Two of my eight porcelain veneers have a periapical abscess. I thought I had a sinus infection, but my teeth are causing the problem. My dentist referred me to an endodontist for root canals. I am concerned about losing the veneers or having them turn dark. I know the endodontist is a root canal specialist who will focus on the infection—not how my veneers look afterward—but I must get the condition under control. What do you suggest for my veneers? – Thank you. Genesis
Genesis,
Thank you for your inquiry. It is good that you recognize the need to remove the infection and resolve the periapical abscess (pus-filled sac at the tooth root). Otherwise, it will remain in your bone and spread. We are concerned about what led to needing root canal treatment after getting porcelain veneers—and for two teeth.
Porcelain veneer preparation and root canal treatment
It is unusual to require root canal treatment after you receive porcelain veneers. Skilled cosmetic dentists conservatively prepare teeth for porcelain veneers—removing a half millimeter or less of your tooth enamel. With this approach, infection and root canal treatment are extremely rare. But if a dentist aggressively prepares teeth and removes all the enamel, a stub is left. And the dentin (layer beneath the enamel) is exposed.
Some dentists prepare teeth and place full crowns, calling them porcelain veneers instead. Aggressive preparation increases the risk of tooth stress, irritation, and infection that results in the need for root canal treatment. We hope that aggressive tooth preparation is not the cause of infection in your teeth.
Root canal treatment for teeth with porcelain veneers
A skilled cosmetic dentist understands how to work with porcelain veneers and conceal dark teeth beneath them. Photos above courtesy of Gilberto Tostado, DDS
A tooth turns dark after root canal treatment, and darkness will show through your veneers, which have some translucence. But most tooth darkening comes from root canal filling material and cement that a dentist leaves in your tooth. But your endodontist and a family dentist will not know that.
A cosmetic dentist takes these steps to retain the color of your veneers:
- Clean out root canal filling materials and cement from the tooth
- Place a flexible, white fiberglass post deep into the root
- Fill the space with light-colored composite
The results can last five to ten years. And if your dentist placed your veneers correctly, you should not lose them.
If you have any hesitancy about your dentist’s ability to resolve the color issue with your porcelain veneers, you can visit a skilled cosmetic dentist to discuss your options.
Gilberto Tostado, DDS of San Antonio, TX, sponsors this post.