Tag Archives: metal based crowns

Help! Which Crown Should I Get?

I need to get a dental crown on a tooth. My dentist threw all these options at me. While he did explain everything, it was all so fast I can’t remember. I told him I’d let him know this week. I tried to do some research but everything is so confusing. Help!

Lacey

Dear Lacey,

CEREC Crown being placed on a tooth

Sometimes dentists think you can understand everything in 5 minutes that they studied all the way through dental school. Sounds easy, right?

It’s good that you’re doing some research. It’s important to go into these type of decisions informed. One thing to be aware of is that you should always feel free to tell your dentist to slow down and to repeat himself if necessary. You should never feel rushed.

To help, I’ll go over the three most common types of dental crowns.

Three Most Common Dental Crowns

The first has been in place for many years and it’s been a staple in the dental diet. These are conventional crowns, also known as porcelain-fused-to-metal crowns. As their name implies, these have porcelain on top and a metal base underneath. These are best used for back teeth because of the amount of biting force we use with our back teeth. If you have a metal allergy, there are metal-free options.

The second type is all-porcelain crowns. These have porcelain all the way through, even as it’s underside. These are especially useful for front teeth because they look more natural than their metal-based counterparts. With front teeth, there is a completely different biting force and these can withstand the pressure.

Thirdly, there are CEREC crowns. These are also all-porcelain. The biggest differences are they are milled by machine using a single block of porcelain. As a result, they’re able to be done in just one appointment. Be aware, unless you have a highly skilled cosmetic dentist, these won’t have the same subtleties that the non-machine milled crowns will have which are made from several different blocks that have different shades.

There’s really not a horrible choice, though I never recommend metal-based crowns on front teeth. You won’t like the results. I hope this helps.

This blog is brought to you by Lafayette Dentist, Dr. Mike Malone.

Do CEREC Crowns Last Longer than Regular Crowns?

My dentist told me I need three crowns. I was shocked because my last checkup didn’t show any decay. He wants me to get CEREC crowns. I like the fact that they can be done in one appointment. But, my insurance only covers the older crowns. Is it worth the extra cost? Do they last longer than the regular crowns?

Elliot

Dear Elliot

Machine for CEREC Crowns
CEREC Crowns are Milled by Computer

When you’re talking about the longevity of crowns, it’s not as much whether you use CEREC or traditional. The length of time any crown lasts, regardless of the kind, depends on two factors—the skill of the dentist and the habits of the patient.

On the patient end, it’s important you keep up with your home care. Regular brushing and flossing are a must. The dentist has several responsibilities. They have to choose the right materials. They have to know the proper techniques for attaching the crown. Traditional crowns are cemented. CEREC crowns are bonded, which is a completely different (and more involved) technique.

Two dentists can make the same crown. One will last five years; the other will last ten. It wasn’t a difference between the type of crown as much as the skill of the dentist. Don’t hesitate to ask your dentist how long his crowns typically last.

The Differences Between CEREC and Traditional Crowns

There are two advantages to CEREC crowns. The most obvious one is you can have all three of your crowns completed in one visit. Second, they’re milled by a computer which generally helps with their fit. They’re actually great for side teeth. Some cosmetic dentists don’t like placing them on front teeth because they’re milled from a single block of porcelain. In that case, they feel they can craft them better traditionally.

Another weakness for CEREC crowns AND traditional all-porcelain crowns are on back teeth. They can’t always hold up to the pressure of the biting forces your molars have to take. In that case, you’d want either a metal-based crown or a zirconia crown if you have any metal sensitivities.

No matter what crown you choose. Once the crown is made, the color is permanent, so if you’ve been considering teeth whitening be sure to do it before you get your crowns if they’re in a visible place. If they’re all back teeth, that won’t matter. You can get your crowns and then whiten later.

Consider a Second Opinion

One thing you said bothered me. You mentioned your last checkup showed no signs of decay and suddenly you need three crowns. That sounds just a bit hinky to me. While it’s possible that you could have decay that spread quickly, if you get regular cleanings there should have been some sign of decay.

This blog is brought to you by Dr. Mike Malone.

Can I Switch My Metal Crowns with Porcelain Veneers?

I’ve got four metal-based crowns. I’ve never been thrilled with them. They’ve always looked more cloudy than my natural teeth, but it was better than no teeth. Lately, though, there’s been this dark line at my gumline. It’s making it impossible for me to smile without feeling humiliated. I’ve started avoiding going out in public. Last night, I saw an article about porcelain veneers. The pictures were stunning. First, are they really that gorgeous or was that clever photoshopping? Second, can I switch out my metal-based crowns with porcelain veneers?

Millie M. – Indiana

Millie,

No one should be embarrassed to smile. With that said, I don’t want you to feel alone. There are many people (Americans especially) who are unhappy with some aspect of their smile. We want perfection. Cloudy teeth you can maybe get away with. It’s not ideal, but it’s not necessarily distracting or ugly. A gray line at your gumline is both distracting and ugly. I understand your desire to make a switch.

Porcelain veneers really can be that stunning. Whether they are or not depends on the skill of the cosmetic dentist. A skilled, artistic cosmetic dentist can give you a gorgeous smile. Toward that end, I have good news and bad news regarding switching out your crowns with veneers.

First, the bad news. You cannot. It doesn’t matter what type of crown it is. The reason is the structural difference between the two treatments. Porcelain veneers bond to the very front of the teeth. Hardly any tooth structure is removed to place them. Dental crowns, on the other hand, fit over the entirety of your teeth, which requires grinding down a large amount of tooth structure. Because of that, there’s not enough tooth left for the veneers to be bonded to.

Now for the good news. You can still replace these ugly crowns and get a gorgeous smile. Instead of replacing your metal-based crowns with porcelain veneers, you can replace them with all-porcelain crowns. These can be created just as beautifully as porcelain veneers. Unlike their metal-based relations, all-porcelain crowns will not look cloudy. It’s the base that makes which makes that necessary in order to hide the metal. Also, you’ll never have to worry about them developing that unsightly gray line.

The key will be the dentist. The get the best results, look for an AACD accredited dentist. Accreditation is different than membership. You can purchase membership. Accreditation is earned by demonstrating proficiency in both technical skill and artistry.

This blog is brought to you by Dr. Mike Malone.

My Dentist Wants to Put A Metal Crown On My Tooth

I’m not sure if I should go forward with something my dentist wants to do. I need a crown. But, he wants to put a metal based crown on the tooth. My mother had one of those and it was horribly ugly. Would mine be ugly too or have their been more developments since then?

Ally R. – Idaho

Ally,

I haven’t seen your mother’s crown, nor do I know when she had it placed, so it would be hard for me to tell you if there have been advancements. However, I can tell you that cosmetic dentists (who care as much about form as they do function) would not put a metal based crown on a front tooth.

The reason for that is the appearance, as you’ve noted about your mother’s old crown. A metal based crown requires a more opaque layering in order to “cover” the metal. Plus, you will eventually develop a gray line at your gumline, which will be unattractive and distracting.

Instead, I’d recommend an all-porcelain crown. These are perfectly strong enough to be placed on your front teeth, and are much more attractive.

That being said, you’ll need to have a good cosmetic dentist to do it. Even the most beautiful materials need artistic hands to make their beauty shine.  Especially because it is a front teeth you’re talking about, I cannot stress how much the skill of the cosmetic dentist will make a difference on how the crown will look.

The best cosmetic dentists are accredited with the American Academy of Cosmetic Dentistry (AACD).

This blog is brought to you by Dr. Mike Malone.