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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

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

  1. hahndds

    Dear Carol,

    Sounds like you had a dental crown nigthmare! Sorry. It is difficult to give an exact answer as I really would need to see a good x-ray for this one…but, I am not a huge fan of bonding teeth together for many reasons, especially on the front two teeth.
    So, if they look bad and you can’t speak correctly I would remove them and fix it. Implants are a good solution but you would never want to place 2 implants next to each other on the front teeth either…
    Look up a AACD Accredited dentist http://www.aacd.com and they can help you :)

    Keep smiling,

    Dr. Chris

  2. hahndds

    Sorry I just got this email Ann Li, there are literally hundreds of questions :)

    You can send me a picture to chahn {@} idealdentistry.com (wrote it like that to avoid spam bots).

    Keep smiling,

    Dr. Chris

  3. hahndds

    Dear Rachel,

    The smell probably is from the crown – if it does not fit right then stuff gets under it and causes a rot smell…Anyhow, I would see a quality dentist (ideally someone that does not take insurance) and get a second opinion. Most top dentists will do that for you for a nominal fee.

    Keep smiling,

    Dr. Chris

  4. hahndds

    Dear Susan…..

    You are in the prime location for cosmetics :) There are a lot of good choices.

    I like Brian LeSage, he is a great dentist and a nice guy.

    http://www.cosmetic-dentistry.com

    Keep smiling,

    Dr. Chris

  5. Susan Bourg

    Thank you for your reply. When I read these posts I have had all these problems with my crowns. Too big, redone too small, Foul smell coming from the gum line of my two front teeth. I am not going back to the denist that has created these problems.
    I went back to my old denist. Dr. Masliash on Wilshire. He sent me to Dr. Bustomonte he just finished doing gum surgery to clean underneath one of my crowns because I had a bad infection. I don’t understand how some dentist just don’t think long term. They just don’t care. I am debating to have my two front crowns done (odor under gum line) for a 3 rd time with Dr. Masliah whom I trust. He just fitted me with a night guard to help with the stress I have been feeling because of bad dentistry. Then we are going to figure out what to do. My insurance said that if Masliah can make a case for bad workmanship they will cover them being redone. I will also research the dentist you recommended. Thank you so much for your website to help all of us.

  6. Carol

    Dr. Chris – thank you for your response. Perhaps, I didn’t indicate in my previous question that I will do anything to avoid dental implants – particularly, in the front. I had a failed dental implant (lower back tooth) that left me with partial numbness on my bottom lip. As I mentioned in my earlier comment, both teeth in front are endodontically treated with one having had a pin/post inserted – so it is even more fragile. Since dental implants are my absolute last choice, could these fused crowns be removed safely without breaking natural teeth – then affix new “layered” zirconium crowns to my teeth by bonding them on? (I believe you mentioned herein that “if little tooth structure was left then the crown needs to be bonded on.” ) But, you went on to say that a correctly bonded crown will last a long time but “make sure the dentist has enough experience to place bonded restorations.” Since my treated teeth are much darker, your suggestions to one commenter regarding placing a layered (not just stained) zirconium crown might offer better esthetics – sounds like the route I’d like to take. Not only do these two crowns look totally unnatural, but, after two years, they are still terribly uncomfortable (tight), stick out from the rest of my teeth and cause increased saliva (feels like I’m always about to drool) . In addition, because of the bulkiness of these teeth, my overbite has created additional problems: bruxism and TMJ problems. With that being said, can you suggest an accredited cosmetic dentist (I tried searching on http://www.accd.com, to no avail) who has vast experience in bonding crowns (as opposed to cementing) who is interested foremost in saving natural teeth and who has a good lab? Although I live in Alabama, I am willing to travel to obtain the best treatment. Thank you so much.

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