I am rather upset about my smile makeover. My dentist made six porcelain crowns for me. First, not only does the color not match the rest of my teeth, but the crowns themselves are turning yellow and I have not had them that long, in fact it has only been a little less than a month. I’ve got a consultation with another dentist, a Dr. —- [Name withheld] from New Orleans. Do you have any tips for me for when I go? I’m not even sure what to ask him.
Holly
Dear Holly,
There are some red flags here about the dentist who did your smile makeover. One thing I am curious about is why he gave you porcelain crowns. Did you already have crowns on those teeth? If not, the right procedure for a smile makeover would have been to get porcelain veneers. In almost every case when crowns are suggested instead of veneers, it is because the dentist is not really trained in smile makeovers and they’re falling back to the procedure they know best. Cosmetic dentistry is not a recognized specialty and smile makeovers are not taught in dental school, so a dentist has to invest in post-doctoral training on their own to develop the skills necessary to do this properly.
Another thing that bothers me is the color mismatch. You didn’t mention if the crowns or your natural teeth are whiter at this point. Either way, it is another indication he didn’t know what he was doing. A typical smile is eight to ten teeth wide. When doing a smile makeover with fewer veneers (or crowns in your case), it is standard procedure to have teeth whitening done first so that your natural teeth can blend with the new smile makeover. It sounds like this didn’t happen in your case.
Thirdly, if these crowns were made of porcelain, they should be stain resistant. The fact that they are staining means that either he did not actually give you porcelain crowns or somehow they damaged the glazing on them. This can happen if your hygienist uses something like a power prophy jet or acidulated fluoride during your appointment. Without that protective glaze, they will stain remarkably easily.
Getting a Second Opinion
It sounds like you are already okay with getting a second opinion on these. That is great and my recommendation. However, I don’t think the dentist you listed will be the best dentist to go to for this. I looked at his website and he has no post-doctoral training in cosmetic dentistry. He doesn’t even have a smile gallery, which is a standard for all true cosmetic dentists. In your place, I would look for an AACD accredited dentist in your area. These are the best cosmetic dentists in the country.
One other tip. When you go, make it a blind second opinion. That means you don’t tell them who the dentist is that did the work. The dental world is small and they probably know each other. Just have them look at the crowns and ask them why they are staining without knowing who did the work.
This blog is brought to you by Des Moines Cosmetic Dentist Dr. Phelan Thomas.