Dentistry these days! No more silver amalgam fillings or porcelain-over-gold crowns for me!

Baley

So, I went to the dentist today to have a 20+ year old crown replaced on a molar...

back in the day, this was at least a two-visit process, the first they'd prep the tooth, take an impression, stick on a temporary, and tell you to come back in a couple of weeks.

in the meantime (while your temp sometimes fit wrong, came off when eating, and generally bothered you) they'd send the impression to a lab, who would build you a permanent crown by manufacturing a precious metal base and then firing on some white porcelain, and they'd send that back to the dentist, who would fit it in your mouth better or worse, and it would have a variable level of strength and comfort (depending on the skill of the dentist and lab.. my old crown was about average)

Nowadays, a state of the art dental crown can be done in one visit using CEREC system which carves a precision-engineered CAD crown out of a single block of super-strong porcelain, with look, fit, feel, and strength, in my experience, better than natural teeth (certainly my natural teeth!)

in and out in about two hours, and that's it, this particular tooth is expected to last the rest of my natural days. And while expensive (my after-insurance bill was $451, or about one fourth of the total cost)) this process uses no precious metals.

Anyone get any dental work done lately using gold or other PM's? Any statistics on the trend in using PMs in dentistry? It's got to be on the decline... I'm not going back to gold.

PS: no, I didn't ask for the old crown.

roadrunner

I think the metal fillings and repairs have been slowly on the way out. The sooner I can get all the mercury fillings out of my mouth the happier I'll be. I talked to my dentist about this and said there's no risk to mercury (silver amalgam) fillings. The FDA agrees.....as if they wouldn't. However, there's certainly no risk in having too little Hg, Zinc, Silver, Tin, and Copper in one's mouth. I get enough of those metals from other sources.

I have a crown due in the near future and it will replace a monster sized amalgam filling on one of my molars. My dental "plan" doesn't cover crowns so that $1300-$1600 will come out of my pocket. My last crown was done a year ago to replace another 50 year old monster-molar filling that was cracking. I don't know how they messed up so bad, but I had to have 4 visits to get that done. The first crown didn't seal up properly (too short on one side) so they did another one (temp crown, bad crown, temp crown, final crown). I think they were planning to get the new equipment into the office so they can do the work in one visit.

fishteeth

Cerec is nice, however, best restorations right now for strength and esthetics are probably milled zirconium at the lab, down side is 2 appointments, but much less tooth needs to be removed (2+mm vs 1mm or so) and we can do a lot more with the color at the lab. Cerec not bad, but still the best restoration out there is probably gold, most dentist including me have gold on their back teeth. Similar wear properties as enamel so much nicer to opposing teeth. I charge the same for gold, just nobody wants it anymore.

fishteeth

you might as well take the old crown. We always offer it back with the name of some jewelers who offer a fair price, although I love it when they decline taking them. Usually a nice chunk of gold at the end of each year to have refined

fishteeth

seeing the prices you guys quote for crowns, I need to get out of WI. Average price out here is probably 800-1000 for cerec/zirconium/gold etc.
actual cost to get a crown made at a US lab is currently about 100-140 dollars and takes about 30 minutes chair time to prep and 20 to insert, at 1500 a piece I would be retired in no time

roadrunner

My last crown cost me around $1300. My brother was an oral surgeon and in his part of the state (50 miles away) the going rate was $1600-$1800. There's a lot more money the closer you get to NY City. I also had checked with a lower cost/lower overhead dentist in my area and his estimate was around $650-$750. His overhead is a lot less than the others. But, considering the run-down condition of those offices, I'm not sure what kind of quality crown I'm going to get for that low price. His cleanings are only $50. My regular dentist is $150. I tried a cut rate cleaning and they spent 15 min actually cleaning the teeth vs. 30-45 min for my regular guy.

bronco2078

I just had the second appt of a root canal yesterday. Crown to be done some time after the first of the year. 1380 was the quote for the crown , a 2 visit type . It says noble something or other on the estimate.

The last crown I got in 2010 was only half that. In my case its all out of pocket no dental insurance.

ranshdow

I had a porcelain-over-noble crown recently. I only briefly glanced at the dentist's docs, I believe I saw palladium and rhodium?

fishteeth

We are lucky out here that rent and real estate is cheap. Just purchased a second office, paid 400,000 for a 6 yr old all stone (brick with limestone accent) 4200 sq ft on the main highway in town. My other location is about 20 miles away and for 2000 sq ft have to pay 2000 a month with utilities. Now my equipment is all top of the line (in fact heading to Adec headquarters in a couple of weeks to pick out 4 new ops), all digital xrays, digital impressions etc etc. My prices are probably in the top 10% in the area. The sad thing is the prices do not have to be as high as they are in many areas. We are often told at lectures do less and charge more, if I do one crown for 1500 that could be more profitable than doing 3 crowns for 700. However, I want to help people, not gouge them. I am also young and can work for 10 hrs a day.

fishteeth

Noble crown means roughly 30-50%(can't remember the exact percent needed to qualify) high noble metals (palladium, gold, platinum)
High Nobel is over 50% noble metals
Base metal is basically crome colbalt or some other junk that should not be used in ones mouth (often used bythe big chains to keep prices low and then often made in China)

Some of the gold I use is as high as 18 karat, that can get pricy, but still the best solid gold crowns.

