I recently have had five porcelain fused metal crowns placed in my mouth. Each time, I have paid an extra $264.00 to my dentist for “extra covering” to keep any black from showing at the gum line. Unfortunately, the black shows on almost all of them, either on the inside or the oustside. Is this normal? Thanks in advance!
– Mary from California
I’m guessing that what you are paying extra for is what is called a “porcelain butt margin.” It sounds like the dentist is doing an old-fashioned porcelain fused to metal crown, but is having the porcelain technician cut back the metal near the base of the crown on the front so that it isn’t so conspicuous, leaving it so the margin is all in porcelain.
The effect of this is to make the black line at the gumline that is typical with porcelain fused to metal crowns, to make that more subdued. It may be more gray than black, but it is still a darker area.
I’m surprised at the extra $264 fee for this. The dental laboratory will charge the dentist about $35 extra for this service, and there is no extra cost or labor for the dentist, so it appears that your dentist is getting quite a bit of profit margin on this “upgrade.”
The best thing is to have an all-porcelain crown. When pure porcelain is bonded onto the tooth, it can be made in such a way that the entire result looks absolutely natural and beautiful. But a lot of dentists haven’t learned anything other than what they were taught in dental school, and there they were taught to do porcelain-fused-to-metal crowns. And another problem is that the dentist feels that this looks good enough and that you’re being too fussy if you think this is a problem.
This is at the heart of why I do this website – to help people find dentists who are passionate about the appearance of their work and who know how to create beautiful dentistry. Tell your friends so they don’t make this same mistake and go to the wrong dentist, if they need work done on their front teeth that they want to look beautiful and natural.