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. Then, I had an appointment with my sister’s dentist, and his response was the same – replace the crowns. The crowns are in good shape other than the chips. Do they have to be replaced, or is there a way to fix the chips? Are these dentists trying to make money? – Thanks. Everett from Austin, TX
The dentists you spoke with likely want to replace your crowns because they have limited skill in concealing with composite bonding and concealing the metal. But understandably, a dentist who worked you into the schedule might not have the time to complete the work during an emergency appointment.
Although Dr. Sirin would need to examine the condition of your crowns, a dentist with advanced training in aesthetics and bonding technology may be able to restore them. Sometimes, cosmetic dentists use 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
It’s rare for a dentist who cares about your smile’s aesthetics to place porcelain-fused-to-metal-crowns on front teeth. If your current dentist placed the crowns, it’s unlikely that they are skilled with ceramics and getting natural-looking results.
Although a cosmetic dentist will seamlessly restore your crowns as they age and need to be replaced, consider receiving 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. You can schedule consultations with them to examine your crowns and discuss your options.
Elgin, Illinois cosmetic dentist Dr. Steve Elgin sponsors this post.