My son has his four front teeth capped with the caps that have a white color in the front and the silver on the back. One of the crown is chipping revealing the silver under the white front. No dentist in or around town says they can help me without replacing the crown. Is there anything that can be done to simply make the front all white again without replacing the whole crown?
– Bobbi from New Mexico
I have a couple of things to say about your son’s situation.
Yes, there is a way to repair a crown that is chipping and showing the underlying metal, but you’re going to need to go to a dentist with particular expertise in cosmetic dentistry and bonding technology. In Las Cruces that would be Dr. Brian Gilbert. Do a Google search for “Bright Star Dental” and you’ll find him. Over 95% of dentists are not going to know how to do this or have the equipment needed to do this.
The process is very similar to the technique I wrote about several years ago for repairing a porcelain bridge. The underlying metal has to be etched with a small sand blaster and then treated with a metal bonding agent like Panavia. The fractured edges of the porcelain have to also be etched either with the same sand blaster or hydrofluoric acid or both and then my preference is to treat it with a silane coupling agent. Then the metal has to be coated with an opaquer. The crown is then ready for bonding with composite restoratives, to match the color and surface luster of the porcelain.
But there is more to this situation than just repairing the crown. The question that comes to my mind is, Why is this crown chipping? You are writing on behalf of your son, which suggests to me that he is still young, meaning these crowns haven’t been on him for that long. The crowns are porcelain fused to metal, which is pretty strong. When they chip, it is usually because of some flaw in the making of the crown. And you say, “is chipping.” I’m going on sketchy details from you here, but your putting it that way suggests that this is a process that is occurring over time, not a single event. Is it going to chip some more? Something is either wrong with this crown, that it would do this, or there is something happening with your son that is particularly abusive to this crown.
And then I have the question, why were porcelain fused to metal crowns placed on your son’s front teeth in the first place? Dentists who care much about the appearance of their work will put all-porcelain crowns on front teeth almost exclusively, not porcelain fused to metal. I’m really questioning the dentist who did this work.
I’m admitting that my advice here is based on my trying to fill in the blanks with things that you haven’t told me explicitly. If I am filling in the blanks correctly, then here is what I would advise doing. First, I would go back to the dentist who did this and see if he or she will make this right by replacing this one crown for free. If that doesn’t work, then I would go to Dr. Gilbert and have him repair the crown. Then, when your son is college age, if he isn’t that age yet, I would replace all of these crowns with natural-looking all-porcelain crowns.
I’d be interested in hearing more about your case, if you care to write back.
– Dr. Hall
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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.