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What Should A Good Porcelain Crown Look Like?

Dentistry is a unique profession. We don’t just deliver a service, but we also deliver a product. Porcelain crowns, or caps, among many other type of restorations are delivered on a daily basis in a dental practice. So, what makes one dentist different from another? Why does one dentist charge more? What could the big difference be?

Here is a quick example of the difference between a good crown and a bad crown.

The sole purpose of a porcelain crown is to repair and preserve the tooth, mimicking its original shape and function. The color should match the existing teeth, so it blends in.

 

This is what we expect from a GOOD crown:

  1. Perfect Fit
  2. Matching contour to the neighboring teeth
  3. Straight emergence profile from the gum tissue
  4. Good contact between the teeth and the opposing biting surface
  5. Good color and stain match to neighboring teeth

 

Common errors seen in a BAD crown:

  1. Poor fit of crown – Results in recurrent decay, sensitivity, quick failure of crown.
  2. Over contoured crown – Results in inflammation around tooth, gum disease, recurrent decay and quick failure of crown.
  3. Crown fits on tooth like hat on a hat rack – Result is same as #2
  4. Crown is either too tight between teeth, too light or no contact at all – Results in food impaction, and consequent recurrent decay.
  5. Crown looks like a marshmallow or corn kernal rather than a tooth.

 

So now you know what a good crown should look and fit like. Now why are not all crowns made like this? Simply put, making a good crown is an art and requires a high level of skill. It takes time, and time is money.

The dentist needs to deliver a perfectly prepared tooth, a perfect mold of that tooth, and a perfect prescription to what he/she wants from the technician.

The technician needs to perfectly trim the model, perfectly build the crown on the model, and perfectly adjust that crown on the model. Then the dentist needs to try this crown on the tooth first, make any necessary adjustments, and then cement the crown perfectly. There is no room for error!

Preparing the tooth takes time and skill. Taking a perfect mold takes time and skill. The less a dentist gets paid for a procedure the less time he/she can spend on it. It is a simple matter of economics. It is a business. Running a dental practice is very expensive and there is significant cost involved.

Now, once a perfect mold exists the crown needs to be made by a highly skilled technician. The more skill the technician has the higher the cost. It is a very simple formula. You get what you pay for!

All these steps and requirements put together are what it takes to make a good crown. A bad crown is not much better, and sometimes worse, than no crown at all.

Look at the photos and see if you can identify the differences between the good and bad crowns. Then, decide which type of crown you want in your mouth.

Good Crown
Good Crown
Good Crown
Good Crown
Bad crown
Bad Crowns
Bad Crown
Bad Crowns
Bad Crown

I could literally post thousands of photos of bad dentistry.

The difference between a good and a bad crown is immense – the aesthetics are better, the fit is better, the longevity is better.  Would you expect to pay the same for a good and a bad crown? Of course not. A crown should last a very long time – decades. So, if the cost difference is less than a few pennies per day over the lifespan of the crown, why not get the good crown?

At Ideal Dentistry we only place good crowns because that is the right thing to do.

Keep smiling,

Dr. Chris

posted in Blog, Cosmetic Dentistry

214 thoughts on “What Should A Good Porcelain Crown Look Like?

  1. Dr. Chris

    Dear R Nash,

    It was a good thing that your dentist redid the crowns. Now, getting the bite correct is not “optional”, but required. Take all the time you need to get this done right, regardless of how “annoyed” the dentist may get.
    Maybe you should have him put in writing that he/she would be paying for any problems arising from having a bad bite that was not there before the 2 crowns were placed. For some reason I don’t think he/she would sign that paper and go ahead and adjust your bite :) Sorry, a bit passive aggressive but this type of problem should never happen…

    Keep smiling,

    Dr. Chris

  2. Kim

    Hi Is it normal for my crown to have a silver ring all around the bottom? I don’t have it on the bottom of my upper crowns (all molars) . Also one of my crowns has silver (looks like a filling in it) do you know why they would have made it that way?

  3. Dr. Chris

    Dear Kim,

    Sounds like it is a porcelain fused to metal crown. The dentists opted for this crown for their reasons and should have probably discussed with you the options first. I would ask your dentist why he/she used this type of crown as it is becoming less and less prevalent.

    Cheers,
    Dr. Chris

  4. Kim

    Hi Dr. Chris,

    Thank you for getting back to me. I just had another crown put in and this one has it too. Is it cheaper for the dentist? Is it stronger? He only showed me the outside and he held it so I didn’t really see it inside. He did not show it to me in my mouth before he cemented it in, but the other ones he has done look good, except for that ring around the bottom of them which I really don’t like. I just want to make sure there is no amalgam in them as that is what I wanted to cover up. Such a shame I have been leaking mercury into my system for years, as that is really what is in amalgam fillings. I think it is very interesting that almost no one gets amalgam fillings anymore, yet no one ever really talked about the change. Makes me wonder why??

