain veneers.

This blog is brought to you by Decatur, AL Dentists Drs. Drake and Wallace.

Can You Put a Maryland Bridge Between Two Dental Implants?

Posted on January 20, 2025 by writeradmin.

I have two dental implants with a natural tooth between them. Now the natural tooth needs to be extracted. Is it possible to get a Maryland bridge to place between the two dental implants? Will the bridge bond to the porcelain crowns?

Andy

Dear Andy,

While, technically, you can attach a Maryland Bridge to porcelain crowns, they will not be as secure a bond as you would get to natural tooth structure. The bond to porcelain will be weaker. Plus, you have the added complication of the fact that very few dentists know how to do this bonding procedure.

Another complicating issue is that for the Maryland Bridge to stay properly, it is not a simple matter of it being bonded to the adjacent teeth. It will also require a grove to be cut into the crowns. This damages them.

Ideally, your dentist would have planned ahead. Knowing that you have two dental implants and there is a good chance that you will need a third, he or she should have placed the first two in a way that would have the abutments parallel. That way, when the middle tooth went it would have been a simple matter of removing the two dental crowns and adding a bridge to those teeth with a false tooth suspended between them.

Your best option at this point is to see if there is enough room to place a third dental implant in there. Talk to your dentist and see if that is a possibility.

This blog is brought to you by Decatur, AL Dentists Drs. Drake and Wallace.
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Shared Tooth Trauma

Posted on April 11, 2024 by writeradmin.

I had an accident that injured two front teeth. The dentist that treated me said that one of the teeth needed a root canal treatment, but the other one appeared to be fine. A couple of months later the dentist put a crown on the root canaled tooth. Close to two years later the tooth began to bother me again. It became sensitive to both hot and cold. I went to see the dentist again who didn’t see anything wrong with the tooth. He did take an x-ray but said nothing was there. I went to see an endodontist who said the pain was probably coming from the tooth next to it because it looks like I clench and grind my teeth. I went home discouraged. Now there is a pimple on the gum next to the tooth with the root canal. I’m terrified that I am going to lose this tooth. Do you have any advise for me? The pain is getting worse and nobody seems to be listening to me.

Anne

Dear Anne,

I am a bit bothered by the type of care you are getting. I don’t think this is the best dentist for you. This is not really a tricky diagnostic procedure. Once you had the root canal treatment, the pain could not be coming from that tooth, which would have removed the nerve. A front tooth would not have any tricky canals that could have been missed the way a molar could.

Not seeing anything on the x-ray is not surprising because the inflammation would not show up until the infection set in. The pimple on your gums is a sign of an infection called a tooth abscess.

When there is trauma to a tooth, it is not unusual for a tooth that has been traumatized to not show any symptoms for quite some time. Some will take years. However, there is an infection now and it needs to be dealt with. My suggestion is to go back to your dentist and show him the abscess. If he still won’t help you, there are dentists who will see non-established patients in the case of dental emergencies. I would consider your case one that would qualify. You will likely need another root canal treatment and dental crown. Hopefully, your dentist placed a porcelain crown on your front tooth. That is what you will want.

This blog is brought to you by Decatur, AL Dentists Drs. Drake and Wallace.

My New Crowns Are Turning Yellow

Posted on June 19, 2023 by writeradmin.

I had six dental crowns placed about a month ago. They were not the white color I wanted, but the dentist assured me they were the whitest color available. With how white teeth are these days, I found that a bit surprising. But, he’d already bonded them in so what could I do. However, I am now finding that they are already picking up stains. I do drink coffee every day, but assumed that as long as I brushed my teeth, I’d be fine. I don’t know if teeth whitening will help this, but I’m pretty distraught about how things have turned out. My smile makeover has turned out to be a disaster. I think I need to see another dentist to get this redone, which is going to cost me a fortune…again. Is there any advice you can give me?

Ellie

Dear Ellie,

I am going to address the color first. It sounds like your general dentist is just that, your standard bread and butter dentist who does not do a lot of cosmetic work. If you look at the shade guide above, all the shades to the right of the small addition on the left are the shades dentists used for decades. When teeth whitening grew in popularity, those shades were no longer white enough. That is when that addition was made to the shade guide. You are probably looking for a BL1, the color all the way to the left. Your dentist may not even have known that was an option if he does not keep up with the cosmetic side of his field.

Even with that, he should not have bonded them in without you getting a good look at them and approving them. That was bad form on his part. If they are truly porcelain crowns, then they should not be picking up stains as they are, even with you drinking coffee. This tells me that something happened to the protective glaze on the porcelain. This can happen if a hygienist uses something like a power prophy jet or acidulate fluoride (as opposed to neutral fluoride) during your dental appointment. An office that doesn’t do a lot of cosmetic work may not understand how those tools can damage cosmetic work.

Teeth whitening will not work as a solution for this. First, it will only work on natural tooth structure. Second, with the damage to the crowns, they will just immediately begin picking up stains again. The good news is because they are damaged, you have a right to ask for at least a partial refund. These crowns have to be re-done. Don’t let them try to talk you into just letting them re-do them. They’re obviously not qualified. Tell them you’re looking for someone with more expertise in cosmetic work.

