I need some advice. My daughter (12 years old) had a pretty bad fall. She’s broken her wrist as well as her front teeth. It is like a bunch of the bottom and middle of the two front teeth broke off. The outside edges are still intact. Her pediatric dentist wasn’t sure what to do so we took her to our family dentist. It was getting time to switch her over anyway. He suggested dental bonding to repair the missing structure. We went ahead and did it. The results were a disaster. The color doesn’t match and the centers of the teeth are all lumpy. My daughter is in tears and I do not blame her. School starts in just a few weeks for her and she does not want to go back looking that way. Is there anything that can be done to fix this? When my dentist saw how upset my daughter was he offered to put dental crowns on her front teeth, but that has me uncomfortable for some reason so I wanted to do some research first.
First, let me say I am sorry this happened to your daughter. This is no way for her to end her summer vacation. The good news is that this can be fixed and she can go to school confident that her two front teeth will look beautiful and natural.
While your dentist was correct about the way to repair this, based on what you said, he does not have the cosemtic training to know how to do it well. Most patients are unaware that cosmetic dentistry is not a recognized specialty. Because of that, any general dentist can do it regardless of the amount of post-doctoral training they received. Unfortunately, dental bonding is quite an advanced procedure because it has to be done freehand. It is not adequately taught in dental school, so that additional training is necessary.
In your place, I would look for a dentist who has received accreditation from the American Academy of Cosmetic Dentistry (AACD). The type of case your daughter has is actually one of the case studies they have to do successfully in order to receive accreditation. AACD accredited dentists have proven technical skill and artistry. These are only dentists I would trust with such a complicated case as your daughter’s.
Your gut feeling about doing crowns is right. There are two big problems with doing crowns on the front teeth of someone your daughter’s age. The first is that her pulp is still larger than an adult’s pulp. Because of this it is close to the surface. A procedure like that could actually kill the pulp. Secondly, her teeth are still erupting. This will expose the margins of her teeth making it obvious she has dental crowns on them as well as putting her at risk of greater decay. Stick with the dental bonding.
This blog is brought to you by Lexington Cosmetic Dentist Dr. Fred Arnold.