Dr. McKay,
I recently had a dental implant replacing a single front tooth. But now the gumline is higher for the implant and the tooth sticks out like a sore thump. I’m wearing a temporary now. Should I expect the temporary to look like the final result I want.
- Marilyn from Saskatchewan
Marilyn,
Many dentists use temporary crowns only as a temporary physical protection of the tooth between appointments. They cut down the air sensitivity of the tooth and keep your bite straight.
But with dental implants, you really need to plan ahead carefully how you want them to look, so we would do what we call a “prototype” crown - made out of plastic for ease of manufacture and ease to work with it.
Expecially when there is a problem with the height of the gums. That can be a tricky one to solve. I don’t know that they would grow back or not. If they show when you smile, I’d pay really close attention to the position of the gums. If they don’t show during a normal, wide smile, I wouldn’t worry about it. But placing a well-made temporary crown here is the best thing for trying to get the gums to grow back normally.
So in your case, I would make sure that the temporary looks the way you want it to before going ahead with placing the actual false tooth onto the tooth root.
If you have any trouble, I’d consider getting a second opinion from another dentist.
- Dr. McKay
Related links:
Read about snap-on-smiles for a compete smile that’s temporary.
Click here to read more about Dr. McKay’s beautiful cosmetic dentistry.
Dr. McKay specializing in teating suffering from bulimia and teeth damage.
Here is a list of suggestions for you, if you suffer from bulimia and have not yet overcome it, but want to protect your teeth as much as possible:
Professional care - Stay up-to-date with dental checkups. Purging strips the enamel from the insides of the teeth, particularly the upper front teeth. Your dentist will need to keep a close eye on this. As an added protection, having regular professional fluoride treatments will help strengthen your teeth against the acid attacks of bulimia.
Home care - Besides regular brushing and flossing, you can also get a prescription for home fluoride treatments in custom trays.
After vomiting, rinse your mouth with water as soon as possible. The quicker you get the acid out of your mouth, the better.
Restorative treatment is best done after you have begun recovery from bulimia.
Other links:
Read more about Seattle cosmetic dentist Dr. Brian McKay and the services he offers.
Read what Dr. McKay has to say about bulimia and teeth. People suffering from bulimia come to him from great distances, because of his expertise in dealing with this disorder and his supportive attitude.
I broke tooth #15 and need a crown. I don’t understand all the types of descriptions. My dentist says I need a “Porcelain fused to High Noble.” What is that? I don’t see “Gold” listed in any of the descriptions of crowns offered. What is high noble compared to noble? What about 3/4cast high noble. What is base metal? I do not have insurance, and am 60 years old. The old fillng is at least 45 years old. I will have this crown done, but want to go as economical as possible. I am retired. Any suggestions? Thank you.
- Judy from California
Judy,
I can see where all the terminology could be confusing to you.
There are three basic types of crowns: All metal, porcelain fused to metal, and all porcelain. And there are variations on these three types.
The term “high noble” refers to the type of metal, and it basically means the metal has a lot of gold or platinum in it. With a lot of noble metals, the crown can be made to exacting standards, so it gives the best fit. And it is the most corrosion-resistant and malleable. Base metal is at the other end. It is cheaper but is harder to work with and doesn’t fit the tooth as precisely. It may also have nickel in it, which provokes allergies in some people. Noble metal, as opposed to high noble, would have some gold or platinum in it, but it would be an alloy with a lot of some other metal also in it.
So a porcelain fused to high noble crown would be porcelain fused to metal, and the metal is gold or platinum. While this works okay for back teeth, in the front it tends to show a gray or black line at the gumline, and it is opaque. So it can never look as natural as an all porcelain crown. The problem with all porcelain is that it requires sophisticated bonding techniques and many dentists aren’t trained in those techniques. In our office, we prefer the all porcelain crowns because we are very comfortable with these bonding techniques. We use them all day long.
Tooth #15 is an upper left second molar. This is the least visible of any tooth in the mouth. If appearance is of no importance to you on this tooth, then you don’t need porcelain here. That would leave you with a metal crown. And, while you would save a little money by using a cheaper metal, there is only about one pennyweight of gold in a crown, which amounts to about a five percent savings in the fee and a substantial sacrifice in the fit of the crown. I can’t see where that is worth it, because it compromises the life of the crown.
Hopefully this helps you understand what your dentist is offering you.
