For this week’s article we are going to open up the old mail bag.

Actually, in modern times, it’s the e-mail bag.

Dr. Chip,
I have an old cap on a front tooth that is starting to get a grey ring around it.
I’m afraid it is going to break off. Please help.

Sincerely,
Getting Grey in the Tooth

Dear Grey,

While it is very difficult to diagnose a tooth over the internet, it appears you are suffering from a very common concern…an old crown (cap) that is starting to show its age. We see and correct them every day (yours truly used to have one in his mouth). The good news is it probably won’t break off just yet.

To understand why your cap is starting to look less than its best, we have to look at what it was originally made of. Back in the day, almost all tooth colored crowns were made with a metal substructure (the grey showing through your gums) with tooth colored porcelain built up in the shape of a tooth to hide the metal. Sometimes,
the whole back of the crown was metal for added strength. When your cap was originally placed the junction between this metal and your tooth (we call this the margin) was sitting below the gums and could not be seen. It is common for the gums that hid this metal collar to recede with age and…voila, there is now a grey ring around the tooth.

Additionally, you might have noticed that your crown has lost its luster over the years. The mouth is a harsh environment with acids, heat, staining liquids, abrasive toothpastes, and cold all damaging the porcelain over the years. Porcelain tooth colored crowns that have been in a mouth for years usually start to look dull and sometimes even chip away. Unfortunately, nothing lasts forever.

The good news is that materials have improved and we can now make crowns without any metal. These are called all-porcelain crowns and they blend into the natural tooth much better at the gumline. If your gums do recede, the junction between your tooth and the crown can now match. No more grey around the gums. Additionally, newer porcelain systems reflect light much better than the old porcelain to metal crowns. This light reflection makes dentistry truly esthetic.

Your old crown can be removed and replaced with a new all porcelain crown is as few as two visits. Just remember to whiten your teeth first if you want a lighter colored crown. Teeth whiten, but crowns don’t.

Until next week, keep smiling.

-Please send comments to Drs. Parrish at www.ParrishDental.com.