A chipped or discolored front tooth: what your options really are

Two of the three before and after results shown on our cosmetic dentistry page are front teeth. That is not a coincidence. Front teeth are the ones people notice in their own photographs, and they are the ones that finally prompt a call.

The useful thing to understand is that whitening, bonding and a crown are not three grades of the same treatment. They fix genuinely different problems. Picking the wrong one is how people end up disappointed with work that was carried out perfectly well.

Start with what is actually wrong

There are three separate questions, and the answers point in different directions.

• Is the tooth sound but the wrong color
• Is a piece of the tooth missing or broken
• Is the tooth itself structurally weak or heavily filled

Color with no damage points toward whitening. Missing material on an otherwise healthy tooth points toward bonding. A weak or heavily restored tooth points toward a crown. And a tooth that cannot be kept at all points toward a partial denture or an implant.

Whitening

Tooth whitening, also called bleaching, lifts the shade of a tooth that is structurally fine. It is the most straightforward of these treatments and the one most people should try first when color is the only complaint.

It has a real limit that is worth knowing in advance. Whitening works on natural tooth. It does not change the color of an existing filling, crown or veneer. So if you have a white filling in a front tooth and you whiten everything around it, that filling will stay exactly the shade it was and may end up standing out more than before.

That is not a reason to avoid whitening. It is a reason to plan the order of work. Whiten first, then match any new restoration to the shade you have ended up with.

Bonding for a chip

For a chipped corner on a tooth that is otherwise healthy, tooth colored material is shaped onto the tooth and set in place. It is usually done in one visit, it is the most conservative option in terms of how much tooth is touched, and it is the least expensive of the repairs.

It is a repair rather than a rebuild. Bonding can stain over years, particularly with coffee, tea or tobacco, and a large piece of bonding on a tooth taking heavy biting force may eventually need replacing. For a modest chip on a front tooth, it is very often the right answer.

When a crown is the honest answer

A crown covers the whole tooth. It is the option when there is not enough sound tooth left for a repair to hold, which typically means a large old filling, a crack, or a tooth that has had a root canal.

It is more work and it costs more, and it also lasts differently, because it is protecting the tooth structurally rather than patching its appearance. One of the three results on our cosmetic page is exactly this kind of work, a crown and filling replacement on the back teeth.

Impressions for a crown are taken here with a digital impression scanner rather than a tray of material, which is both more comfortable and more accurate. On a front tooth, where a fractionally wrong shape or shade is immediately visible, that accuracy earns its keep.

When the tooth cannot be kept

If a front tooth is already missing or cannot be saved, the two routes are a partial denture or a dental implant. We provide both. A partial is removable and less involved. An implant is fixed and is planned around the bone you actually have.

Which suits you depends on more than preference, and it is not a decision to make from an article. It needs an x ray and a look.

How to decide without guessing

Come in and have it looked at. With an intra oral video camera we can show you the tooth on a screen at a size where the difference between a surface chip and a crack is obvious, and you can see what we are basing the recommendation on rather than taking it on trust.

Cosmetic work is elective, which also means there is no reason to be uncomfortable during it. Nitrous oxide and oral sedation are both available if you want them.

Call our office on 406-727-1006 to have a front tooth looked at. We are at 3224 10th Avenue South in Great Falls, open Tuesday to Thursday 8 to 5 and Friday 8 to 3.