Posted by writeradmin
I have a porcelain bridge for my four front teeth. It is time to replace it and I wanted something both more permanent and more esthetic looking. I am a bit concerned. I chose four separate dental implants one for each of the teeth. He’s actually going to do two extra crowns on the canines so that he can work with the color more to get them to match. What I am hoping for is something that looks completely natural. Here are the things that I am concerned about:
- I have a very high smile that shows a lot of gum. With my dental bridge, it just sort of sat on my gums. I was hoping he’d reshape my gums some how to help with that, but he hasn’t even mentioned it.
- I want to be sure about the type of crown. I keep reading that either all-porcelain or all-ceramic is the way to go. Which one is it? The one thing I know is not to use a metal based crown.
Dean
Dear Dean,
The most important decision you can make when it comes to having an aesthetic result with dental implants is the dentist you choose to do it. I am a bit concerned that you chose the wrong one. Here are some of the things which concern me.
First, most smiles are eight to ten teeth wide. At most, your dentist is doing six, which is something we’ll get to in a minute. This means you will still have other teeth visible when you smile. Your dentist should have recommended that you have your teeth whitened first so your adjacent teeth can blend into the remainder of your teeth. It is not too late for you to have that done. But, the fact that it was not recommended concerns me.
There are other issues as well. It appears your dentist has not made any plans for your gumline. He should be planning on building up the gumline. He also should have spoken with you about the type of crown he is planning on using. The reason you have heard conflicting issues is that both all-porcelain and all-ceramic are okay and very similar. As for the metal base, if he uses a traditional dental implant, then it is already a metal base. What you need is a dentist who knows how to make the crown opaque enough to block out the metal implant, but look translucent enough to appear natural.
Another big red flag is that he is planning on using two additional crowns in order to help with the color. This is a rookie move done by dentists who are not comfortable with cosmetic dentistry. To me this does not bode well for an artistic result.
I want you to look for some other dentist who has post-doctoral training in both dental implants as well as cosmetic dentistry. I also want you to make sure that they are willing to try in your dental crowns provisionally with temporary try in paste. Until you love how they look, they do not get bonded on permanently.
Also, you should not need those other two crowns. A good cosmetic dentist can match the implant crowns without them. It may take a couple of try-ins, but can be done.
This blog is brought to you by Lafayette, LA Dentist Dr. John Theriot.