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FAQ:  Porcelain Veneers

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    Veneer Questions Ask The Dentist Corinne Scalzitti Question:
    How many times can a veneer be replaced? My daughter (young adult) has a dark bruised-looking front tooth.

    The dentist says she had some trauma to the gum, perhaps years ago, and killed some nerves which are just now showing. She thinks enough of the nerves are good that no further treatment is needed.

    The tooth has a bruised look. The dentist is concerned that too much tooth needs to be removed to put enough porcelain to actually cover up the darkness and does not recommend a veneer.

    Browsing the internet about problems with veneers is scary, and my daughter is only 22, so faces many years of veneer replacement.

    Is there a limit to how many times a veneer can be replaced? Will the tooth material removal weaken the tooth? ...Visitor from TX

    It sounds like your daughter had significant trauma to this tooth at some time.

    The pulp of the tooth provides nerves and blood supply to the tooth. If the pulp bleeds as a result of trauma, the blood will turn brown and stain the tooth. The stain on the gum is probably showing through from the brown on the root of the tooth.

    I would recommend seeing an endodontist (root canal specialist). I think that a root canal will help her situation, but sometimes the inside of the tooth can calcify after long ago trauma, which would complicate the treatment because he may not be able to get through the calcified area to remove all of the damaged tissue.

    If he can negotiate to remove the damaged and stained tissue in the pulp, you may be able to bleach the tooth from the inside of the nerve chamber and remove the stains. This is called a walking bleach.

    The tooth will probably still need a veneer, or probably a porcelain crown to give it strength. A tooth with a root canal is now missing the blood supply and can become brittle.

    A well-done and perfectly matched crown (you want the laboratory to do the shade) should last for years and not need to be replaced often.

    If the stains cannot be removed, you can consider a Captek crown which has gold foil under the porcelain, is strong, and can be quite beautiful. The gold can cover the stains and shows through the porcelain about the same way the dentin of a normal tooth shows through regular tooth enamel.

    Hope this helps. You want to find a really talented and well-trained cosmetic dentist for this tooth. He may want to do both front teeth to make them look perfect because the eye wants to see perfect symmetry of the front teeth as you look at a smile.

    Corinne Scalzitti, DMD, MAGD

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