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Dentist’s Disastrous Treatment Plan

I went to see my dentist to get a crown and veneer placed and I have some concerns about his suggested treatment plan. First, some background. I have one dental crown and three porcelain veneers. The reason I wanted the crown replaced is two-fold. First, it has never looked that great. Second, now there is a dark line at the gumline. The porcelain veneer I want to be replaced is chipped. My dentist is suggesting I get dental crowns on all my teeth because none of them are very white. Here is my concern. On occasion, I suffer from dry mouth. This isn’t always, but it does happen. I am worried getting crowns on all my teeth will contribute to that. Is there a better solution to my situation?


Dear Belinda,

A porcelain veneer being placed

I am so glad you contacted us before following through with this plan. What your dentist is suggesting is a full-mouth reconstruction and is a massive overtreatment for what is going on with you at the moment. A full-mouth reconstruction is usually reserved for either a patient with significant TMJ Disorder issues or who has ground their existing teeth down to nubs. Unless you left out some information, you are not in either of those categories.

If I understand what you are saying correctly, your dentist is suggesting this because your teeth aren’t white enough. If that is the only reason, why hasn’t he suggested whitening your teeth? That would be the traditional, not to mention inexpensive, solution to this problem. Teeth whitening brings a dentist a few hundred dollars. A full-mouth reconstruction brings in between $30K – $60k.

Replacing Your Dental Work

Here is a sensible solution. First, whiten your teeth. If you are in a hurry to get that done you can do an in-office type of whitening, such as Zoom Whitening. Otherwise, your dentist can fashion custom trays for you that will fit your bite exactly. These allow you to whiten gradually at home, controlling the level of whitening.

From there, I would replace the single crown with an all-porcelain crown. The reason your current crown has a dark line at the gumline is because you were originally given a porcelain fused to metal crown. These are never as natural-looking and always develop that dark line. This is why skilled cosmetic dentists will recommend an all-porcelain crown instead, which does not have the same problems.

Then, I’d replace the porcelain veneers with…porcelain veneers. Whenever a dentist suggests placing crowns instead of veneers it tells me they are not comfortable with cosmetic dentistry and are steering you toward what they are comfortable with. This is not the person you want re-doing your cosmetic work.

I’m going to suggest you go to the mynewsmile.com website. This site is run by a retired cosmetic dentist who pre-screens dentist for their technical knowledge, training, as well as the artistry of their work. Anyone listed on their site will be able to do a wonderful job for you.

This blog is brought to you by Naperville Cosmetic Dentist Dr. David Newkirk.