Do I Need To See An Emergency Dentist For A Defective Crown

When I was just starting out my career, I had porcelain crowns done across all my front teeth. They look great overall, and I’m actually still very happy with the aesthetics. One of them has always had a rough spot or a divot, though. I can feel it with my tongue, but I have never been able to see anything wrong with it. I did mention it to the dentist who did the crowns and she smoothed it out some, but I’ve still noticed over the years. It was close, but not quite perfect. Lately, it has been feeling different- much more rough,  and I can actually see a dark mark. I don’t know if it’s just attracting stains or what, but I don’t think I’ve changed my habits and I get regular cleanings. I’m a little concerned that that it is failing and that I’m going to be out on a business trip and the whole thing will crumble. Is this urgent enough to warrant a trip to the emergency dentist? Should I have the crown redone now or am I worrying about nothing?



Dear Hank,

This may not necessitate a trip to the emergency dentist and it isn’t exactly “urgent,” in that you need to get in as soon as possible, but it is something you should get checked out in the near future. It’s common for crowns (and natural teeth) to have some defects, but it sounds like yours is changing, and that could mean it’s actually cracked now, not just a defect. In this case, it would also pick up stains more readily and there’s a chance it will break sometime soon. It’s impossible to guess when it will happen, though.

Rather than letting it turn into a trip to the emergency dentist, especially if you’re an avid traveler, you should find a dentist who is skilled at cosmetic work and have him examine it. Due to the age of the crowns, it might be time to start thinking about replacing them all. Don’t be surprised if the dentist mentions this.

However, the only reason to update the others is age or wear and tear. If the dentist suggests switching them all out so he can make them all match, that’s a sign that you’re not working with a skilled cosmetic dentist. You should be able to have just that one replaced and have it blend naturally, without having the others redone, too. Best of luck to you.

This blog is brought to you by Dr. Kevin Peck.

What Happened to my son’s tooth?

When my son was three, he took a tumble and bumped his face. He was upset and cut his lip, but his teeth looked fine, so I didn’t even consider taking him to the pediatric dentist back then. Here we are six months later and his tooth is turning an ugly gray color. At first, I thought it was just come kind of staining, but I have scrubbed at it to no avail and it looks like the whole thing is colored. I know in an adult this means the tooth is dead, but my son doesn’t seem bothered by it at all unless I’m messing with it. I think this must be connected to the fall, but I don’t understand why it would take so long to develop- he’s four now. I’m kicking myself for not taking him to the pediatric dentist back then. Could this have been prevented? Going forward, do I need to book him with a pediatric dentist, a root canal specialist, or should I just monitor for more symptoms?



Dear Delilah,

It does sound like that tooth has died. When a tooth is injured, it can start to look like a bruise is developing from the inside. This may be from the fall he experienced earlier or from an unrelated incident. It’s not always easy to tell with small kids. Moreover, a dead or dying tooth doesn’t always cause pain. It just depends on what happened with the nerve. Taking him to the pediatric dentist right after the fall would not have prevented this from happening. The damage was instantaneous and even if it wasn’t killed right away, nothing could have stopped the progression.

At a certain point, baby teeth begin the process of resorption, in which the body starts diminishing the roots in order for the tooth to fall out. The pulp fades away naturally at this point anyway, and your son could be getting to that stage. With an adult, there’s concern over bacteria entering the chamber and creating an infection, which is why a root canal is necessary. The dentist cleans out the canal, and then fills the space so bacteria can’t seep in and cause a problem.

Given that your son will probably lose the tooth naturally in the next couple of years, you may not need to treat the tooth at all. It’s a good idea to keep an eye on it and if you’re worried about anything, you can have it checked out by the pediatric dentist.

This blog is brought to you by Dr. Kevin Peck.

Are off-brands of Lumineers causing bad breath?

I worked hard to get my body and teeth in shape.  I went through a gazillion deep cleanings to try and get rid of my gum disease. I finally got to the point that my dentist would let me get lumineers. Now, though, a couple of months later and I have horrible bad breath. I know my dentist used an off-brand of veneers. Could that be the problem?

Chloe S. – Arkansas


I can’t be definitive with you because diagnosing bad breath over a computer isn’t actually a great idea. But, I have a couple of thoughts.

Porcelain veneers don’t really cause bad breath. Bacteria does. That bacteria can be from poor hygiene or from an illness you have.

Has your doctor checked you for something like strep? Normally you have a high fever and a sore throat with it, but not always.

More likely, though, it’s your gum disease raising its ugly head again.  You may not have noticed before, because you’d been living with it a long time. Now, that you had it gone, you would notice a difference if it returned.  You were doing lots of deep cleanings to help with the bacteria. However, you’re in your normal routine again now.

You many need to go back and deal with the potential gum disease and find out where your oral hygiene issue is.  It may be your not brushing or flossing correctly. Let your dentist see how you’re doing it and he or she may have some advice for you.

This blog is borught to you by Dr. Kevin Peck.