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Archives for November 2021

All-Ceramic Versus Porcelain Fused to Metal

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I need a dental crown on tooth number four. My dentist wants me to get an all ceramic one,  think zirconia. But, those cost more money (shocker). I just want to get the porcelain fused to metal one because I don’t see any cosmetic/esthetic value in putting the other on tooth number 4. Maybe a front tooth, but not number 4. Why spend the extra money?

Grady

Dear Grady,

before and after all porcelain crowns

 

There are two things you need to be aware of when it comes to porcelain-fused-to-metal crowns. First, is they need to be made more opaque in order to cover the metal base. This tends to give them a dense chalky look. The second thing to be aware of is they will all eventually develop a black line at the gumline. Many consider this to be unsightly and a bit distracting. All-porcelain crowns do not have this problem. Neither do all ceramic crowns. One benefit of zirconia crowns is not only are they all ceramic, but they also are strong enough to use on back teeth.

Tooth number four is still in what dentists consider the smile zone. That means it is visible when you smile. Because of that, I disagree with the idea that there is no cosmetic benefit to using an all-porcelain crown. That being said, it is your smile, your money, and your choice. Your dentist is obligated to advise you on every option available to you, but he should be willing to allow you to make the final choice. Not all dentists will, however. Because your smile reflects on their business, there may be dentists who will only do procedures that will leave you with a beautiful smile.

If you really want the metal based crown, you can get it, but you may have to see a different dentist to do the work.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Dentist Doesn’t Want to Fix Her Teeth

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I have really bad teeth and have all my life. I take care of them and go to the dentist but there always seems to be issues to fix. Recently my dentist said I’d be better off just removing my teeth and getting dentures. I’m only 32, surely we can fix these teeth?

Karlyn

Dear Karlyn,

illustration of a woman's profile before and after facial collapse

 

I am going to say right off the bat that you are too young for completely removable dentures. When your teeth are removed, your body deals with that by resorbing the minerals in your jawbone to use in other places in your body that it feels they will be more useful. While it is great for natural conservation, it has the unfortunate effect of shrinking your jawbone. After ten or so years, you will look decades older and will not even be able to keep your dentures in place. This is known as facial collapse.

While I haven’t examined you, I am not convinced that at least some of your teeth cannot be saved. Different dentists have varying degrees of enthusiasm for hard work and it sounds like your teeth are hard work. I want you to find a dentist who is passionate about saving your teeth. They are out there.

If there are teeth that cannot be saved. The better replacement for someone as young as you are would be to get a dental implant. This uses a prosthetic tooth root that will preserve your jawbone.

One thing you can do that you may not have tried is to limit your snacking. I don’t know if you are a snacker but that can derail oral health. This is because our saliva is the greatest defense we have against decay. If you don’t have breaks between meals without snacking, your saliva doesn’t have the time it needs to do its job. I would limit yourself to no more than one snack a day. You may already be doing this, but it was worth mentioning.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.