Repair or Replace My Crowns After a Fall?

I have crowns on my center front teeth and the teeth immediately behind them. The crowns are about three years old. I fell recently, and two crowns have small chips on them, but the silver metal is showing. I scheduled an emergency appointment with my dentist, and he looked at the crowns and my teeth, said there was no apparent trauma, and asked me to schedule an appointment to see if he could fix the crowns. When I returned to the office, my dentist took a quick look at the crowns and said that he needed to replace them. I got a second opinion from my sister’s dentist, and his response was basically the same – replace the crowns. The crowns are in decent shape other than the chips. Do they have to be replaced, or are these dentists trying to make money? – Thanks. Greg from S. Dakota

Greg,

The dentists you spoke with may want to replace your crowns because they have limited skill in concealing with composite bonding and concealing the metal. But understandably, a dentist might not have the time to complete the work during an emergency appointment.

Dental crowns

A dentist with advanced training in aesthetics and bonding technology can restore your crowns with a process like this:

• Etch the metal with a small sandblaster and treat it with a metal bonding agent
• Etch the broken edges of porcelain with a sandblaster or hydrofluoric acid
• Treat the porcelain with a silane coupling agent
• Coat the metal with an opaquer
• Blend composite to match the color and luster of the porcelain and bond it to the crowns

Dentists who care about the aesthetics of your smile do not typically place porcelain-fused-to-metal-crowns on front teeth. If your current dentist placed the crowns, it is unlikely that he is skilled with ceramics and getting natural-looking results.

Although a cosmetic dentist can seamlessly restore your crowns, they will eventually age. When you need new crowns, consider getting all-ceramic crowns for natural-looking results that will enhance your smile.

Look for two cosmetic dentists in your area who have post-graduate training in cosmetic dentistry. Schedule consultations with them to examine your crowns and discuss your options.

Dr. Steve Sirin, an Elgin, Illinois dentist, sponsors this post.