Veneer or Crown for Calcified Tooth?

Question

My front left tooth has been dead for some 15+ years. It apparently calcified, creating its own root canal. I have never had work on it. The tooth is completely intack but very discolored. Would you recommend Veneer or Crown?

Scott Young, DDS · Answer

If discoloration is the issue, I would use a porcelain veneer to correct the aesthetic concern. This would be much more conservative that a full crown. In addition, should the tooth ever "flare" up and need a root canal the could do it from the inside of the tooth without affecting your porcelain veneer.

Ted Murray, DDS · Answer

I see this frequently. In my hands a direct resin veneer (bonding) is the best way to handle this situation. I have total control over the shade, shape and form. Darkness can be dealt with. It's immediate and it does not involve an off-site lab. It's simple and straightforward to match the adjacent teeth exactly. The shade transitions, nuances and translucencies can all be designed in. It only involves one tooth and it's the least invasive. Properly done direct resin veneers are a superior restoration.

Wendy S. Spektor, DDS · Answer

Great question!!!  Find a dentist who will do a consultation about your front tooth and look into walking bleach. 

	Walking bleach can be very successful and the easiest and quickess way to whiten your front tooth if it has calcified.  I am assuming your tooth is not broken.  You can then whiten the rest of your teeth if you want everything whiter.  The next best option is a veneer but those are very hard to match when it is just one tooth. 

	Do your research-Much success-Dr. Wendy

Scott Greenhalgh, DDS · Answer

There are a number of options that MIGHT match your color perfectly. You can have procedures like Whitening, or even a veneer placed to correct the color.

	I find that most patients want to have the result match really well and have it look good for a long time. After 22 years as a Denver cosmetic dentist, I tend to go to the most predictable results.

	It's possible that a veneer can match well-it really depends upon the type of discoloration and the color of the neighboring teeth.

	Even though it might sounds more invasive, I have found sometimes it takes making a porcelain crown to get the best color result.  I have tried many different conservative solutions and candidly, they are often an improvement, but not often a great match. With some of the whitening options, you will get some fading and re-darkening and will need to re-whiten again in the future.

	The key is the communication between the cosmetic dentist and the ceramist who will make the porcelain (veneer or crown). Their collaboration will ensure you get a wonderful result.

	Thank you,

	Scott Greenhalgh, DDS

John Whittemore, DDS · Answer

Bleaching the tooth internal as was suggested by another doctor here can be a great way to get the color back without losing so much of your natural tooth structure. The only trouble you might encounter is that there may be some residual nerve tissue and when you go in to internally bleach the tooth it may rear it's ugly head, requiring a root canal. The odds are high in fact, so be ready to do a root canal with a specialist (calcified canals can be tough to treat) as part of the plan. Even so, this would likely be cheaper than a veneer or crown and would preserve a lot more tooth structure. This is not a perfect science, though, so it may not match perfectly. A highly skilled cosmetic dentist and ceramist can match the tooth with a veneer or a crown.

Michael Gulizio, DMD, MS · Answer

Aside from placing a veneer or crown, my first treatment of choice for my patients would be to offer them selective deep bleaching of the tooth in question. 
	
	Deep bleaching is the most conservative treatment option because it may be possible that a veneer or crown is not needed at all.  The deep bleaching process takes approximately 2 weeks, followed by a one hour in-office professional whitening.  A special whitening tray is fabricated for your tooth (not the typical bleaching trays made by your dentist) and a proprietary whitening agent (made by KOR Whitening) is used in the tray for 2 weeks.  During this 2 week period, the whitening agent is "conditioning" your tooth.  At the end of these 2 weeks, your dentist would then "power bleach" your tooth to get your tooth as white as possible.  There are only a handful of dentists that have this deep bleaching system, so visit the KOR website to find a dentist in your area that offers this whitening system.

	If slight to no improvement is seen after the deep bleaching process, I would recommend a single veneer with multiple try-ins to get the shade to match your adjacent tooth.  Good luck!

Heather M. Wilmore, DDS · Answer

Hello, I would recommend a full coverage crown for your discolored tooth. A veneer is very thin and may not be able to mask the dark discoloration of your tooth. A crown is thicker and will be able to cover the dark discoloration better. A crown would be more predictable.

Susan Goode Estep, DMD · Answer

Since a veneer is a more conservative treatment for the tooth (I don't have to grind the tooth down very much), I will typically use a veneer in your case - as long as the tooth is otherwise intact, healthy, and has no other large restorations. To be honest, in cases like yours I will often veneer both front teeth with extremely conservative veneers (even no-prep veneers should the case allow), so that the two front teeth will be made out of the same material -- if I do only the one front tooth, I will have several try-in appointments so that I can tweak the porcelain until I get it as close a match as possible to the neighbor tooth. If you choose to do just one, it costs the same as two due to the greater number of appointments needed to get it just right.

Lance Timmerman, DMD, MAGD - Account Suspended · Answer

If the goal is simply to fix the appearance, then the most conservative approach would be my choice.  A veneer would cover only what shows and preserve the rest of the tooth.
What you describe may be what is called calcific metamorphosis.  While the root canal system may not appear on an xray, it may still be present.  It may never be a problem, but it could.  If it does, having a veneer allows treatment without destruction of the veneer.

Veneer or Crown for Calcified Tooth?

Answers (9)

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