My son got a crown on a front tooth, but the crown shows a dark line of metal near his gum. He asked the dentist to cover the line with porcelain, but the dentist said if they will do that he maybe will get gum disease in a few years.
What kind gum disease can he get from a crown, if the porcelain will be covering the metal all the way to the edge of the crown? Should the dentist do the crown deeper and the porcelain will cover the tooth to all way to the gum?
- Gail from California
Gail,
I’m not sure I understand exactly what’s happening here, but I’ll try to be helpful.
If the dentist covers the existing line with a white restorative material, that usually doesn’t work too well. It doesn’t block out the color well, and it’s difficult to get everything to look natural. A porcelain fused to metal crown has a lot of opaquer to cover the metal, and getting that to blend with the tooth without looking funny is very difficult.
Depending on the anatomy of this tooth and how it relates to the gums, if the dentist works to cover this line, it is possible that this could irritate the gums and provoke gum disease. It’s also possible that the dentist simply doesn’t want to do this, either because it is very difficult and the dentist isn’t confident he or she could create a satisfactory result, or because it is too much work and too expensive.
Re-doing the crown could work, and the dentist could put the metal margin up under the gum a little. Or, the dentist could use what is called a porcelain butt margin that masks the metal a little bit. But even with these techniques, eventually the gum will recede a little and the dark line will become visible. And both would require completely re-doing the crown, which would be expensive for the dentist. And I wonder why it wasn’t done this way in the first place.
But the best solution is to do an all porcelain crown, with no metal in it. This can be made to look perfectly natural. But I wouldn’t ask your dentist to do this. Few dentists know how to do this type of crown well. If he or she felt comfortable doing all porcelain crowns, this would have been suggested at the beginning. Dentists who know how to do all porcelain crowns will strongly recommend them for front teeth, because there is no comparison with how beautiful they look. Dentists never like to show their discomfort to a patient, so if you press this matter, you may be pushing your dentist out of his or her comfort zone and end up with real problems.
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