  5. Kerri

    Hi Dr Chris
    I had a root canal done over a year ago and from day one have had a problem with it.. The best way to describe it is that it feels like the post and crown are way to tight. After reading this it confirms what I already knew and that is that I also have a bad crown. It looks like a blob of porcelain was just laid over my tooth. The tooth is really bothering me lately. When I went back right after I was told there was nothing wrong with the root canal.. I have two others that I don’t even think about. The only difference between this one and the others is the post. Is it possible a post could have been put in wrong and can this be fixed?

  6. Patricia

    I’ve been a patient of my dentist for 15 years and had extensive dental work. One of my more recent crowns has been cold sensitive ever since it was placed several years ago. It wasn’t cold sensitive before the crown. There is a very noticeable gap on the inside between the crown and my gums. Could that be the reason? I could tell he was not happy with it when he was placing it. When I complained about the sensitivity I was told it was temporary. When it didn’t subside he adjusted my bite and said if that didn’t help he would have to do a root canal.

  7. Katie

    Hello,

    I have just had 3 crowns fitted over very discoloured teeth, due to very old fillings from when I was a teenager (now 26), whilst they do look quite d=good, I can just see the black of my real tooth around the top of the crown where it meets the gum and also if i look inside my mouth the white crown doesnt go all the way up to the gum on the inside and therefore is showing black from my actual tooth. I am very self conscious with black teeth and I had these crowns hoping they would cover all the black. Question being, should I be able to see any black of my real tooth?

    Many thanks,

  8. cara

    How long should a dentist replace a bad crown for free? Tooth # 15 was chipped so my dentist put a porcelain fused to metal crown on, problem was it didn’t fit so he sanded off the porcelain on the back side of the tooth, exposing the metal underneath. since this is a back molar you can’t see the exposed metal unless my mouth is wide open and you are really looking. I asked him to replace it a few months after it was placed, but he said the crown was fine and didn’t recommend replacing it. I have since changed dentists and my new dentist wants to replace the crown. The crown is only 2 years old, is my old dentist required to replace it for free? My insurance won’t cover it because it is less than 5 years old.

    Thanks

  9. eric weaver

    what about trimming good teeth to fit the crown/ I figured the crown was too big and they would trim the crown instead of my other teeth

  10. Dr. Chris

    Dear Eric,

    Sometimes the bite is adjusted on the opposing tooth for various reasons. Regardless, the dentist should explain to you “why”. If the tooth that is receiving the new crown is already cut down to it’s minimum size and there is still not enough room for porcelain or gold then the opposing tooth will need to be adjusted.

    If the new crown is just too big then you are right, the crown itself must be adjusted and not the opposing tooth.

    Cheers,

    Dr. Chris

  11. Dr. Chris

    Dear Cara,

    If the crown was adjusted to the point were it was worn down to the metal it should have been replaced before it was cemented. Crowns should be adjust prior to being cemented of course for these reasons. The metal usually is super thin!
    Now, 2 years later you will have a tough time proving that this was the case as the chart notes most likely will not reflect your story.
    On a good note, as long as the metal is not worn away the crown is sealed and should be fine, meaning that it does not need to be replaced for that reason. Why does your new dentist want to replace it? The metal showing is not reason enough for a replacement unless you wear through the metal……
    Insurance, which is not concerned about you one bit fyi, won’t pay for a replacement because the just picked the 5 year number out of a hat. I do not let insurance dictate treatment and would look at your health first – sometimes crowns placed a month ago by dentists should be replaced!

    I hope this helps,

    Dr. Chris

  12. Dr. Chris

    Dear Katie,

    The black from your underlying tooth is visible due to many reasons…if the dentist wanted to hide it completely he/she would need to put the edge/margin of the crown deep below the tissue. That being said, if this was one of your chief complaints then you need to discuss this with your dentist as the crown may be a functional success but esthetic failure. Most dentists will want you to be happy and possibly redo them with a margin that goes deeper below the tissue.
    Now, margins that are above the tissue are actually healthier for you! Getting the tissue exactly right is the pinnacle of Cosmetic Dentistry and not easy for most to get perfect.

    I hope this helps,

    Dr. Chris

  13. Dr. Chris

    Dear Patricia,

    If there is a gap where the crown touches the tooth then it needs to be redone asap! If your dentist is not communicating with you on this then go get a second opinion on that tooth before you do need to kill the tooth with a root canal. Most dentists will work with you on getting it right :)

    Cheers,

    Dr. Chris

  14. Dr. Chris

    Dear Kerri,

    There are so many variables here….I would need to see a picture of the root canal and post to give you an honest opinion. One thing I can say though, your feelings usually are right and you may need a second opinion to look at this situation.
    You should not be able to feel the post or root canal for that matter. The crown may be too tight and have poor contours which would result in the situation you described.

    Cheers,

    Dr. Chris

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