I don’t want crowns! Will porcelain veneers work?

I have been looking forward to getting porcelain veneers, since my last dentist appointment. Even though my dentist said he found a couple little cavities, he said I could still get them since some of the tooth is removed anyway. He said if the cavities ended up being deeper than he thought, he would fill them a little bit. But, he said I was still a candidate for porcelain veneers.

Shortly after that appointment, we had to move out-of-state for work. Now, I’m seeing a new cosmetic dentist. He is telling me that porcelain veneers are not an option. So, he wants me to get crowns done. This new dentist says the teeth have too much decay. Also, he wants me to get crowns with a metal framework to help with strength. I don’t want crowns and I don’t want metal in my mouth. It doesn’t seem possible that the cavities would have progressed so much that I cannot get porcelain veneers. Do you think I should get another opinion?

-Sheila in Kentucky

Tooth decay is a tricky thing. It can progress very quickly and sometimes it is much worse than the x-rays show. There are no guidelines for how quickly it advances. For example, it may destroy one tooth rapidly and not progress at all on the one next to it.

Therefore, it is a judgement call by the dentist. Some dentists take a less invasive approach and recommend minimal treatment. Others will be more proactive and treat the problem now, so more work isn’t required in the future. It would be a bummer to get porcelain veneers now and have to get them replaced with crowns after a short time.

Although, there are a couple things that don’t add up. Typically, an excellent cosmetic dentist will not recommend porcelain-fused-to-metal crowns, especially on the front teeth. This is mainly because it is very challenging to make porcelain-fused-to-metal crowns look beautiful. This type of crown will inevitably end up with a gray line at the gum, when the gums recede over time. Most dentists agree that the use of metal in crowns is much better suited for back teeth.

It’s probably a good idea to get a second opinion from another reputable cosmetic dentist. Unfortunately, based on what you have described, I cannot recommend you get porcelain veneers over crowns.

This post is sponsored by Lexington cosmetic dentist Hamburg Expressions.