Front Crowns, Aesthetics & Dental Insurance

s0ur_cherry

Hi guys,

Basically I knocked off about half of one of my upper front teeth last August. This resulted in me needing a root canal, shaving down of said broken tooth and insertion of an all-porcelain crown. However, over the year I think the small remainder of broken tooth has rotted and now the crown over it has a noticeable black/grey sheen to it. I am very unhappy with this considering the expense of the root canal & crown treatment.

I went back to the dentist and she told me that to correct the colour problem I would need a porcelain fused to metal crown, which would cost a further €850. BUT I remember last year she told me that porcelain fused to metal crowns are not good for front teeth because they have compromised aesthetics and basically don't look natural. She also told me I'd need to have the crown replaced every few years as the metal would show on the gumline over time. My dilemma is I don't really want to(/literally can't) invest that much money without knowing for certain my tooth will look completely natural and with great aesthetics.

So my questions are, firstly, do I have any other options to restore the natural look to this tooth? I am also wondering who the top specialist in cosmetic dentistry/prosthodontics is in Dublin/Ireland?

Secondly, does anyone know if there is any dental insurance/plan that might cover this sort of work, even partially so? I've looked into the VHI dental plan and they state that they will cover 50% of costs for crowns or other major procedures (after a 12 month waiting period). However, does anyone know if this extends to replacement of crowns in cases such as mine? (i.e. when it is not completely necessary for function)

Thanks in advance!

Oral Surgeon

Sorry to hear OP.

Sure enough, root canal treated teeth can get dark and appear grey/dark.

First thing to consider is if the tooth root is fixable or restorable;
This depends on a few things; is the root canal good, is there any latent infection/inflammation, is there enough sound tooth structure present over the gum line to predictably place a crown on it??
If the root canal is good and there is enough tooth to work with- then a crown is likely your best option. There are many different types with lots of pros and cons to all. metal ceramic are strong and can be made to look natural if sufficient bulk of ceramic is used. Depending on your lip line and the amount of gum you show when you smile- the crown root margin can be hidden at the gum margin to give a natural cleanable look- if you don't keep it clean or scrub the hell out of it- you may get gum recession and show this margin but if looked after should not happen. All crowns have a finite life, 10-15 years is the norm so you should expect to have it replaced at this interval.

If the root canal is bad, you have the option of a re-do. or if the tooth is not crownable as there is little tooth to crown- you are best off getting rid of it and considering an implant.....

Bottom line, you have many options and done correctly this can look good again...

OS

swanangel

Hey OP,

I can PM the name of my prosthodontist if you like and you can check him out, I'm actually going in for my final appointment today - front teeth crowns.
If you look at my other posts you can see how my treatment has gone. Hope all works out for you in the end.

Take care.

iMax

I know someone who has the top front four crowned with porcelain fused to metal (for strength). No colour difference & they're in place 25 years, only reason he's considering replacement is his gum line has receeded. Otherwise they're totally natural. He had them done in newery

btkm8unsl0w5r4

Metal ceramic crowns are just as aesthetic as all ceramic crowns if done correctly. High quality ones have a type of ceramic edge that doesnt show metal if there is recession. The advantage of metal ceramic is it blocks out the underlying colour and also has superior strength if needed (grinders etc.).

Metal ceramic crowns get a bad reputation but if you avoid the nasty looking inferior ones they look terrific.

One of these teeth is a metal ceramic crown


One of these teeth are metal ceramic


Metal ceramic to block out severe discolouration

Oral Surgeon

Olivia Chilly Prodigy wrote: »

Metal ceramic crowns are just as aesthetic as all ceramic crowns if done correctly. High quality ones have a type of ceramic edge that doesnt show metal if there is recession. The advantage of metal ceramic is it blocks out the underlying colour and also has superior strength if needed (grinders etc.).

Metal ceramic crowns get a bad reputation but if you avoid the nasty looking inferior ones they look terrific.

One of these teeth is a metal ceramic crown


One of these teeth are metal ceramic


Metal ceramic to block out severe discolouration

Show off...!!!

s0ur_cherry

Oral Surgeon wrote: »

Sorry to hear OP.

Sure enough, root canal treated teeth can get dark and appear grey/dark.

First thing to consider is if the tooth root is fixable or restorable;
This depends on a few things; is the root canal good, is there any latent infection/inflammation, is there enough sound tooth structure present over the gum line to predictably place a crown on it??
If the root canal is good and there is enough tooth to work with- then a crown is likely your best option. There are many different types with lots of pros and cons to all. metal ceramic are strong and can be made to look natural if sufficient bulk of ceramic is used. Depending on your lip line and the amount of gum you show when you smile- the crown root margin can be hidden at the gum margin to give a natural cleanable look- if you don't keep it clean or scrub the hell out of it- you may get gum recession and show this margin but if looked after should not happen. All crowns have a finite life, 10-15 years is the norm so you should expect to have it replaced at this interval.

If the root canal is bad, you have the option of a re-do. or if the tooth is not crownable as there is little tooth to crown- you are best off getting rid of it and considering an implant.....

Bottom line, you have many options and done correctly this can look good again...

OS

Thanks very much for your reply!

How would one know if a root canal is good? Would I be able to figure this out myself or would I need to consult a dentist? Forgive me if my understanding of root canal treatment is somewhat inaccurate but it does refer to the removal of the nerve & blood supply of the tooth in question, right? As my tooth is most likely very black would that suggest a well done root canal? Sometimes it does feel a bit odd still when I bite with the crown, but the dentist told me that was to be expected.

Oral Surgeon

s0ur_cherry wrote: »

Thanks very much for your reply!

How would one know if a root canal is good? Would I be able to figure this out myself or would I need to consult a dentist? Forgive me if my understanding of root canal treatment is somewhat inaccurate but it does refer to the removal of the nerve & blood supply of the tooth in question, right? As my tooth is most likely very black would that suggest a well done root canal? Sometimes it does feel a bit odd still when I bite with the crown, but the dentist told me that was to be expected.

A successful root canal treated tooth has 3 components;

• The tooth should be symptom free, ie painless with hot cold and not tender to bite on or on tapping the tooth. The tooth should be infection free, ie have no associated infected swelling, gumboil etc. There sould be no associated pathology or preexisting pathology should be resolving (eg cysts). You can tell most of these your self
• The root canal should be well filled and sealed on xray, again with no associated pathology or pre-existing cysts etc should be resolving. Only your dentist can tell this one...
• The final root canal treated tooth/ root must be restorable and capable of holding a filling/crown predictably without falling off (if there is not enough tooth structure to bond or cement to). Your dentist should decide this but general rule of thumb is not to bother with an expensive root canal treatment if you think that a filling or crown is not possible...

A dark tooth does not mean a good or bad root canal...it usually means that the tooth was dead for some time prior to getting the root canal and the dead nerve/ blood vessel breakdown products leaked out down the dentinal tubules in the tooth and stained them. This can usually be resolved using a bleaching agent within the tooth but may not be necessary if getting a good crown.

OS