I have a crown on a front tooth that has never been very attractive but it was better than just having a stub there or no tooth at all. Recently, I noticed that there is a grey line at the top of the crown where my gumline is. I showed it to a friend that I was comfortable enough to be vulnerable with. She said that my dentist gave me the old-fashioned metal based crowns. Apparently, now they use all-porcelain crowns on teeth. She told me she has a crown on her incisor. I couldn’t believe it. Her crown looks just like the rest of her teeth. I will admit to being jealous. So, my questions are: Am I with the wrong dentist if he can’t make crowns that look like my teeth and he’s using outdated material? Also, is there anything I can do about this grey line?
Janice
Dear Janice,
While there are a lot of dentists who still use metal-based dental crowns, very few of them do it on front teeth anymore for the very reasons that are bothering you. The grey line is inevitable with them and you certainly don’t want that on a visible tooth. They also have to be made much more opaque looking in order to cover the dark metal. So, they end up looking less natural than their all-porcelain crown counterparts.
The reason they are still used on back teeth is because you need something strong enough to withstand the biting forces on the back teeth. However, these days we now have zirconia crowns that are strong enough for the back and are metal-free.
It sounds like your dentist is comfortable doing things the way they have always been done. That may suit some patients just fine, but it sounds like you are looking for someone who is more up to date with the latest materials and methods. He will not be the best dentist for you. At the very least, you will want someone who cares more about the appearance related side of dentistry, which means someone who has invested in cosmetic training. Additionally, they should do a try in with your crowns before permanently bonding them on in order to make sure you are happy with their appearance. If you’re not they should send them back to the lab to make changes. This is especially true on a front tooth because they are more difficult to get to match. It will often take two or three goes before there is an exact match with a front tooth.
As to the gray line, the only way to fix that is to replace the crown. As you hate how it looks you may want to do that anyway.
This blog is brought to you by Portage, MI Dentist Dr. Susan Dennis.