May 2016 - Arnold Dental

I have tetracycline stained teeth. I was thinking about getting either crowns or veneers to make my teeth less embarrassing. I was thinking veneers might be better because my dentist gave me a crown and the color seems flat. I understand veneers have variation in color even in individual veneers so that might look more natural. My dentist says either one is about the same. What are your thoughts?

Ellie B. – New Jersey

Ellie,

I’m very glad you wrote. There are some things you’ve said that make me think you could end up with a disaster. First, tetracycline stains are very difficult to treat. Automatically, you’re at a disadvantage. They require an expert cosmetic dentist to get them to look right. Some cosmetic dentists are tempted just to make them more opaque to hide the stains, but that doesn’t look very natural. You don’t want that. A balance has to be struck.

Second, you mentioned the dental crown your dentist had already done. You said it didn’t have any color variation. That isn’t a distinction of crowns. It’s more an indictment of your dentist’s artistic abilities.

Third, dental crowns and veneers are NOT the same treatment. Crowns require you grind down your teeth to place them. Porcelain veneers only require minimal tooth preparation.

I’d shift your thinking from which procedure to finding the right dentist. I know there are AACD accredited dentists in New Jersey. Some who reached accreditation status will be able to give you a beautiful smile.

This blog is brought to you by Dr. Fred Arnold.

My mom had a stroke and now has cognitive issues. I take care of her. She recently complained of a toothache, which was no major surprise because she avoided the dentist before her stroke and never really took care of her teeth. I took her to a local school for dentists and was shocked to find she didn’t even have a tooth where she was complaining of tooth pain. They surmised that, because her back two teeth were missing, her top tooth had come down and was hitting on her jawbone every time she bit. We’re at the point where she pretty much needs all her teeth pulled and dentures, but she wants to know if dental implants can be put in the place where her other tooth is hitting. Are dental implants a viable option here, is there another option, or should we just plan to have the “long tooth” pulled?

Karen- Detroit

Dear Karen,

This is a difficult thing to advise you on because she really needs a full mouth evaluation. Their assesment is likely correct about her partner tooth. Teeth rely on their biting partners to stay in place. When the opposing tooth is gone, a tooth will begin to protrude because there’s no opposing biting force, but this generally takes years to occur to the degree your mother is experiencing.

This would have been simple if dental implants were place when she first lost her teeth, but now it will be much more complicated. If dental implants had been placed back when those teeth were initially lost, they would have prevented the problem. Going forward, it’s not quite so simple.

Based on what you’ve shared, your mother may not be a good candidate. First, dental implants need a healthy mouth in order to be successful. Periodontal disease, or severe gum disease, is a contraindication for treatment. There is a high risk of failure and infetion in these cases.She may need additional treatment in order for dental implants to be an option.

Secondly, with the tooth above the spot already connecting with the bone below it, there isn’t room for any type of device, be it a dental implant or appliance, to stop the two from connecting.

Your first step is a full-mouth evaluation

I’m very sorry for what you and your mother are going through.

This blog is brought to you by Dr. Fred Arnold.

Are crowns or veneers better for tetracycline stains?

Missing tooth causing pain

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