When you do go to the next dentist make sure they only do a temporary try-in with your crowns and do NOT bond them until you are completely satisfied with their color and appearance.

I hope this helps.
This blog is brought to tyou by Decatur, AL Dentists Drs. Drake and Wallace.

Questions about Touching Up Teeth

Posted on April 19, 2023 by writeradmin.

I am about to get a dental crown for my lateral incisors. However, I would like to touch them up before deciding on the final color for my crown. My dentist couldn’t answer my questions, so I am hoping you can. I want to get this party going.

Here are my questions:
I used Opalenscence PF at 20% strength using trays.

1. How long should I touch-up (for example, 1 week, 2 weeks)?
2. How many hours each day (1 hr., 2 hours, or 3 hours)?
3. Is it necessary to stop whitening a certain length of time before the appointment (not necessary, 1 week, 2 weeks)?

Miranda

Dear Miranda,

Professional Teeth Whitening Trays

I am glad you wrote. I will answer your question but will admit that I am a bit concerned your dentist was not able to answer this for you. Teeth whitening is the simplest of all the cosmetic procedures. If he cannot advise you on that, then how will he create a beautiful crown for you on a tooth that is visible? My suggestion before you move forward with this is that you have him show you some before and after images of crowns he’s done on the front teeth so you can get an idea if he can truly match the adjacent teeth.

Touching Up with Teeth Whitening

There are no real specifics, except for your last question. However, there is a general principle. The longer you leave the whitening trays on the faster they will whiten. Most people get the fastest result by wearing the trays overnight. One thing to be aware of is that you will want to wait about a week from the termination of the teeth whitening before you decide on the final color. This is because the teeth will continue to whiten for 7 or so days. Sometimes up to two weeks.

This blog is brought to you by Decatur, AL Dentists Drs. Drake and Wallace.

Why are My Teeth Whiter Than My Crown?

Posted on December 22, 2021 by writeradmin.

I had to get my first dental crown ever. My dentist said he gave me the whitest shade, but my teeth are whiter. How can my teeth be whiter than the whitest shade? It looks really weird. Can I use teeth whitening on the crown?

Leslie

Hi Leslie,

I’m glad you wrote and am certain I can help you. I’m having to make some assumptions here because I haven’t actually examined you. If any of these are wrong, feel free to write back and we’ll work the problem a different way. First, I am assuming that you have used teeth whitening in the past. Second, it appears your dentist does not do a lot of cosmetic work. With those two assumptions, here is what I think is going on, as well as how you can fix it.

First, when dentists are looking to match a shade of a tooth in order to match a crown to it, they always start with a shade guide. Directly above, I have posted an image of the old shade guide that dentists would use. Then, the 1990s came along and things changed. Teeth whitening skyrocketed in popularity. Suddenly, patients were coming into the dentist’s office with teeth that were whiter than anything on the shade guide. Dentists had a hard time matching dental work to their patient’s teeth.

Fortunately, it didn’t take long for cosmetic dentists to express the need for these shade guides to be updated, and the supply companies stepped up to the bat. Above, I have an image of an updated shade guide. Notice the extension on the left. This is where those brighter shades are placed. They are all much whiter than the whitest shade on the old shade guide.

I believe your dentist is still using the old shade guide. So, how do you fix this? Teeth whitening, while remarkably effective on teeth, will only whiten teeth. That means your natural teeth will get whiter but your dental crown will stay the same color. That will not have the effect you were hoping for. Instead, I suggest you inform your dentist about the new shade guide so he can give you the correct color crown. You can even show him this post if it helps.

This blog is brought to you by Decatur, AL Dentists Drs. Drake and Wallace.

Are CEREC Crowns More Affordable?

Posted on August 26, 2020 by writeradmin.

I need to get a dental crown, but don’t have a lot of money. Are CEREC crowns more affordable because you only need one appointment?

Paula

Dear Paula,

While I can see where patients would think one appointment should be cheaper than two, the truth is a traditional crown and a CEREC crown work out to roughly the same cost. This is because the technology is expensive. A CEREC machine costs a dentist $100,000.00. The payments they have to make for their patients to have the convenience of a one-day crown are substantial. That cost is passed on to patients.

Your best bet is to pick the type of crown that is best for your restoration and then see an affordable dentist that offers the type of crown you want. They are more willing to work out payment options with patients in a financial bind. However, I don’t want you to confuse cheap with affordable.

If a crown costs $500 but you have to replace it every three years, yet another crown costs $900 but will last you fifteen years, which one is actually more affordable? If you have a dentist who is significantly less money than other dentists around them, you should check their reviews to make sure their work actually holds up.

In most cases, dentists are compassionate. They want to help their patients. If you are open and honest about your financial situation, the will likely be willing to work with you.

If you absolutely cannot find a dentist who will do payment plans and you don’t have the money for the crown, you can try Care Credit. This is a medical credit company that will pay your caregiver upfront and allows you to pay them out. Their rates are extraordinarily reasonable as well.

Best of luck!
This blog is brought to you by the Decatur, AL Dentists Drs. Drake and Wallace.

