Hello. I have a gold crown. I have had it for 28 years now, and it still feels fine. However, there is a spot on the chewing surface where the gold has worn through.
I have two questions. First, should I have this replaced, or just repaired. My denitst says he can cut the top off and fill it in with amalgam, keeping the gold around the sides of the tooth. Second, I don’t like the idea of doing amalgam because it looks dark. Could composite be used there?
- Penny
Penny,
If this crown is otherwise doing fine, Id keep it. Gold crowns, if they are done well, can last a long time. You appear to be learning that with this tooth. And it isn’t unusual, after twenty or more years, for parts of the chewing surface to wear through and need repair.
But I would agree with you that I would want the repair with composite filling material rather than the silver-mercury amalgam. A complication with the amalgam is that you would end up with two dissimilar metals, silver-mercury and gold, touching each other. With the electrolytes in your saliva, this sets itself up like a little battery in your mouth, and the electrical current can accelerate the corrosion of the amalgam and makes it turn black quickly.
There is a problem, though, in that the use of composite on the back teeth requires special techniques, especially where you are bonding to gold, and it’s unlikely that an amalgam dentist is familiar with these and also unlikely that he would actually admit any weakness in this area. So my recommendation is to either stick with this dentist and let him repair the tooth the way he wants, or find another dentist who does lots of posterior composites and knows metal-bonding techniques, to do the repair for you.
he complication is that, if your dentist prefers using amalgam here, he is not one I would ask to do the composite repair. Dentists who know how to do the composite repair well almost universally prefer that technique. It is very risky to try to nudge a dentist out of his or her comfort zone. They will not want to reveal their discomfort with a procedure, and it’s a recipe for disaster. These composite fillings are very technique sensitive, and many dentists don’t know how to do them well.
Read about porcelain onlays.
Dr. Thein is a mercury-free dentist.
Dr. Azarbal of Pasadena is also a mercury-free dentist.