I’ve had porcelain fused to metal crowns for many years, due to a childhood accident that damaged most of my top front teeth. They have always looked pretty fake, but in recent years I have developed a black line right at the gumline. It is getting a little bit worse every year.
What can I do about this? Is there some way to do dental bonding over those spots on my crowns? Can you please tell me all my options, from most expensive to least expensive?
Samuel in Marlboro, SC
Dear Samuel,
I am afraid there is no inexpensive way to correct this problem.
The “fake” appearance you mention is the reason why few true cosmetic dentists will use porcelain fused to metal crowns on the front teeth. The problem is not in the skill of the dentist placing the crowns, but in the structure of the crowns themselves. The metal underneath the porcelain makes it impossible for the crowns to mimic the translucency of natural teeth, giving the crowns that fake appearance. The black line that troubles you is part of the structure of the crown, and becomes evident over the years as the gums recede. If a dentist were to try and drill away that dark material and bond over it, the end result would not be any kind of improvement over what you have now, and could likely look a great deal worse.
This leaves you with two choices. The first choice actually is inexpensive, as it involves doing nothing and learning to live with the dark line. The only other option is to get new porcelain crowns. This will not be inexpensive, though you may be able to find a dentist who will help you phase treatment so you can budget for each phase of treatment.
One final word-when you are searching for a dentist to help you with this procedure, make sure you chose an experienced, talented cosmetic dentist. Ask to see examples of their work, and check out their training and credentials. This is an expensive investment, but one that could pay enormous dividends in your confidence. Make sure you choose the right professional to help you.