I had a dental implant done on a front tooth. So far my dentist has had to re-do my porcelain crown for the implant three different times. Each time the color wasn’t close to matching. The temporary dental flipper she gave me matched better than the crowns. She said it is because my teeth are between shades. She said for my teeth A1 is too gray and A2 is too yellow. The last time I went in asking if we can try again, she implied I’m being too demanding and that I am fortunate my dental implant hasn’t fallen out as many times as she’s had to manipulate it to try to satisfy me. Now she has me afraid to do anything with it. Do I just leave my two front teeth mismatched? Am I too demanding?

Olivia

Dear Olivia,

No, I do not think you are being unreasonable, especially if you were satisfied with the dental flipper. These tend to be less satisfying to people. It bothers me when dentists blame their lack of skills on the patient being “too demanding”. It’s not asking for too much to have your front teeth to match.

The problem here lies in the fact that your dentist has very little, if any, training in cosmetic dentistry. She may have placed hundreds of dental crowns during her career, but crowns on a front tooth are more challenging. They’re harder to match because the light hits them more directly so all the little variations are obvious.

Even an expert cosmetic dentist will have several try-ins before perfectly matching one. This brings me to another issue your dentist doesn’t understand. She is not doing a try in. She’s having the dental crown made and then bonding it on. A true cosmetic dentist would use a temporary try-in paste, look at it carefully up against the other teeth to make sure it matches, then let you look at it to be certain you are completely satisfied before bonding it on.

If any adjustments need to be made those are noted and sent to the ceramist to re-work the crown.

Getting Front Teeth to Match

Your dentist is obviously more used to placing crowns on back teeth where you can pick a single shade, such as A1, and it will be close enough. That is because there isn’t as much light hitting our back teeth so you can’t make out the subtle differences in the shades. For a front tooth, a cosmetic dentist would take the basic shade and then create a map for the ceramist of where to place different types of tints to bring out the right coloring of the crown. They wouldn’t be satisfied until it was a perfect match. You shouldn’t be either.

As for your dental implant coming out, if she did that right it will be strong enough to withstand another crown being placed. After all, it is supposed to be strong enough for you to eat with several times a day, right?

In your place, I would ask for a refund on the dental crown. The implant seems fine, so don’t ask for a full refund. Tell her you appreciate the work she tried to do on the crown but she hasn’t been able to match the tooth so you’ll have the crown finished elsewhere.

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