Should I put a veneer on a healthy front tooth in order to better match an adjacent front tooth crown that will be replaced?

Question

My original question was edited by RS, which changed its meaning beyond recognition. So I am trying again: I am having a very old front tooth crown replaced for cosmetic reasons (color no longer matches other teeth & exposed metal base at gumline.) My dentist advised a veneer on the adjacent healthy front tooth, to better match the two. Is it really advisable to destroy a perfectly good tooth - is it really that difficult to get an acceptable match to the color of the healthy tooth? Thanks.

Sarah Thompson, DMD · Answer

Based on your photo and description, the answer is that it depends.  A great cosmetic dentist should be able to match the color and shade extremely well, but every patient's mouth is different and may require that more than one veneer be placed to achieve an optimal appearance.  My advice to you is that whenever dealing with veneering or crowning the FRONT teeth, always view before and after patient photos online of the doctor that you select, so that you know that the doctor is capable of giving you the results that you desire.  Good luck and I hope this helps. Follow me if you have more questions.Sarah Thompson, DMD

Norman Huefner, DDS · Answer

The first question I have for you is do you just want "a better result" with your new crown, or do you want your front two teeth to looks as closely as possible to one another?If your answer is "just a better result", then one crown should be able to be done with a much better result then you presently have.However, if you want them to look almost identical, then I agree with your dentist, redo the one crown in all ceramic porcelain and place a porcelain veneer on the other front tooth.  Of course, making sure that both crown and veneer are made with the same type of porcelain.Many cosmetic dentists will tell you that doing just one central incisor is one of the most difficult procedures in cosmetic dentistry. However, by doing two, they have much more control over getting the same color, shape, texture, translucency, etc.However, saying all that, and looking at the photo you posted, for the absolute best results I would even suggest placing porcelain veneers on your lateral incisors.  I understand that you might not be interested in that, but it would certainly give you a much better looking smile.

Scott Greenhalgh, DDS · Answer

After treating cases like this for more than twenty years-here are my insights:A lot depends upon the health, and color of the tooth under the crown. If it's really dark or damaged, then a crown that's more opaque has to be used. Candidly, it's difficult to match a very opaque crown to a vital tooth that lets a lot of light through it. It can be done, but even experienced cosmetic dentists and master ceramists can need more than one fitting to make it look good. It can be pretty good, not even with the best of efforts and execution, not always perfect. If there are even minor issues with the neighboring natural tooth, then considering a no-prep veneer can both improve that tooth, as well as make matching the front teeth easier. After doing this for more than twenty years, there are occasionally cases where the limit is "pretty good". Frankly that's not a result I enjoy delivering. I'd rather see an AMAZING result. Sometimes it does require doing veneer on the other to get to amazing.Discuss this with your cosmetic dentist before you start. You need a highly skilled cosmetic dentist AND a great (preferably local) master ceramist. In our approach, we'd have you also visit with the ceramist before we started. Then we'd all have a good idea of what are reasonable expectations. In the end it may come down to you choosing between: one crown with a pretty good result ORone crown and one veneer to get an amazing result.

Graham T. Egger, DDS · Answer

Matching a single front tooth crown to your natural teeth is very hard. A veneer can oftentimes be done that requires very little to no preparation of the tooth that is being veneered to. The final decision comes down to your desired cosmetic outcome. If you are OK with an improved look but maybe still having slight differences in appearance between the two front teeth then electing to only have the crown replaced is fine. If you desire the best cosmetic outcome possible then veneering the other front tooth and possibly other anterior teeth may be needed.

Should I put a veneer on a healthy front tooth in order to better match an adjacent front tooth crown that will be replaced?

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