Why not go for the gold?


Gold crowns and other types of gold restorations ( inlays and onlays)  are increasingly less popular with dentists and their patients. It is a shame, because other than these crowns are not tooth colored, they are close to an ideal restoration. They are virtually unbreakable, kind to opposing teeth, require less reduction of underlying tooth structure and have a simpler tooth preparation requirements. They work with long teeth, short teeth and in between sizes.

Possibly I am old fashioned, but I still prefer this type of crowns for my second and third molar restorations since these teeth can experience more occlusal stress than more anterior teeth. They work well for bruxers ( tooth grinders) and personally I like the way they look in the posterior section. Where as ceramic crowns need a greater thickness to work well, Gold crowns need much less, There  is never a need for them to be bulky since they can be paper thin on the buccal and lingual and still work fine.

So why are they not more popular with dentists and their patients? Most patients don't care for how they look.  When I propose one for a patient  I often hear them protest "I don't want a metal mouth!", "I hate the way they look!" or the ever popular "I don't want to look like an immigrant!"(possibly Donald Trump supporters?)

Dentists may not enthusiastically endorse them, mostly because they are not always well reimbursed by insurance and the lab bills for high gold crowns can be much more expensive ( up o three times as much) than the  newer cad cam zirconium crowns.

Still gold crowns have a place in my practice and when I talk to my colleagues privately, they admit they are still an excellent option, even if they don't make many for their patients. It seems a shame to me since they are such a good restoration for patients' most posterior teeth.





from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/08/why-not-go-for-gold.html - http://lspindelnycdds.blogspot.com/

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