Should my temporary crowns look like the permanent ones?

I am having crowns replaced on all my teeth, upper and lower. Should the temporaries in my mouth now be what I should be expecting the final teeth to look like as far as the shapes and sizes? The dentist states that the lab will change many things before the delivery of the crowns. Should the temporaries not be changed to replicate what the final crowns will be like?
Confused
- Rebecca

Rebecca,
I can’t tell enough from what you’re saying whether you need to be concerned or not.
If the appearance of this dental work is a big concern of yours, you should be going to an expert cosmetic dentist, and there aren’t many of those around. Most dentists are good technicians but not very artistic, and they just don’t have a passion for beauty in their work. They’re good at fixing things. And if that’s all you want is to have your teeth fixed, then you’re probably fine. But if you want to end up with a beautiful smile, you may be in the wrong place.

Expert cosmetic dentists will use different ways to help them be sure that the patient is happy with the final appearance of the work. Some will use computer simulation, creating the smile on the computer before any work is started, and then will make the smile to match that simulation. Some will use the temporaries as a “provisional smile” and will want the patient to be happy with the temporaries before the permanent porcelain crowns or porcelain veneers are placed, and the permanent ones will be patterned after the temporaries.

In our office, we are very fussy about the appearance of the final result and about you being happy with how they look. Before we put on a new smile, we give you full opportunity to look at it, to try it on, and we won’t put it on if you have any hesitation or question that it is anything other than a beautiful new smile that fits you perfectly. But over 90% of dentists are simply not that concerned about how the final result looks. They’re completely focused on how the crowns fit and function and often think that being overly concerned about the appearance is frivolous. That is how dentists are taught. But we are very concerned about all three issues: fit, function, and appearance. 

So what you are seeing may be okay, or it may be a red flag. It may be that the dentist has no intention of seeking much input from you as to how the final case will look. That is the personality style of most dentists, and is a strong part of their training - that the dentist knows best and the dentist decides how this is supposed to look. But this runs against the grain of artistic cosmetic dentists.

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Not liking the look of my porcelain veneers

I just had six upper veneers put on. Is it normal for the two front teeth to be a different color than the teeth beside them? I was expecting them to all be the same. They look a few shades darker. Also my third tooth on the side doesn’t blend in with the teeth in the back. They’re longer and thicker. my veneered teeth appear to be larger than the teeth in the back. I don’t care for the look.
- Kathy from Pennsylvania

Kathy,
All the points you made about why you don’t like your new smile are valid. Your experience is like so many patients who have their family dentist do a new smile for them. The natural tendency of dentists, which is reinforced by dental school training, is to think that they’re the ones to decide how the teeth should look. So they make a new smile for you and as they’re standing over you ready to bond it to your teeth, they give you a quick look in the mirror while you’re upside down in the chair. Then you get home and get a good look at it and you don’t like it.

Unfortunately, fixing the problems you’re seeing is going to require having the porcelain veneers removed and completely re-done. If it’s important to you, I would ask the dentist to do that. After all, you paid for porcelain veneers to give you a beautiful smile, and I believe you’re entitled to get that result.

In our office, we make sure that the patient loves their new smile before we ever bond it on. When we’re doing cosmetic dentistry, it is done to treat the self-image of the patient. And if the patient doesn’t absolutely love the smile, the case is a failure.

Links:
Seattle Cosmetic Dentist
You may be interested in reading Dr. McKay’s new book, Bulimia is a Dental Disease.

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Snap-on smiles

Is there such thing as dental flippers that cover all of your teeth (such as the ones beauty pageant contestants wear). If so, can you please provide me with more information?
-Jeri from Seattle

Jeri,
I’m guessing you may be referring to what is called a “snap-on smile.” This is a set of temporary acrylic teeth that are made to snap over your existing teeth for a temporary situation, such as a wedding.

But these aren’t worn by beauty pageant contestants, because while they may look okay from a distance, from close up they look a little fake, not first class. For beauty pageants, they get regular smile makeovers with porcelain veneers and/or porcelain crowns. Many of them also have Zoom whitening done or some other tooth whitening procedure. For beauty pageants, they need to look their best and snap-on smiles simply aren’t good enough.

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