Warren had most all of his teeth “crowned” by another dentist. He said he didn’t like his porcelain crowns from the beginning and came to us to discuss his options. “If you redo them for me, how would you do them differently,” asked Warren?
After carefully looking at Warren’s porcelain crowns and smile it was obvious that the dentist was very skilled and had worked very hard with Warren’s treatment. We told Warren upfront, all of his crowns fit properly, his bite was good and the treatment was well within the standard of care.
But to answer his question, it was obvious that Warren had very high expectations and had particular ideas of his own about what he wanted his smile to look like. We asked Warren to explain just what it was that he was displeased with his dentist’s porcelain crown work?
He was very quick to list his concerns:
- The teeth aren’t white enough
- The teeth don’t look “real”
- They are too thick
We explained to Warren that the issues that concerned him were probably a result of several things:
- The dentist and he not really communicating before treatment about what he wanted (we would make sure that we were all on the same wavelength before beginning any treatment)
- The dentist’s choice of very opaque porcelain (we would recommend more life-like Empress and EMax porcelain crowns)
- The choice of color (since he knew he wanted whiter teeth it would be easier for his to choose the color he wanted from the tooth shade guide)
- The actual style of porcelain crowns done by the dentist’s technician (we utilize a nationally known maser cosmetic ceramist with three decades of experience and has also been the recipient of many awards for his outstanding achievement in cosmetic dentistry)
- The smile style prescribed by the dentist (see tooth shapes). Warren said he didn’t remember his dentist discussing tooth shapes with him at all, so it may be that the dentist didn’t actually prescribe a specific style of tooth shapes and the decision was left up to the ceramist who actually never met or spoke with Warren. Most cosmetic dentists today will discuss smile design with the patient and specify a smile design for the ceramist to follow.
Further explaining to Warren, now really understanding what he wanted accomplished, if we were going to remake them for him we would use a more natural looking porcelain for his crowns that would not only be lighter in color, but also would have more natural looking translucency (Empress porcelain for the front teeth, EMax porcelain for the back teeth).
Warren was pleased to know that our ceramist has a very consistent style of creating crowns that really look like natural teeth and don’t look “too thick” or “bulky” like Warren currently had.
The last thing we suggested was a more masculine smile design. Warren is a very masculine looking man and his current porcelain crowns were very generic looking, especially having rounded corners on his four front teeth which sometimes is considered a more feminine or youthful look. We suggested a more masculine looking smile design (see tooth shape library) by making the front four teeth flatter without the rounded corners.
After more discussion Warren decided that he was ready to redo his old porcelain crowns. “I like your plan,” he said. “I think we’re communicating well and on the right track together. I really hate the way my porcelain crowns look so I’m ready to go ahead and get started.”
We preceded with Warren’s cosmetic dental treatment, removed his old porcelain crowns and made new ones for him. We met all of Warren’s treatment goals and the end result were teeth (all-porcelain crowns) that were whiter, “real looking”, more life-like translucency and a smile design that was masculine more natural looking than his previous dentistry.