Gold or Porcelain Crowns? The Factors to Consider

Gold is more than a financial commodity or a symbol of wealth - it's one of the best materials for restoring damaged tooth crowns, the visible portion above the gum line. It's extremely durable and can last for several decades if properly maintained. It also causes minimal wear to adjacent teeth.

But as new, more life-like materials have come into prominence, gold restorations have diminished in popularity. Dental porcelain in particular, a type of fired ceramic glass that mimics the look and color of teeth, has increased in popularity for use in highly visible areas.

But unlike gold, all porcelain crowns lack strength, tend to be more brittle and can abrade other teeth during biting and chewing. If they break, they can shatter beyond repair. All porcelain crowns are improving dramatically as newer space age materials become available. Historically, though, they are thought of as less unpredictable when used for back teeth; the greater biting forces make them more susceptible to failure than with front teeth.

A Porcelain-Fused-To-Metal (PFM) crown is a hybrid of these two materials that seeks to impart the strengths of both - the aesthetic appeal of porcelain and the durability of gold or platinum. But a PFM crown also has drawbacks: the porcelain surface may still abrade opposing teeth; they can lose their aesthetic appeal if the metal collar becomes visible if gum tissues recede; and they can fail if the porcelain fractures or separates from the metal.

To address some of porcelain's weaknesses, some PFM variations reduce the amount of porcelain by placing it only on the visible side of a cast gold crown. In addition, other porcelain materials are now coming into use that may be more durable yet just as life-like.

Choosing which material to use for a crown depends on many factors: cost, the location of the crown, and, of course, the patient's desires for the resulting smile appearance. It all begins with a comprehensive exam: from there, we can advise you on your options and help you make a choice - gold, porcelain or something in between - that's durable and pleasing to the eye.

If you would like more information about dental implants, please see our website at www.myParkDental.com or call us at (239) 263-1151 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article "Gold or Porcelain Crowns?."

Jamie Foxx Gets Into Character With Help From His Dentist

If you were a well-known actor, how far would you go to get inside the character you're playing in a movie? Plenty of stars have gained or lost weight to fit the role; some have tried to relate to their character by giving up creature comforts, going through boot camp, even trying out another occupation for a time. But when Jamie Foxx played a homeless musician in the 2009 film The Soloist, he went even further: He had part of his front tooth chipped out!

"My teeth are just so big and white - a homeless person would never have them," he told an interviewer. "I just wanted to come up with something to make the part unique. I had one [tooth] chipped out with a chisel."

Now, even if you're trying to be a successful actor, we're not suggesting you have your teeth chipped intentionally. However, if you have a tooth that has been chipped accidentally, we want you to know that we can repair it beautifully. One way to do that is with cosmetic bonding.

Bonding uses tooth-colored materials called "composite resins" (because they contain a mixture of plastic and glass) to replace missing tooth structure. The composite actually bonds, or becomes one, with the rest of the tooth.

Composite resins come in a variety of lifelike tooth shades, making it virtually impossible to distinguish the bonded tooth from its neighbors. Though bonding will not last as long as a dental veneer, it also does not require the involvement of a dental laboratory and, most often, can be done with minor reshaping of the tooth.

Cosmetic Bonding for Chipped Teeth
A chipped tooth can usually be bonded in a single visit to the dental office. First, the surface of the tooth may be beveled slightly with a drill, and then it is cleaned. Next, it is "etched" with an acidic gel that opens up tiny pores. After the etching gel is rinsed off, the liquid composite resin in a well-matched shade is painted on in a thin layer, filling these tiny pores to create a strong bond. A special curing light is used to harden this bonding material. Once the first layer is cured, another layer is painted on and cured. Layers can continue to be built up until the restoration has the necessary thickness. The bonding material is then shaped and polished. The whole procedure takes only about 30 minutes!

If you would like more information about cosmetic bonding, please see our website at www.myParkDental.com or call us at (239) 263-1151 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article "Repairing Chipped Teeth" and "Artistic Repair of Chipped Teeth With Composite Resin."

It Can Pay to Spend on Dental Implants

If you're missing a tooth, you're not alone; in fact 35 million Americans are missing all of their teeth in at least one jaw! Whether it's one tooth or many, it's important to replace what's missing. Depending on the number of teeth lost, the potential drawbacks to doing nothing may become hard to ignore: impediments to eating, interference with speech, and unaesthetic appearance, for example.

Traditional bridges and dentures are the most affordable options for replacing teeth. Tooth implants - tiny titanium, screw-like substitutes for a tooth's natural root to which natural-looking dental crowns are attached - are pricier but confer an important extra benefit. In addition to addressing the common problems previously mentioned, by acting like the original tooth root, an implant can maintain or stimulate "remodeling," of the jawbone below. Without a tooth root to provide stimulation, mature bone cells will continue to be removed, or resorbed, but no new bone cells will regenerate to replace them, leading to a progressive loss of bone width, height and density. The more teeth are lost, and with less bone structure to support it, the whole shape of the face can change.

Unfortunately, when greater numbers of teeth must be replaced, implants can become financially unrealistic for some people. But in appropriate cases there is a third option: a bridge or denture/implant hybrid. In the case of a bridge intended to fill a gap when multiple teeth are missing, an implant can be used on either side of the gap to support the bridge, leaving the natural teeth undisturbed. Strategically placed implants can be used to support a removable denture, too.

If you would like more information about dental implants, please see our website at www.myParkDental.com or call us at (239) 263-1151 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article "Your Best Option For Replacing Teeth."

Tooth-Harming Habits to Avoid

Did you know that you probably do at least one thing during the course of an average day that puts your healthy smile at risk? These are some of the more common offenders:

Coffee, Soda, and Sports Drink Consumption
If you really can't give them up, try to consume these beverages with restraint. Their high acidity and/or sugar content can erode protective tooth enamel, making your pearly whites more prone to staining and decay. Even natural fruit juices should be consumed in moderation as they tend to be high in sugar and sometimes acidity (e.g. orange juice). Your best bet? Water, of course. It won't damage your teeth and thanks to fluoridation may even help remineralize and fortify your enamel.

Brushing Immediately After Eating
If you were told to brush after every meal, forget it. Acids in foods and beverages can soften your enamel, and brushing may actually accelerate erosion. Wait at least an hour to brush, which is the time it generally takes for your oral pH to normalize and your tooth enamel to reharden. However, it is advisable after eating to floss and rinse out your mouth with plain water or a mineralized dental wash to help wash away food particles.

Jaw Clenching, Tooth Grinding, Pencil Chewing
These and similar "parafunctional" behaviors - outside the uses for which teeth are designed - can cause undue tooth wear and exert stresses that can cause chips and fractures. They can affect other parts of the oral system, too, potentially resulting in jaw joint pain and muscle spasms, headaches and other head and neck ailments.

It's hard to cut out all high-sugar/high-acid foods and beverages, so where complete elimination isn't possible, focus on moderation and try to consume them only during mealtime. Jaw clenching and other parafunctional behaviors are often subconscious and may be harder to control; in such cases an unobtrusive device like a clear occlusal (bite) guard can alleviate the problem.

If you would like more information about tooth damage and prevention, please see our website at www.myParkDental.com or call us at (239) 263-1151 to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article "Tooth Decay" and "Stress & Tooth Habits."