Tooth with a Porcelain Veneers has a Cavity

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I have a front tooth that has a cavity on it. This tooth has a porcelain veneer. My dentist wants to remove the porcelain veneer, treat the cavity, and then replace it with a dental crown. I’m not too crazy about the idea of a crown. Is that absolutely necessary? I wish I could go back to the original dentist who did the work, but he is retired.

Carrie

Dear Carrie,

I’ll say right off the bat that a cavity would need to have eaten away about 30% of the tooth for a dental crown to be necessary. You did not indicate anything that extensive. This makes me think that he is not comfortable placing porcelain veneers and is, instead, steering you toward a common dental procedure. That is a problem because it tells me that he does not have significant training in dental cosmetics. I sincerely doubt either the dentist or his lab will be able to match a dental crown to the veneered teeth. Only the top cosmetic dentists can accomplish this. In fact, I’d think only about the top 1-3% could do it.

There is a second issue to consider. My guess is that the cavity is toward the margin of the tooth, which is where the veneer will be the most susceptible. Bonding the porcelain veneer to the composite bonding used to repair the cavity is much trickier than bonding it to the natural tooth structure. There is another area that would require some expertise.

I’d like to suggest you go to get a second opinion by another dentist who can examine your tooth. Look for one with post-doctoral training in cosmetic dentistry. For example, Dr. Dudney has the following qualifications: