Dr. Hall
I have to replace my 3 crowns b/c they are very old (possibly 20 yrs). Two of them are the molars on either side next to the end one. I am trying to decide if PFM crown is good enough or if I need to spend the extra money on lava crowns. The dentist is recommending that I go with the the lava b/c there seems to be some gum receding where the crowns are. I can’t tell if there is or not but the lava crowns are $200 more expensive for each. Is there that much of an advantage to go with the Lava vs. PFM if they are not one of the front teeth and more in the back? thank you very much I appreciate any advice.
– Helen from California
Helen,
Maybe I’m missing something. I can’t understand, from what you’ve told me, why your dentist thinks Lava crowns are better on first molars. I don’t know what it has to do with gum recession because no one will see that tooth very well.
A Lava crown is all ceramic. As such it is more esthetic than a porcelain fused to metal crown. But it isn’t quite as strong. And besides being stronger, a porcelain fused to metal crown will generally fit more precisely, especially if the metal is a high noble metal. Esthetics in a crown are more important the closer the crown is to the front of your mouth. But strength is more important the further back you go, because the chewing forces are much more powerful in the back of your mouth.
I recently got crowns on my upper left first and second molars. I wanted the very best, and I got a porcelain fused to gold crown on my first molar, and a full gold crown on my second molar.
If these first molars are upper first molars and you have an exceptionally wide smile, it is possible that the esthetics of the Lava crown could matter. But for over 95% of patients, there will be no noticeable difference in the esthetics, because these teeth, while they may show a little bit, are in the shadows.
And just because a crown is old is not a reason to replace it. I’ve seen crowns 20 and 30 years old that are functioning just fine. If there is decay leaking in, then yes, it needs to be replaced.
I’d suggest a second opinion. What you’re telling me about your dental needs isn’t adding up.
Dr. Hall
About David A. Hall
Dr. David A. Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does advanced internet marketing for dentists.
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