David C. Geen, DDS

Once a crown has been fabricated, and cemented in the mouth, the color is stable and so can not be modified.  In addition to the color, the translucency of the ceramics need to be close to that of the surrounding natural teeth or this too can contribute to the new tooth not blending in.  Meeting with another doctor for a second opinion will allow this to be evaluated, and give you an opportunity to discuss your options.  You may end up having to consider replacing some of the components such as the crown or abutment in order to achieve the result that you are looking for.  Good luck!  Dr. Geen

We often see these areas of the teeth exaggerated immediately following teeth whitening/ dental bleaching.  The good news is that they tend to settle down within a few days after you have stopped bleaching, and most people see them return to being no less or more visible than they had been before bleaching started.  What you are seeing is areas of the enamel that have a different mineral content than the rest of the enamel.  The white cloudy spots are not really being created by the whitening process; its just that the process is allowing you to visualize something which was already there but was not easily seen.

Assuming that the root canal treatment is healthy, one possible cause could be something called "violation of biologic width".  There needs to be a certain amount of distance between the edge (margin) of a crown and the bone which supports the tooth/root.  If a patient's crown margin gets too close to the bone then the result can be red and inflamed looking gingiva (gums) alongside that particular tooth.  It is usually seen in the few millimeters close to where the tooth and gingiva meet.  This sometimes happens when patients have crowns over teeth which had deep cavities or which were broken and the crown extends far below the soft tissue.  In those cases a periodontal procedure called crown lengthening is often used to address the problem, however in cosmetic areas (like upper front teeth) this can have negative cosmetic consequences and so other options may be discussed.

Without doing a clinical exam and seeing an x-ray, it isn't possible to answer your question with certainty.  It sounds like you definitely should consider getting a second opinion.  Another possible cause could be inflamation related to the root canal if that is not healthy.

I hope the above information will be valuable.  Good luck.
David Geen DDS

From what we can see in the photo you provided, orthodontic treatment would certainly be the recommended way to treat your teeth.  Orthodontics can vastly improve the crooked and asymmetrical appearance of your teeth and smile, and could accomplish this in the most conservative way.  You want to create a result that will be beautiful and healthy for long term stability.  When we use restorative techniques such as veneers for correcting crooked teeth, it often requires removal of more tooth structure making it a less conservative option.  Even when we are choosing to do veneers, we will often have patients with crooked teeth go through orthodontic treatment first to allow our restorative treatment to be as conservative as possible.  You mention that you are looking for quick results, but sometimes the best treatment options can take some time.  Veneers are an excellent choice when treating teeth with damaged enamel as that can be replaced with porcelain.  In cases where the enamel is healthy and the major problem is the positioning of the teeth, addressing this positioning issue is often the best first step to take.

I hope the above information will be helpful as you do your research.  Good luck.
David Geen DDS

It will take an Orthodontist to determine if the positioning of your teeth, and the balance of your smile, can be fully addressed with braces alone or if you would benefit from braces in conjunction with surgery to correct the position of your jaw.  You may likely find that once the position of the teeth are in a more ideal position, the support to your lip will change and this may make it easier to smile more symmetrically.  Many people who show asymmetry in the way their lips lie when smiling do so out of habit and muscle memory.  You should try practicing your smile in front of a mirror.  We have seen patients make dramatic changes simply by teaching themselves and conditioning themselves to smile differently.  One last consideration, we commonly see people who have noses that are themselves canted in their positioning (that are not positioned straight up and down).  If a patient's nose is perfectly straight then that can be valuable as a guide for teeth, however if it is not then it can be misleading.  Letting someone take photographs from directly in front of you is a better way to evaluate this, rather than trying to gauge what you see in a mirror.

I hope this information is helpful.  Good luck!
David Geen DDS