Do I Need a Prosthodontist or Cosmetic Dentist for my Dental Crowns?

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I made the regrettable decision of going to Mexico to have two dental crowns placed. I needed one on the front on two on the back. The dentist told me if you’re doing front teeth you have to do both of them and I was naive enough to believe him. So I have two on the front and two on the back. The front teeth look ugly and now have metalish gray stuff showing on the top, which makes me wonder if I have decay there now. The back teeth have been a problem from the beginning and my jaw hurts all the time, and extra when I chew, because the new crowns hit together before the rest of my teeth do. On all of them, it is difficult (if not impossible to floss). I finally have saved up enough money to do something about these crowns but am unsure if I should see a prosthodontist or a cosmetic dentist.

Kristie

Dear Kristie,

I am sorry for all you had to go through with this experience. Many patients have been burned by dental tourism. Let’s look at what is going on with your mouth. While it is possible there is some decay, those metallic grayish lines are because you were probably given porcelain fused to metal crowns. These should never be placed on front teeth for that very reason. They also tend to look less natural than their all-porcelain counterparts.

I’m not sure why the dentist said you needed two crowns for front teeth when only one tooth had a problem. Sometimes, dentists who are inexperienced in cosmetic dentistry will imply that it is necessary in order to get them to match, but that is not true.

Prosthodontists are skilled in the engineering side of crowns in getting them to align with the bite properly. However, very few of them invest in the training for cosmetic dentistry because they feel the structural training is enough. It is a rare prosthodontist that cares what you think about the appearance of the crowns. Because you have two front teeth being crowned, I think the cosmetic side of things will be an important skill. So, unless you know of a prosthodontist who also invested in cosmetic dental training, I would go with the cosmetic dentist.

The good news is that all dentists know how to do crowns, though admittedly some are better than others at doing it well. You shouldn’t have a problem finding a dentist who understands how your bite should come together.

There are two things for you to look out for before you allow any dentist to bond your crowns on permanently. The first is that they feel comfortable and natural. The crowns should not hit before anything else. You should feel like you have healthy, natural teeth and not something extra jammed into your mouth. When you bite down it should be with complete comfort.

Additionally, for the front teeth, you will want to look at them in several different types of lighting to ensure that you like the way they look. If there is anything you do not like about them, they should go back to the lab. For all of this to work, you will need to make sure he or she only uses a temporary try-in paste. The dentist should only permanently bond it when you are completely satisfied.

This blog is brought to you by Annapolis, MD Dentist Dr. Esposito.