I have just had a back tooth crowned with a precious metal and porcelain crown

Patient: Question for a dentist please..I have just had a back tooth crowned with a precious metal and porcelain crown but am concerned on two counts..the crown I have already had in the past was all ceramic as I am allergic to most metals (the only exception I know of is gold and silver, so I am unsure if my gum is going to go sore and inflamed with the palladium and gold crown). I requested ceramic crown but dentist overlooked my request & gave me this with metal. He maintains that an all ceramic crown would not be strong enough for a back tooth, but I have one already that has been fine for 10 + years. He suggested I ‘see how it goes’ with the crown he had made, and I feel he just wanted me to not waste his crown!! Still so far so good, it is not inflamed and have had it 5 days-but on the inner edge there is a gap between the gum line and the start of the porcelain crown, while the outer edge fits flush to the gumline. Food collects in this gap. Do I need this filled or replaced maybe?

Optional Information
Gender: Female
Age: 53
Already Tried: I am cleaning the gap between gum and start of crown edge very well with water pick and copious regular brushing and rising with a mouthwash. However my mouth felt *cleaner* when I had the lost filling and the original tooth than it does with the crown. It is also slightly high on the bite so my teeth don’t sit in line..the botton row crown hits the top teeth. Will it ‘bed down’ at all as time passes? If I have to have it replaced, should my dentist replace it at his cost or would I have to pay again (I paid £370 as a National Health patient!) I did ask my dentist about the gap on a phonecall and he said it would be fine, that I could just feel a ‘ledge’ and it wasn’t an actual gap where food could reach under the crown..should I trust this remark? I feel he should take a look at it? If so, how soon? Could it get infected or will it be Ok till my next filling appointment in 3 weeks? I am rather concerned as I already had an apisectomy on another crown 8 yrs ago and then months into years of intermittent antibiotics as the infection went into the sinus..then I ended up having the crown and root out anyway, so now have a gap (awaiting a bridge or implant but he wont do it yet).Also I wanted some veneers and he said ‘my type of teeth weren’t suitable for veneers’..is there such a thing as unsuitable teeth? They are sound but crooked in places? I now have seen these very fine veneers (thin as contact lenses) that can be had so maybe I could have those!Thanks in advance!

Doctor: thanks for posting your question on Health.is.edu ,

there is absoulutely no allergy problem with the high noble gold ceramic crown,

the metals are non allergic

if there is a little problem at the inner margin, the most common problem is in adequate brushing and flossing

I suggest you brush and improve your home care in that area

also you you try this tooth brush

www.sonicare.com

sonicare flexcare is a very good tooth brush

improvement in gum hygiene will help greatly

if there is no improvement in one week you should visit your dentist for an evaluation but in 90 percent of the cases you will not require a replacement

if you have to visit the dentist, please go with an open mind and explain your concerns for the gum margin

please do not worry about allergy

best wishes

Dr Craig

Patient: Hi, that was so fast, thank you! Is the crown I have (palldium and silver) with porcelain a ‘gold’ ceramic crown then? I am in England so is this the same as the one to which you refer? Thanks very much, I will look into the sonic care toothbrush sytem as well 🙂 Many thanks!

Have a good day!

Doctor: Hi,

thanks for your reply yes, They are referred to as Noble Metal crowns they all have gold, platinum pallidium and silver to give the best strength corrosion resistance and they are non allergic

the sonicare tooth brush is the top of the line you will like you have been to the dentist every time you brush with it.

Yes I saw you are in England, and I spell colour like you too and I speak the queens english(color in the US )

Best wishes

Dr Craig

Patient: *Smile* Thanks for your information..I’m not even sure if I speak the Queen’s English! Many experts here are in USA – that’s the only reason I mentioned it :)) I Just still have a query on the second part of the original question about the ‘gap’ between inside edge of crown and gum please? Thanks very much 🙂

I think it must be awfully pressurising to be a Dentist, down everyone’s throats all day and always having to do every task perfectly..I have great admiration for Dentists!

Patient: Sorry I didn’t clarify that query very well..what i mean is could food get under the crown at that gapped edge? I of course can clean it out but will it last as long if I am having to do that all the time? Thanks 🙂

Doctor: sorry for the delay i dropped my laptop and had to start things up again

No food cannot get under the edge usually the crowns are cemented with strong cement which does not leak
you may feel the margin with your tongue but usually the inside margins of the crowns only have metal not porcelain over them hence you may feel the difference

if you keep your crown margins clean you should have no problems

well it is very stressful to be a dentist and now it is my 20th year, I am tired of hearing “I hate the dentist ” most people tell me that
and I have to smile at them and just work

Best wishes not to worry if you gum condition does not improve with brushing and flossing please visit your dentist

Best wishes

Dr Craig

hope this helps I am out for the day now If you have any other questions I will reply later

Good luck

Patient:

That’s great, thank you, ….I sympathise with the ‘hate the dentist’ problem..but the great thing is most people go home feeling so much better and their smile is so important to them so you are a real key person in a person’s self esteem and confidence and everyone really feels that..maybe its a pity we dont say it as much as we should while in the chair!

Personally I love the dentists visit as its a time to get things sorted out that have been niggling for a while..and I’m fortunately not nervous..was at one time but not anymore..there are far worse things in life!

I always try and cheer my dentist up as he always seems so low key ..maybe I annoy him with my breezing in..as I have been a bit of a ‘problem patient’ with the infected tooth and apisectomy and so on, in the past.

He seems to have lost his confidence with me so I in turn am not as confident about him as I used to be but I really love his fillings (quick and painless, and invisble where it matters) and his small hands (!!) makes a big difference when you are the patient..not to have a mouth rammed full of fingers, but bigger hands are better for other things !^ 🙂

Anyway I hope you have a lovely day and you have brightened my weekend up already with your reassurance so very many thanks, I am really grateful!

Take care and you have a great chairside..I mean cyberspace manner!!

Thanks again & have a good day out

Christina

Doctor: thank you Christina, I am in michigan today i am just about to go for
lessons to fly this
www.cheaptrikeflyer.com
i am just reaching the airport now as we speak

best wishes

Patient: That looks good scary fun! It has a 4 stroke V-twin engine !! Be careful as you go!!!! That’s a lot of power on a hand held throttle!!!!!!

Enjoy your day!!