Dental Health

I Had a Root Canal and Now My Tooth Is Dark. How Can I Get My Bright Smile Back?

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.

Treatment Options

Internal Dental Bleaching

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.

Bright Smiles with Dental Veneers and Crowns

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

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Do I Need an Extreme Makeover? Why Do My Dental Crowns Look Fake?

The most common complaint associated with crowns is that they look "opaque," "lifeless," and "fake" compared to natural teeth. Do you need an expensive dental makeover to solve the problem? No!

The appearance of a crown is affected by many factors, but ultimately, the final result is determined by how the crown reacts with light. Natural teeth have a high degree of translucency, which means a certain amount of light passes through the tooth. The result of this is that the tooth appears to have depth and vitality.

Porcelain Dental Crowns With a Metal Substructure

Traditionally, crowns are made of two materials:

• porcelain, which gives it the tooth-colored appearance
• metal substructure, which gives the crown its strength

Generally, it is this type of crown that can appear opaque. The reason for this is that while porcelain is very translucent and lets light travel easily through it, no light can pass through the underlying metal. In order to prevent the metal color from showing through the porcelain, which would make the crown seem dark or gray, the metal has to be "masked out" with an opaquing material. It is this masking or opaquing that can affect the final appearance, giving rise to the opaque or lifeless look.

Do All Porcelain Crowns With a Metal Substructure Appear Lifeless?

The answer is no. One thing that can be done to improve the appearance is to remove the metal margin that goes around the crown. By keeping the metal inside the crown and having porcelain at the junction between the crown and the tooth, the "black line" appearance at the gum line can be eliminated, thereby increasing the translucency in this area. It also is necessary to have an adequate thickness of porcelain over the metal substructure. If the metal that has been masked out is too close to the outer surface of the crown, the appearance of depth is lost. What it mostly comes down to, however, is the skill level and artistry of the technician who is making the crown. When done correctly, porcelain crowns with a metal substructure can give you the best of both worlds without the expense of an extreme makeover. They can be made to exactly match your other teeth while still appearing lifelike, and since there is metal in it, they have increased strength.

Dental Crowns

Today, there are dental crowns available that do not require a metal substructure and are made of only porcelain. Depending on the specific type, they get their strength either from the bond to the remaining tooth structure or from a dense tooth colored substructure. Since there is no metal, these types of dental crowns allow more light to pass through, which enables them to have more depth and vitality, much like natural teeth. So why isn't this type of crown used all the time? The main reason is that they are not as strong as crowns with a metal substructure. So, if a person grinds their teeth, these crowns have a greater risk of fracture. Another reason why an all-ceramic dental crown cannot be used in all situations is if the underlying tooth structure itself is dark. Very dark teeth are difficult to mask with these types of crowns because of their translucency. In these instances, the dark color may show through the crown. So, for situations where a lot of force will be placed on the teeth (such as grinding habits) or if a tooth is really dark, a well-made porcelain crown with a metal substructure may be a better restoration.

By Greggory Kinzer, DDS, MSD

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.