550 Water Street, Bldg. K-1
Santa Cruz, CA 95060
Torabinejad, Mahmoud D.D.S.
600 N Euclid Ave # 102
Upland, CA, 91786-4779
Fukawa, Michael R D.D.S.
2000 Forest Ave # D
San Jose, CA, 95128-4831
Endodontic Care Ctr
3017 Telegraph Ave # 200
Berkeley, CA, 94705-2049
Jitsumyo, Aileen E D.D.S.
3551 Farquhar Ave # 201
Los Alamitos, CA, 90720-2003
Throughout history, dentists have tried to recreate the function and beauty of natural teeth when tooth structure has been lost. Restoring function used to be the main goal of a dentist because prior to the 1970's, dentistry lacked the proper technology to achieve fine esthetics as well as function. Dentists could only predictably offer patients a restoration that would simply "fill" the empty space. Today, dentistry has more advanced dental materials and newly developed techniques that allow dentists to offer artistically-recreated, natural-looking crowns and modern tooth bonding that would fool even the most critical eye.
Before you can understand how crowns and tooth bonding can mimic teeth you must understand why natural teeth appear as they do.
It is a common mistake for patients to think that their teeth are all one color. Your teeth are never just one color. They are a series of superimposed translucent layers of varying shades. Teeth also have different surface textures that reflect light in ways that affect the color of your teeth.
Your teeth are made up of three layers: pulp, dentin, and enamel. Each layer has a specific thickness, composition and structure. Additionally, the way light reflects off of or transluces through the layers gives you the color of your teeth. Using knowledge about the three layers of teeth allow dentists and dental technicians to recreate natural-looking dental crowns and tooth bonding.
Dental crown technicians are the true artisans in dentistry. Dentists begin the crown-making process by reducing the size of the tooth, making an impression of the reduced tooth, and selecting the proper shades of the tooth. This information is then transferred to the dental technician so a crown can be made.
Dental technicians blend science with artistic knowledge to recreate natural-looking teeth. Artistically, they use frame and reference, proportion and idealism, perspective and illusion as well as symmetry to mimic nature. Understanding the language of colors and using new dental materials and techniques has allowed the dentist to not only "fill" missing spaces but create cosmetic dentistry artwork from crowns and tooth bonding as well.
By Benjamin O. Watkins, III, DDS
It is not uncommon for teeth to turn darker in color either before or after being treated with a root canal. Deposition of pigment within the tooth from the nerve, usually due to major trauma, can cause the tooth to turn either gray or brown. What happens is a reactive process causing calcification within the tooth can cause it to turn yellow. The treatment to regain your bright smile now depends on both the type and the severity of the color change.
By far the easiest way to correct the color is by dental bleaching the tooth. The procedure for this is different than for conventional dental bleaching, where you are whitening all of your teeth.
The technique involves your dentist or endodontist placing a small amount of extremely strong dental bleaching material inside the tooth where the nerve was. It is placed through the small hole in your tooth through which the root canal was done. A temporary filling is then placed to seal in the tooth whitening material for three to four days.
The tooth will start to lighten almost immediately, and you will often see improvement on the night that it was placed. You will have to return to your dentist to have the dental bleaching material replaced because its effectiveness decreases over time. It usually takes two to three applications to regain your bright smile.
Once the tooth is lightened, a permanent filling will be placed. This procedure is very stable and it works best for teeth that have turned brown or gray. Even though the tooth color is lightened, it is difficult to obtain a perfect match with your other teeth.
Another treatment option is to use a restoration to cover the tooth to mask the color change. The type of restoration needed will vary depending on how dark the tooth is and how much lighter it needs to be.
For teeth that are slightly to moderately dark, the best restoration is a porcelain veneer. Porcelain veneers are thin restorations that, when bonded to the tooth, can change both its shape and color.
Because of the thinness of the porcelain veneers, the color may show through the veneer if the tooth is too dark. Therefore, they are most successful for treating color changes that are not severe. For extremely dark teeth, a crown may be indicated to help mask the color.
It is important to note that although a crown or veneer may mask the darkness from the tooth, there may still be some darkness from the root that can show slightly through the gum tissue. The effect of this will vary depending on how dark the tooth is and the type of gum tissue.
A darker tooth with thinner gum tissue is more likely to have the dark color show through than a lighter tooth with thicker gum tissue. This darkness may not be a factor if the lip does not move up high enough to show the area at the gum line when smiling. If it does show and is an issue, the treatment will most likely need to include dental bleaching of the tooth, as previously discussed, with or without a restoration.
By Greggory Kinzer, DDS, MSD