Ceramic does not imitate a tooth. It continues one.
This is the part that shows and chews at the same time. Aesthetics is what gets noticed, prosthetics is what lasts, and doing either without the other ruins both.
Worn or chipped teeth, ageing fillings, shapes that no longer hold
A natural tooth does not have a colour. It has at least three: a more saturated neck, a middle body, and an incisal edge that is close to transparent and lets the darkness behind it show through. That is why a single-shade restoration is recognisable from two metres away even when the base shade was matched correctly.
So I take the tooth apart before rebuilding it. I photograph it with the shade tab beside it under one light, and I write down where saturation shifts, where the white bands sit, and how translucent the edge is. Those notes travel to the laboratory alongside the shape, because the technician never meets the patient and works with whatever I send.
The forms I use run from thin bonded restorations, where very little enamel is removed, to full coverage, when the tooth has already lost too much to support anything partial. That choice is not made on how it sounds. It is made on how much enamel is left: adhesion holds on enamel, and holds more weakly and less predictably on dentine.
When a tooth is vital and merely worn, I favour the option that removes less, even when it costs an extra stage. An intact tooth can never be put back.
Shade corrections between try-in and bonding are common. They are normal, and they are cheaper there than afterwards.
Nothing is bonded for good before you have seen it in your mouth
- 01
Reading the tooth
We establish what is still sound, whether the tooth is vital, whether it carries cracks, and how the opposing tooth meets it when you close. The bite dictates thicknesses, and thicknesses dictate which kind of restoration is even possible.
- 02
Preparation and scan
Only as much is removed as the material genuinely needs, under magnification. The impression is digital, and if the margin runs under the gum I expose it first, so the laboratory receives a clear line instead of an assumption.
- 03
Temporary phase
You wear a temporary restoration that copies the approved shape. It does two jobs: it protects the tooth, and it shows me how the shape behaves while you speak and eat, before the ceramic exists.
- 04
Try-in and bonding
The ceramic is tried in unbonded, with try-in pastes, in daylight, with you holding the mirror. It is bonded only once you agree, under isolation, because adhesive bonding does not forgive moisture.
What ceramic cannot do, however well it is made
It does not stand in for a root. If a tooth has a vertical crack running down the root, no coverage stops it. A restoration would postpone the extraction by a few months and make it harder, so in that situation I say from the start that we are going a different way.
It does not make up for hygiene. A crown margin is a place where plaque collects and the gum answers back. If interdental cleaning does not become routine, the restoration outlasts the tooth underneath it, which is precisely the wrong way round.
It neither replaces root canal treatment nor repairs one. When there is infection at the apex, that gets resolved first, with a verified result, and only then does the tooth get covered.
It does not survive forces it was never designed for. Thin ceramic placed in someone who grinds will crack, and that is not a material defect, it is a misuse of the material. Which is why I ask about grinding beforehand rather than afterwards.
And it does not freeze time. Gums recede over the years in everyone, and a margin hidden today can become visible later. I cannot promise that will not happen. I can place the margin so that, if it does, it shows as little as possible.
The questions that usually surface at the second visit
Will people be able to tell they are not my own teeth?
It depends how far we move from what you have now. A restoration that keeps the character of the tooth next to it goes unnoticed. One that changes shape, colour and position all at once gets noticed, even when each of those on its own is correct.
How long will it last?
I will not give you a number, because it would be an invented one. What I do know is what shortens the life of one: grinding, poor hygiene, and a bite I failed to correct. Those three I can influence, and that is where predictability comes from.
Does it hurt?
Preparation is done under anaesthetic. Afterwards a vital tooth can be cold-sensitive for a few days. If the sensitivity grows instead of fading, I want to hear about it, because it means something else.
Do I get to pick the shade?
You do, and we pick it together in daylight rather than under the chair light. I will also tell you when a shade you are asking for will read as artificial beside the teeth you are keeping, so the choice is informed rather than a surprise.
What if one of them breaks?
It gets repaired or remade, depending on where it fractured. The first question is not how we remake it but why it broke, otherwise the remake meets the same end.