I’ve wanted to get my teeth fixed for awhile. I asked my dentist about fixing broken front tooth. I asked him if he could place an all-porcelain crown on this tooth, since I want it to look as natural as possible. He recommended a porcelain-fused-to-metal crown instead. He told me that a porcelain-fused-to-metal crown is the only crown strong enough to endure daily chewing, as well as stand up to my teeth-grinding habit.
However, after looking at pictures of porcelain-fused-to-metal crowns, I realized I don’t like how they look. This isn’t a knock against dentists or their work, I just don’t like how a dark line forms between the gum and the crown over time. I avoid smiling enough due to the gap in my teeth, and an unnatural-looking crown would give me another reason to hide my smile. I need the crown but I don’t want it to be obvious that I have one, you know?
I don’t think my dentist will consider a different type of crown in my case. I’m not sure if they even offer different types of crown options. My question is, should I seek a second opinion from a cosmetic dentist? Or will they just tell me that I need a porcelain-fused-to-metal crown due to my teeth grinding? I don’t want to go if a cosmetic dentist can’t offer me any other options. What should I do?
Thank you for your help,
Scotty – New Jersey
Hi there Scotty,
Thank you for taking the time to write to us. Seeing a cosmetic dentist is a good solution for you. A good cosmetic dentist will take your concerns about the crown’s appearance into consideration, and offer you a solution that is both effective and aesthetic.
An all-porcelain crown can stand up to chewing and grinding, but the crown will last longer if you wear a mouthguard at night to prevent teeth grinding. Prolonged grinding can make your teeth vulnerable to breakage – even on your teeth without crowns. So you also may want to consider getting a night guard from your dentist for your teeth grinding.
As you mentioned, all PFM crowns develop a dark, black line at the gum line over time, no matter how expertly they were placed. Since your crown is needed on one of your front teeth, PFM crowns they are not the most aesthetic solution.Fortunately, there are lots of different options for crowns that cosmetic dentists can offer you. Some cosmetic dentists, such as Dr. Rota, offer CEREC crowns, which can be made and placed in just one visit thanks to advancements in dental technology.
Your current dentist may only feel comfortable with porcelain-fused-to-metal (PFM) crowns, and there are a lot of reasons for that. PFM crowns are consistently taught at dental schools, and are strong enough for the daily wear-and-tear that chewing causes. For crowns needed on posterior (back) teeth, they can be a cost-effective and efficient solution. Some dentists are more concerned with the technical side of teeth replacement instead of their appearance. In their eyes, a PFM crown will fix the problem, so why does it matter that it’s not the most aesthetic solution? Cosmetic dentists care as much about fixing the problem as they do about smile design, so going to see one with your concerns is a good idea.
A cosmetic dentist is experienced with different types of porcelain crowns, and has had the training and practice needed to effectively place them. It’s best to go to an experienced cosmetic dentist instead of trying to push your current general dentist out of his comfort zone. Even if he agrees to make it, the color may be wrong, or the crown may be placed incorrectly due to him being unfamiliar with the new material. Seeing a cosmetic dentist eliminates this problem.
Before committing to a PFM crown, seek a cosmetic dentist’s second opinion. To find one that is right for you, check out a local or nearby cosmetic dentist’s smile gallery for samples of their previous work. Check reviews to see what patients thought of their work. This is important because some dentists use cosmetic dentistry for marketing purposes, since it is not a distinct specialization or category. While any dentist can mention cosmetic dentistry, only some have experience or education in the field to backup their claims. For example, Dr. Rota of Colorado Springs has won medals for his smile makeovers in cosmetic dentistry competitions, so be sure to hold the cosmetic dentist you choose to a high standard.
Thank you, and good luck with getting your crown.
This post is sponsored by Colorado Springs cosmetic dentist Dr. Joseph Rota, of Rota Advanced Dental Care.