My Dentist's sense of humor (1 Viewer)

[Patrick Sun]

So I get this envelope in the mail from my dentist. Inside is a card, I open up the card, and almost crapped in my britches. There was a before and after photo of my bottom teeth. In the past 2 years I've had 2 molars (back teeth) on each side replaced with crowns (4 in all). The before photo showed my old molars riddled with fillings and cracks, it makes me nauseated just looking at them. $4000 later, I have crowns in their place, and they look much nicer as depicted in the after photo. But, damn, opening up that card just scared the beejezus out of me!

Thank goodness for my dental plan, or I'd still be slurping ramen noodles now.

 

[DavidY]

Nice dentist!!! Not!
Just curious, what kind of crowns did you get? Gold or porcelain? Although I have two gold crowns, my new dentist (new in town) always recommends porcelain. My preference is gold. What to do?....I will need another crown soon. :frowning:
Dave

 

[Niel_JL]

David
If I am the only dentist here then I feel I must oblige.
First, which tooth is it. There is a big difference between a molar and a premolar as far as what to put on.
Porcelain Advantages: esthetic, wear resistant
Porcelain disadvantages: Overall fit (may have gaps that may enable future decay underneath crown), brittle, will wear opposing natural teeth, aggressive tooth preparation, chemical properties very different from tooth (expansion coefficient is the most important one)
Gold Disadvantage: unesthetic to most, eye catching to few
Gold Advantage: easy to make, great fit at the margins, doesn't wear opposing teeth, conservative tooth preparation, expansion coefficient similar to tooth.

Coefficient of thermal expansion: when subjected to extreme temperatures, every material reacts to it by either contracting or expanding. Typical scenario would be like drinking hot soup along with ice water. The tooth will expand/contract in some way, but so does the gold crown or the porcelain crown. The importance of this is that gold's coefficient matches tooth structure very well, so they expand/contract the same amount. But porcelain expands/contracts very differently than tooth, causing undue stress on both the tooth and the porcelain, which can lead to fracture, or a root canal.

To make a long story short, if it were my tooth and it was a molar, I would want a gold crown. To this day, nothing is better. Porcelain will do just fine, the above scenario is a worst case scenario. I do porcelain crown just as frequently as porcelain, but the average lifetime of one just isn't as long as gold.
Any other tooth, you can make an argument for porcelain since it would be very visible.

hope this helped

JL

 

[JasenP]

For $4000 I would get a nice frame and proudly display those pics.

 

[Patrick Sun]

I opted for porcelain for the bottom molars (vanity took hold of my senses at the time), I also have 2 gold onlays for one top molar on each side.

Niel, thanks for the info on the pro's and con's of gold and porcelain crowns, very interesting.

 

[DennisHP]

Dull Dentitist humor;

What time is it?

Tooth hurty

 

[DavidY]

Thanks for your advice, Niel_JL. It is very much appreciated.

The upcoming crown will be on the second to last molar on the bottom right (note: all my wisdom teeth have already been removed)...the molar currently has a filling (silver type), partially cracked?, with a spot filling on the side.

Dave