My Dentist Suggested PFM White Metal Tooth Crowns for Front Teeth, Should I Ask About Lava? (photo)

First i will take care of the gum inflammation, gingivitis can make everything looks worse than what it is. The are many types of porcelain restorations than can hide discoloration, dark teeth and existing metal posts. A well trained cosmetic dentist, can use dental materials to hide discoloration and the base and root of the tooth. Also by selecting the shade of the tooth after prep can help the Lab tec. to hide things under porcelain, the dentist must provide photos to the lab too. Then a  decision can be determined based on the final results. For final try in your dentist can use try in paste for you to see the final porcelain work before it gets cemented on. Lava crowns are a good option, but sometimes can look opaque because of the white coping under the porcelain.

Lava crowns will achieve the same "blocking out of the dark greyness" of your discolored tooth as the PFM crown will. Lava crowns also have other aesthetic advantages over PFM crowns. However, you should expect to pay more for Lava crowns and well-done PFM crowns will certainly meet the majority of your aesthetic expectations.

You probably don't need an additional appointment to discuss the two different crowns. A phone call to the office to inquire if the doctor uses Lava crowns would suffice and then just let them know you would prefer to have Lava crowns instead of PFM crowns.

Good luck!

It all depends on your cosmetic expectations. If your expectations are really high, then you want to seek out a very well trained and experienced cosmetic dentist. From the looks of your photos, your expectations are probably not too high, because the front 2 teeth appear to be so much larger in proportion to your other anterior teeth. They also protrude much more than the others. There are many ways to dramatically improve your smile, if you so wish.

The aesthetic preferences on how to make the central teeth look pleasing and white will depend on how to cover and hide darkened tooth structure. If the darkened structure is only above the gum it can be hidden with Captec crown (yellow gold substructure) or good all-ceramic crown. The situation will be more complicated if the gray shade of discolored tooth is more apical in the situation when dark root is showing through- most likely it can be corrected with soft tissue graft. You need to have a consult with a specialist who will help to navigate to correct decision.

From the photo :

1) you first need to resolve the gingivitis issue. Your gum is very inflamed and the chances of your two front teeth getting recession is high specially if yuio get a PFM crown.

2) Your two front teeth are so dominant and much larger, a smile make over will resolve everything including the protrusion and the excessive disproportional of your front two teeth.

3) A full porcelaine crown that has had a masking layer placed under , can resolve the issue.

Please visit an experienced cosmetic dentist. If the three points I described to you has not been brought up, the person you are going to doe snot have enough experience in theses matters. Your gum needs attention. You may even be a mouth breather . this too causes the look of your gumsl.