Porcelain Veneers and Root Canal Treatments

I had four porcelain veneers placed. Now I have a periapical abscess in one of them and am wondering how to keep the veneer from being ruined. My dentist is sending me to a root canal specialist to have this done and I don’t know if it should be different with a porcelain veneer. Any advice?

Laurie

Dear Laurie,

I can definitely help you here. I am curious, though, why a tooth with a porcelain veneer placed needs a root canal treatment to begin with. It is very rare for this to happen. When it does it is generally because the dentist was too aggressive with the tooth preparation.

Tooth preparation for a porcelain veneer

When a tooth is prepared for a porcelain veneer, very little structure needs to be removed at all. A dentist should remove about half a millimeter. In the photo above, a dentist is using a depth-limiting diamond bur. Using a tool like this helps prevent too much structure loss. The bur etches away the half-millimeter in spaces, then a dentist will go back and remove the remaining ridges with a traditional diamond.

Tooth preparation for a dental crown

Unfortunately, some dentists don’t invest in the right training or equipment to do this properly and end up taking off much more structure than would be necessary. This would leave the tooth vulnerable after the stress. Even worse, some dentists, with loose ethics or a gross misunderstanding of the procedures in their profession will actually place porcelain crowns and call them porcelain veneers.

Retaining Tooth Color after a Root Canal Treatment

You are wise to realize that not all root canal specialists will understand the cosmetic side of things. Porcelain veneers have a natural translucency to them. As the tooth darkens underneath from the root canal treatment, that will show through “darkening” your porcelain veneer.

Here is what I suggest you ask him or her to do in order to preserve the color of your tooth for as long as possible.

• He needs to remove all the root canal filling material and cement left in the tooth. Most of the darkening that takes place happens from these materials. This means he needs to clean out all of that material from the crown of your tooth.
• The next step is to place a white fiberglass post into the root. It needs to be white.
• Once the post is placed, he should fill the remaining space of the crown with a light-colored composite.

Taking these simple steps will prolong the color of your tooth significantly.

One other thing, as long as your porcelain veneers was placed correctly, it shouldn’t fall off during the procedure. If it does, your dentist will need to replace it. This is not a natural result of having the root canal done.

This blog is brought to you by Naperville Cosmetic Dentist Dr. David Newkirk.