A new patient in her 60’s came in today with a broken piece of her tooth in a mini zip lock baggie. She was really bent out of shape. “Not another tooth….I can’t lose another tooth “, she frantically screeched.
She sat uncomfortably in the chair, when I said,”smile”. With a slight demure hesitation she released her puckered lips and showed the faintest smile. It was her upper left first bicuspid that suffered a shattering. The tooth was within her esthetic zone (it showed BIG when she smiled). She reported no pain or temperature sensitivity. “Those damm almonds”, she said (you can read about that one in one of me previous blogs). I quickly instructed my assistant to take an X-ray, but deep inside I knew before evaluating the digital radiograph, that she was keeping the tooth based upon her clinical symptoms. In my head, I knew with my technical talent and technology that I could save the remains of her tooth and her, the torment of another extraction, but that was not the problem. What freakin color do I go with? That was the biggest problem…….
Radiographic confirmed that the overall remaining tooth structure was sound and No Problem for me to restore.
I told her that I could save the tooth easily with the CEREC technology. One visit crown. Done! I then asked the question, “What color do want?
The Discussion/Options: The Following are only THOUGHTS that go through my head when faced with the complexity of tooth shade selection.
Option #1 Do I match the pre-existing previously selected dentistry tooth shade?
This is always preferred. On the other hand, what if there is no other pre-existing dentistry? This may be the patient’s first crown. How about, what if the patient has tetracycline stained “ribboned colored” teeth from taking antibiotics as child? I have never met a patient who loved their wrecked enamel dark stained teeth.
What if all the pre-existing crown dentistry was simply mis-matched? A classic checkerboard smile. It’s my experience, when it comes to color that some patients just don’t care…. “Ahhh doc, it’s a back tooth. Who’s going to look back there anyway?” A patient may have many dentists over a life time. For instance, different lighting in operatory rooms will offer different shading. Some days may not offer the benefit of natural lighting for optimal tooth shade selection. Incidentally, some dentists are just bad at color selection. I have multiple assistants come to a consensus to pick color for dental work. They are experts at that.
Option #2 Do I CREATE a new potential tooth shade Standard?
Do I say to the patient,”Get rid of that corn cobb yellow. Just screw it! Go for those bright white teeth that you always wanted. Now is the time to commit. Let’s do them all!” (some what exaggerated perhaps)
Option #3 Do I keep everything the same and custom shade and blend ceramics?
This option requires multiple visits and time. Many returns back and forth to a specialized local laboratory sculpted by my kind, patient, valium induced ceramist.
ANSWER: Not for me to decide. I’ll give you all the options. They are your teeth, your body. Your Choice.
The End Result
Dr. Emilio & Associates, Always Accepts New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.
His goal is to keep his patients’ Teeth and Gums Healthy For Life.
Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week
OPEN on Weekdays. 7:30am -8:00pm (M<T<W<T)
Weekends (Saturday only). 8:00am-2:00pm
111 East Avenue, Norwalk, Connecticut 06851.
You can always contact me directly via email email@example.com
Office (203)866-7164 www.robertemiliodds.com
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