Q&A: After bad results, is it possible to get a crown to match the veneers?

Ask A Doctor Question: 

I have three veneers and a crown in the top,front of my mouth. When I had this work completed, all four teeth matched. Since that time, the crown lost the finish and I had to have it replaced. I spent four months with a temporary in my mouth while the crown was returned several times because it was not correct. I am very upset with the finished product. My crown looks fake and you can see metal through the top of it.I am embarrassed to open my mouth. Is it possible to get a crown to match the veneers? I have consulted another dentist but I am scared that the next crown might be worse.Is it possible to get a crown with the same finish as the veneers? How do I locate a good cosmetic dentist? Thank you for your help! 

- Cindy


Christian Yaste, DDS -

Yes!  It is almost always possible to get a good match of a crown next to veneers.  There are several things that have to be considered by the dentist though.  One is the type of material that your veneers are made out of.  Many of the ceramics on the market have different levels of translucency.  Translucency is the ability to allow light through the ceramic.  What material the veneers are made out of needs to be matched as closely as possible by the crown.  In most instances this is achievable.  There has never been a better time to find dental porcelain options than now.  Another thing that needs to be considered is how much tooth structure underneath your crown needs to be removed to give the dental lab enough room to create a crown that looks like your veneers.  If the design of the preparation is not with adequate reduction, than the laboratory will have a difficult time making the crown look natural.  In order to achieve the best results it is helpful if the dentist takes photographs and uses a complex shading guide to convey the appropriate information to the laboratory.  Sometimes a cosmetic dentist will even have the ceramist who will be making the crown in ceramic, come into the office to measure color, hue, value, and translucency of the surrounding teeth.  
In regards to the finish being lost or different on the crown, that will sometimes happen with different types of porcelain that just don't hold a glaze as well as others.  Also, the amount of acid in your diet and the ph of your saliva can affect the shiny finish of a crown or veneer.  Over time that shiny finish will dull and can become more flat.  Again, an important thing is for the dentist to be familiar with the different types of porcelain and be able to identify which one will look the best next to your veneers.  Although there may be some limiting factors with certain cases, most dentists whose focus is cosmetic dentistry can, with the help of a good ceramist, get a beautiful result.
Cosmetic dentistry is an art as well as a science and a good cosmetic dentist is not always easy to find.  First you must understand that all dentists are not "cosmetic" dentists.  Unfortunately there is no recognized cosmetic specialty in the dental industry, so any dentist can say they do cosmetics, but you want to find a dentist who has an educational background and experience in cosmetic dentistry.  A good cosmetic dentist will listen to your needs and ask questions to better understand your individual situation.  A cosmetic dentist worth your investment should have plenty of before and after photos for you to see.  Most cosmetic dentists are experienced photographers too(at least of teeth).  Be very cautious in dealing with a cosmetic dentist who doesn't have a strong portfolio of their work.  Finally, don't be afraid to ask for references.  A respectable cosmetic dentist will have happy clients.  Many of these clients will be glad to speak to you about their experience and results.
If you would like further answers on the facts you need to know before having cosmetic dentistry and  7 steps to finding the right cosmetic dentist for you, feel free to contact our office for a complimentary copy of our e-book on the subject.  
Best wishes,

--Christian Yaste, DDS
Charlotte, NC


Debra Gray King, DDS -

The problem that you are having was caused in part by the type of crown that was placed. The crown you have described is called a porcelain fused to metal (or PFM) crown. Sometimes PFM crowns are fabricated where the metal margin shows at the gum line and this can give an unsightly aesthetic result. They also frequently lack the translucency and coloring of a natural tooth. If at all possible, an all-porcelain crown would be preferable from an aesthetic standpoint. An all-porcelain crown has the same type of material as was used in the veneers (porcelain) and therefore stands a greater liklihood of matching the veneers. Another problem that arisies in your case is that it presents more of a challenge to the cosmetic dentist and lab to match a single tooth color that is placed after the other restorations are already in place. To the extent that the lab, dentist, batch of porcelain, etc. are different, color and texture matching is made more difficult.

--Debra Gray King, DDS
Atlanta, GA


Frank Peritore, DDS -

Dear Cindy,
I am sorry that you have had a difficult time.  In answer to your question, it is ideal to have the crown and veneers all done at the same time so that the porcelain used will be the same for all.  It is possible to use the same finish as the veneers after the fact but difficult. 
It is our goal to make everything perfect for our patients.  We will do whatever it takes, even if it means that you go directly to the lab for a shade match.
We are not happy until the patient is happy.
Give us a call for a free consult and the chance to make you smile again.

--Frank Peritore, DDS
Brooklyn, NY


You should be able to get a crown that will match the veneers. Many crowns today are all ceramic and do not have a metal understructure which would eliminate the metal that shows near the gum line. We can always do a no cost consultation and evaluate your situation.

--Andrew Rutman, DDS
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