Cavity on a Tooth with a Porcelain Veneer

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Question submitted by Brianne:

I have a tooth that has a porcelain veneer. At my last check up, my dentist said the tooth has a cavity. He now wants to replace the porcelain veneer with a dental crown. Is that the best way to go? I don’t want to damage a tooth unnecessarily.

Brianne

Dear Brianne,

This is something that you will want to get a second opinion on. Nothing you mentioned indicated to me that this cavity is large enough to warrant a dental crown. A tooth would have to be about 20-30% gone before it would truly need a dental crown. Even if you did, very few dentists are able to match a crown to a front tooth. You would need an expert cosmetic dentist to do this and I am not convinced that your dentist fits this category.

Often, when a dentist is not comfortable with porcelain veneers, they will instead point their patient toward a procedure that they are more comfortable with. Every dentist knows how to do a dental crown. Another issue may be where the decay is. The place where porcelain veneers are the most vulnerable is the edge of the porcelain veneer. Your dentist may not have the training or the equipment he or she needs to bond composite bonding to a porcelain veneers.

You can likely tell if this decay is more than 20% of your tooth. If it is not, then you will need to go somewhere else to have this cavity repaired. If you cannot tell, then you still need to go somewhere else in order to get that second opinion.

Look for someone with post-doctoral training in cosmetic dentistry. Also, take the precaution of looking at their smile gallery. This will tell you that they have the artistry to create beautiful smiles in addition to the technical knowledge. Don’t tell them what your dentist is recommending. Don’t even tell them who your dentist is. Just ask how they thing this decay should be handled. The reason for this is that the dental world is a small world and your dentist may not want to say anything negative about the diagnosis of a peer he knows.

This blog is brought to you by Tucson Cosmetic Dentist Dr. Howard Steinberg.