My teeth are healthy but have severe tetracycline stains. I want porcelain veneers, but I’ve been to three dentists who have recommended crowns instead. I don’t want to insist on veneers, but is it unrealistic to think I can get them to cover tetracycline stains? Thanks. Damien from IL
Damien,
Treating severe tetracycline staining is a complex aesthetic challenge. Tetracycline stains occur when a child with developing teeth (before age 12) takes the tetracycline antibiotic, causing a deep gray-brown discoloration within the tooth structure.
Porcelain veneers present specific challenges in these cases. Achieving a natural appearance requires a degree of porcelain translucency, which can allow the dark underlying stain to show through the veneers. Overusing an opaquer to conceal the stain can create an unnatural, chalky appearance. Inadequate coverage can also result in visible dark margins. Expertise in color manipulation is essential for successful treatment.
General dentists may not possess the advanced skills required for complex aesthetic cases like tetracycline staining. When selecting a dentist, prioritize those who can showcase successful porcelain veneer cases with before-and-after photographs. AACD accreditation is another strong indicator of competence in this area. A pre-bonding try-in of the veneers is essential to the aesthetic outcome. Patients should not accept promises of improvement after bonding; the try-in should represent the result.
Advanced dental laboratories and skilled cosmetic dentists sometimes use opalescent porcelain. These materials possess unique light-scattering properties that mimic translucency while effectively masking underlying color.
General dentists occasionally place dental crowns, an aggressive and less desirable treatment approach. Crowns require extensive tooth reduction and are less aesthetic than porcelain veneers. Furthermore, even crowns may not completely mask exceptionally dark tetracycline stains.
Brian LeSage, DDS, an accredited fellow of cosmetic dentistry in Beverly Hills, sponsors this post.
