Dr. Sam, I am considering crowns and porcelain veneers. However, my friend had some done and now has black rims at the bottom of her teeth. This looks awful. Is this normal? – From Linda, Santa Monica
It is very unfortunate when there are black rims around porcelain crowns and porcelain veneers. This should NOT happen!
The black stain around the rim of the crown or porcelain veneers is contamination. The bonding technique was a failure as there was something that was not completed thoroughly.
In all fairness to the dentist, it is very difficult to bond porcelain crowns and porcelain veneers at the gum line. Any tiny speck of blood or spit or fluid from the gums will cause the margin of the restoration to turn black.
How to Remove Black at the Gum Line
The only way to remove the black rim at the gum line is to replace the restorations. It is unfortunate to have to start over, but it is the only way to remove the black rim. The restorations must be removed, the teeth must be properly cleaned and the dentist has to meticulously bond each restoration perfectly. The dentist needs to be using magnification.
There is no way to patch the black gum line or try to repair the veneer with composite resin because it will stain within a year or so. The best way to repair a veneer is to replace the veneer. The tricky part is matching the color of the old porcelain veneers with the new porcelain veneers. This will separate the best cosmetic dentists from the rest of them.
Magnification to Remove the Black Line at the Gums
Magnification dentistry allows the dentist to see better than the naked eye. I have been wearing powerful custom made telescopic eye-wear to visualize the most minuet details.
The tiny bits of moisture or contamination at the gum line that are on the tooth cannot be seen with the naked eye, so black lines at the gums are the result of inadequate technique by the dentist. It takes a special dentist to be able to use magnification properly and to be able to afford the very highest quality lenses and camera systems.
The telescopic magnifying eye wear magnifies about 4 times but the tiny cameras that go inside the patient’s mouth magnify 25 times! It is an instant improvement in quality if the dentist can successfully utilize the high tech magnification systems.
Failure Rate and Magnification
Black lines at the gums as well as porcelain veneers and crowns that come off are a result of micro leakage. The bond is supposed to stop leakage but must be perfect or leakage will occur at any area where the bond is inadequate.
It has been estimated that 35% of American dentists will not be able to consistently bond dental restorations and American dentists are considered the absolute best in the entire world.
Magnification dentistry reduces the failure rate but nobody is perfect. The best multimillion-dollar baseball players only are successful at best, once out of three times at bat! The best football quarterbacks make huge mistakes and throw interceptions or fumble the ball that loose championship games. Dentists that use magnification will have a higher success rate then the best baseball players in history.
Considering Crowns and Porcelain Veneers
The most important choice is not if you choose crowns or porcelain veneers but the dentist that you choose.
The dentist is by far the most important part. The only way to choose a dentist is to look at photos of their patients that show enough detail for you to judge. You need to see at least 10 “before and after photos” of their patients, including full face photos that match. Dentists that have the “before” photo taken with a cheap camera and the “after” photo taken by a professional photographer are NOT presenting their work in a valid manner.
Dentists that have photos of the face in one position and have the “after” photo in a completely different position are not allowing you to honestly evaluate their work. Avoid these dentists. To see the best “before and after cosmetic dentistry photo gallery” ever presented by a dentist of his own work on his own patients, visit the galleries on our various websites.