Allergic to Dental Materials

Posted on August 31, 2019 by writeradmin.

I have type IV metal allergies. Those I know of include allergies to dental cement, formaldehyde, cobalt, chromium, titanium, and many chemicals. Right now I have very bad eczema from all allergies and am in constant pain from work I’ve had done in the past which included materials I now know I’m allergic to. I am willing to travel to get relief. Do you know someone knowledgeable about type IV metal allergies? Could you help me?

Thank you,
Lisa

Dear Lisa,

A woman giving a thumbs up in a dental chair

You can find the right dentist for your needs

There isn’t really any specialty in allergies when it comes to dental work, especially specific types of allergies. What you need, instead, is a creative dentist who is willing to work around your body’s needs and limitations. It doesn’t require any special dentist. However, you may find a holistic dentist more sympathetic and willing to work around your allergies.

This isn’t a specialty either. It is a philosophy of treatment which takes into consideration the whole body and not just the teeth. For instance, a holistic dentist would only place mercury-free white fillings. They also know how to do a sanitary amalgam removal. This will protect you from inhaling any mercury vapors during the removal process.

You didn’t mention what type of dental work needed to be replaced. I wanted you aware of some metal-free dental options available in procedures which previously didn’t have options.

Zirconia is proving useful in plenty of procedures these days. Now we can do metal-free zirconia crowns and even zirconia dental implants. While we have had all-porcelain crowns for a while, they are not strong enough for back teeth which left patients having to use metal-based crowns for molars.

Zirconia, which has been dubbed ceramic steel. It is strong enough to sustain a crown on your back teeth.

Replacing Dental Implants

If you have a dental implant to replace, that is the only one which will be a bit of a pain. It will require a new implant to be placed. Instead of the traditional titanium implant, which is almost positively what you were given before your diagnosis. Fortunately, you can have a zirconia implant.

The problem comes with the need to replace lost bone. When your implant is removed, bone will be removed as well. You’ll have to do some bone grafting done in order for the new implant to be secured. Osseointegration is an important part of dental implant success.

This blog is brought to you by Decatur Dentists Drs. Drake and Wallace.

Do I Need a Cosmetic Dentist for Teeth Whitening?

Posted on June 28, 2019 by writeradmin.

I want to get my teeth whitened but didn’t know if I needed to see a cosmetic specialist for something like that. My dentist is a general dentist and is not interested in getting into any cosmetic work.

Patty

Dear Patty,

Truthfully, there is no recognized specialty in cosmetic dentistry. That means that a cosmetic dentist is just a general dentist who has an interest in doing cosmetic work. However, that doesn’t mean it doesn’t require some expertise and additional training.

One example of that would be with porcelain veneers. Doing smile makeovers aren’t taught in dental school. A dentist has to invest time in post-doctoral training to develop the skills and technique necessary to do this well. Different dentists have more (or less) artistic ability than others, so it is important you ask to see before and after pictures of cases they’ve done.

Any Dentist Can Provide Teeth Whitening

Fortunately, teeth whitening is different. Just about any dentist can do this procedure. It doesn’t take artistic ability to whiten teeth. It is the special gel that does all the work.

You should know ahead of time that the only thing the whitening gel affects is natural tooth structure. If you have any visible dental work, it won’t whiten. For instance, if you have a dental crown on a visible tooth, it will stay the same color. The crown will need to be replaced when you’re done. If you were to replace it, just make sure your dentist replaced it with an all-porcelain crown, which will match much more naturally.

You’ll love having your teeth whitened. It’s one of the simplest and most affordable things you can do to drastically improve your smile, making you look years younger.

This blog is brought to you by Decatur Dentists Drs. Drake and Wallace.

Cracked Porcelain Crown

Posted on June 22, 2019 by writeradmin.

I have a porcelain crown which has always had a divot of sorts which I could kind of see in the front. I talked to my dentist about it and they said it is solid so there’s nothing to worry about. Truthfully, there hasn’t been. It’s eight years old, so it did serve me well. The problem is now the divot has changed. I can see and feel it and it feels like it’s cracked a bit. I’m worried this is going to fall completely apart while I’m in public. Would this be considered a dental emergency?

Katherine

Dear Katherine,

I wouldn’t necessarily consider this a dental emergency, but you will want to get it looked at. Porcelain crowns, like our natural teeth, can have divots and other oddities in shape. That doesn’t make it defective. However, this seems to have changed. If you are feeling it differently it needs to be looked at.

If you trust your current dentist to deal with this, then go back to him or her and have them look at it. It is probably best to just replace it. Though a hassle, this could be a blessing in disguise.

Updating Your Smile When You Replace Your Crown

Often when people get a crown it is because of a dental emergency, which usually accompanies a root canal treatment. They don’t have money to worry about whitening their teeth. Then the color of their crown is permanent so they can’t do anything about it after without replacing their crown.

Because you may be needing to replace the crown anyway, this is an ideal time to do some teeth whitening. Now your teeth can be white and your new porcelain crown can be made to match.

I hope this helps. This blog is brought to you by Decatur, AL Dentists Drs. Drake and Wallace.