Is there anything about the size, shape, color, or arrangement of your teeth or gums that you do not like?
This is a question that we try to ask all of our patients at least once a year. You see, your dentist cannot offer solutions if we do not know your problems. When it comes to esthetic or cosmetic dentistry, every one of us has an opinion of who we see in the mirror. Growing up, I had a terribly ugly cap on one of my front, top teeth. I look back at pictures and cringe. At the time, though, I was pretty full of testosterone and that ugly crown didn’t really slow me down. You can bet it was replaced before I married a dentist.
The look of old crowns is one of the most common complaints that we hear when we discuss cosmetic dentistry. Complaint number one has to do with that gray line or silver ring that tends to appear after a few years in the mouth. That line is the junction of the crown where natural tooth, metal, and tooth colored porcelain all meet together. In dental terms, we call it a margin. The first generation of tooth colored crowns have metal (usually a gold alloy) on the inside of the cap that is covered with tooth colored porcelain on the outside. These crowns (we call them PFM for porcelain fused to metal) have a long track record and are generally very strong. They are still quite common in the back of the mouth where function usually trumps looks.
The one drawback to PFM caps is that the tooth, porcelain, and metal must all meet somewhere. In the front of the mouth, this somewhere is usually hidden by the gums. When first placed on a tooth, healthy gum tissue hides that grey line. Over the years, for a number of reasons, the gums sometimes start to recede and the metal line will start to show.
This problem can be easily addressed by the newer crown materials available. We now have the technology to make crowns one hundred percent tooth colored porcelain with margins that blend the crown into the tooth. The junction of the tooth and cap no longer has to be hidden below the gum line. Technology has provided us a healthier situation (for the gums), as well as a better esthetic outcome. Another advantage of all porcelain crowns is that they reflect light more closely to natural tooth structure, meaning they look more like real teeth.
The process of replacing old, ugly crowns generally takes a couple of visits. The first appointment involves removing the old and cleaning up the underlying tooth structure. A mold is taken and is sent to a dental lab for crown fabrication. A temporary crown is placed on the tooth between visits. Today’s temporary teeth often are more esthetic than older crowns. Two to three weeks later a second appointment is made and the lab made crown is bonded to the tooth. In a matter of weeks, that old grey line gets wiped away.
Until next week, keep smiling.
‐Questions or comments can be sent to Drs. Parrish through their website: www.ParrishDental.com.