My dentist gave me a smile makeover with porcelain veneers crowns on both the top and bottom teeth. Two of the teeth started bothering me and the gums were sensitive. The dentist adjusted the height on both of them several times, but they still hurt. Then, they developed abscesses. The dentist did x-rays and told me the nerves died and I will need root canals on those two teeth. He referred me to a root canal specialist, who found four other teeth in need of root canal treatments. I was frustrated and asked my dentist about this. He said this sometimes happens to people with sensitive teeth, but not to worry because they’ll go through the back of my veneer crown and no one will know. Why didn’t he warn me about that before the procedure? I’m a little worried this is going to be an ongoing nightmare with the remainder of my teeth. Is there anything I can do about this?
Kate
Dear Kate,
I want to clarify something right off the bat. You’ve used the term veneer crown. I want you to know there is no such thing. I am hoping you weren’t misled, but just got some terminology mixed up. There are porcelain veneers and there are porcelain dental crowns, but there is no veneer crown. Based on your descriptions of what has taken place, I feel you were given dental crowns. It would be incredibly rare for there to be nerve damage from the tooth preparation done with a porcelain veneer.
Tooth preparation for porcelain veneers
When a tooth is prepared for porcelain veneers, very little tooth structure is removed, as you can see from the image just above. The structure is removed from the front only and a smidge on the sides. This is because that is where the veneer will be placed. You will never see a porcelain veneer that hugs the entire tooth, going around to the back. It will only be bonded to the front of a tooth.
Because so little preparation is required, there is little risk of any type of nerve damage.
Tooth preparation for a dental crown.
What I think happened to you is the preparation similar to the image directly above. This is necessary because a dental crown goes around the entire tooth, so more room is necessary. If a dentist gets too aggressive in his removal of the tooth structure, there is a greater risk for pulp exposure, leading to a dental infection. This appears to be your situation. With the number of teeth he worked on, I would be more likely to call this a full-mouth reconstruction, not a smile makeover. A full mouth reconstruction crowns all your teeth and it is done to correct a bite that is so off it is causing problems, such as major TMJ disorder. With a smile makeover, you use porcelain veneers, usually only on the teeth that are visible when you smile. Teeth whitening is done ahead of time to ensure all the teeth blend together well.
If your work was done purely for esthetic reasons, your dentist was overly aggressive and caused damage to quite a few teeth. My suggestion is you hold this dentist accountable and have him pay for your root canal treatments and any new ones that become necessary in the next six months. After that, I think everything will have gone to its norm.
I’m sorry this happened to you. For those reading, if you ever want a smile makeover that is done both with technical accuracy as well as stunning beauty, my suggestion is you use an AACD accredited dentist.
This blog is brought to you by La Jolla Cosmetic Dentist Dr. Stephen Doan.