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Why are my porcelain crowns turning dingy and yellow?

I got four porcelain dental crowns placed on my upper front teeth less than a year ago, and they’re already getting discolored. This is frustrating because they’re practically new and I don’t smoke or drink a lot of dark-colored beverages. Why are my crowns turning yellow so quickly? Do they need to be replaced?

— Eliza from Eugene, OR

Hello, Eliza

Porcelain does not stain easily. Your natural teeth are actually more likely to pick up stains and turn yellow than porcelain because porcelain restorations are covered with a non-porous glaze. So if your new crowns already look discolored, then this is a sign that something is wrong with them. Either they were not of the quality you were led to believe at the time they were placed, or something has happened in the months since that caused damage to them.

Here are three possible reasons that your dental crowns are turning yellow:

1. You have recently whitened your teeth.

Teeth whitening treatments do not affect the color of porcelain dental crowns, but as your natural teeth lighten in color, this can make your crowns look dull and yellow in comparison. Granted, you did not mention that you have had whitening treatments, but if you have done any teeth bleaching treatments lately, then this could be a very simple explanation for the reason your crowns look discolored.

2. Your crowns have been damaged.

The protective glaze that helps porcelain crowns retain their color and gloss could have been compromised. The most likely way this could happen is if a hygienist used a power cleaning device on your teeth during a professional teeth cleaning appointment. Hygienists sometimes use a device that blasts a high-pressure stream of baking soda and water on teeth to remove stubborn stains. If your hygienist used this instrument on you, he or she was not careful to avoid your porcelain crowns. The high abrasiveness of this treatment could then have stripped the glaze from your crowns and left them susceptible to picking up stains.

Another possible way your crowns could have been damaged is if you were given an in-office fluoride treatment with acidulated fluoride. This type of fluoride can chemically damage the glaze on porcelain crowns.

Yet another possibility is that your crowns were damaged before they were even placed on your teeth. Perhaps they were not properly glazed during the fabrication process or maybe the glaze was worn down when your dentist was making adjustments.

3. Your dentist placed crowns made of a cheaper material instead of porcelain.

This may be the least likely scenario, but unfortunately, it’s not unheard of. Some patients have received what they thought were porcelain crowns only to learn later that they were made of composite instead, which is prone to staining.

At any rate, it’s clear that something is wrong because your porcelain crowns should not be turning yellow, even if you drank coffee all day, every day.

At this point, we recommend that you seek a second opinion from a cosmetic dentist you can trust. This new dentist can help you learn more about the actual composition and condition of your four so-called porcelain crowns and help you find out the cause of their discoloration.

You are very likely entitled to a refund and then some, if it turns out that your current dentist performed sub-par restorative work. Please see our post responding to a concern about a shoddy porcelain veneer to see our advice for negotiating a refund from your dentist.

This post has been published on behalf of Dr. Heng Lim, an Owasso dentist with experience in smile makeovers and other cosmetic dental procedures.

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My new crown doesn’t feel right. What should I do?

I just got a new crown on a back tooth, but it feels odd when I bite down on it, like it doesn’t quite line up with the other teeth. 

I asked my dentist if he could trim it down so that it fits better, but he checked it and said I just need more time to get used to the sensation. It’s been two weeks at this point, and it’s still bothering me. 

Is it normal for a crown to feel “off” like this?

— Stefanie from Tulsa, OKA woman is frowing in pain and touching the side of her face with her hand because her dental crown doesn't feel right. A dentist experienced in full-mouth reconstruction can help her get relief.

Hi Stefanie,

First of all, it’s not normal for a crown to feel “off.” A crowned tooth should feel so normal that you forget the crown is even there. If your bite started to feel uncomfortable after you got the crown, then this suggests that your crown may need to be adjusted.

So why would your dentist tell you to ‘just get used to it?’

Well, designing a dental crown so that it fits perfectly in line with the opposing teeth is not a simple task. It requires a certain skill set and may even take multiple attempts to create a natural-feeling crown. Most dentists can design crowns that adequately restore individual teeth, but relatively few dentists are experts in creating crowns that help harmonize the entire bite.

“Occlusion” is the scientific term for the way your upper and lower teeth fit together when you bite down. If your dentist does not feel that they are an expert in occlusion science, then he might tell you to ‘just get used to it’ if he can’t find an obvious problem.

On the other hand, a dentist with advanced post-graduate training in restoring balanced occlusion could help you get a more comfortable bite. The Las Vegas Institute for Advanced Dental Studies, for example, is a respected institution that teaches dentists how to improve the function and balance of the bite.

Does this mean that you should visit a new dentist? 

Not necessarily. If your bite just feels slightly “off” but you don’t experience any pain when you bite down on your new crown, then you may indeed get used to the sensation if you give it a few months. You can stay with your original dentist as long as you are confident he has your best interests at heart.

Keep in mind, however, that an unbalanced bite has the potential to cause complications down the road. Too much pressure on one tooth could cause bone loss around that tooth, or an unbalanced bite could even lead to TMJ pain. Adjusting your crown could help that tooth feel better and eliminate your risk of such complications, but it sounds like your current dentist doesn’t know what further adjustments can be made. 

If you are ready to seek more advanced help, then use this opportunity to search for a new dentist who has the qualifications and experience necessary to balance out your bite. A dentist who is skilled in full-mouth reconstruction and in adjusting occlusion can safely adjust your crown. 

You may also want to visit such a skilled professional the next time you need a new dental crown. Search for a dentist near you who has advanced training from a post-graduate dental institution and ask them for a second opinion.

This post has been published on behalf of Owasso dentist Dr. Heng Lim.

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