However, traditional PFM (porcelain to metal) crowns are becoming obsolete, most dentist have switched over to the new material (zirconium)- no longer do I have to worry about porcelain fracturing off the metal.

BAJJERFAN

<< <i>Noble crown means roughly 30-50%(can't remember the exact percent needed to qualify) high noble metals (palladium, gold, platinum)
High Nobel is over 50% noble metals
Base metal is basically crome colbalt or some other junk that should not be used in ones mouth (often used bythe big chains to keep prices low and then often made in China)

Some of the gold I use is as high as 18 karat, that can get pricy, but still the best solid gold crowns.

However, traditional PFM (porcelain to metal) crowns are becoming obsolete, most dentist have switched over to the new material (zirconium)- no longer do I have to worry about porcelain fracturing off the metal. >>





How much of a problem do you have/see with gold crowns getting holes worn into them, esp. of the far back teeth?

I had one pop off a couple years ago that had a hole in it so it made no sense to glue it back on. Also have a 5 piece bridge getting a hole worn into it on one tooth.

Weiss

I got a gold crown in February of this year. It was my second. I specifically asked my dentist for gold.

I got the first in 2008. I asked for the product information for the first one. My dentist used CB-77 Talladium brand type II on the first: Au 77%; Pd 1%; Ag 13.1%. I think the second was the same or very close to the same compound. The dentist's notes indicated it was a 3 dwt crown, or roughly 1/5 of an ounce. That seems pretty heavy but not entirely out of the questions. I've got a big mouth with huge teeth. Maybe fishteeth can "weigh" in on average crown weight?

The second one was considerably larger than the first.

And I've insisted on no porcelain. I want the gold, and I want it to show. I expect I'll need another 2 or 3 crowns over time. It's all good. I love precious metals, and I love gold. Having hand-crafted nuggets of gold/palladium/silver in my skull is exactly what I want

fishteeth

yes gold does wear, and sometimes gets holes. But better to wear the gold than the opposing teeth. I have seen gold crowns in place for nearly 50 years that still look good, sometimes the crown was just made too thin.

Some crowns do have some significant weight to them, we try and prep them with as little tooth reduction as possible so I can make the gold as thin as I can. This is better for the tooth and better for my cost- ideally about 1-2mm reduction at most for gold, sometimes the crowns can be as thin as .5 mm in places. The big gold bridges can have some real weight to them, with implants today we try not to do as many bridges, but I sure love cutting them off and having the patient tell me to keep it.

AUandAG

My Dentist will trade for coins and such.....I don't have insurance and crowns (porcelain) are a grand+.

Gold is quoted at $1,300.

Ask your dentist for a trade for coins. I give them to him at 10% back of retail and do a printout for him of a very
recent auction or eBay sale so there's no problem with valuation.

Since I've had the coins for decades, in most instances, it makes my dental visits much less.

bob

Edited to add that he says, like fishteeth said, that gold is much easier on the surrounding and opposing teeth.

Athena

Bochiman

<< <i>seeing the prices you guys quote for crowns, I need to get out of WI. Average price out here is probably 800-1000 for cerec/zirconium/gold etc.
actual cost to get a crown made at a US lab is currently about 100-140 dollars and takes about 30 minutes chair time to prep and 20 to insert, at 1500 a piece I would be retired in no time >>



Cheaper crowns here are ~$900. Better crowns (my dentist does a 2 parter....and there is a core inside the crown in case the outer piece chips/breaks due to grinding, etc) run ~$1500-$1800. Insurance only picks up ~50-60% of that I think.
My dentist "outsources" the crown to a guy/business set up in the same business park. 1 hour in chair, impressions, send out, wait a couple of weeks, 1 hour back in chair (color matched, etc).

Bochiman

<< <i>yes gold does wear, and sometimes gets holes. But better to wear the gold than the opposing teeth. I have seen gold crowns in place for nearly 50 years that still look good, sometimes the crown was just made too thin.

Some crowns do have some significant weight to them, we try and prep them with as little tooth reduction as possible so I can make the gold as thin as I can. This is better for the tooth and better for my cost- ideally about 1-2mm reduction at most for gold, sometimes the crowns can be as thin as .5 mm in places. The big gold bridges can have some real weight to them, with implants today we try not to do as many bridges, but I sure love cutting them off and having the patient tell me to keep it. >>




Hmmmm...I think I could book a flight, stay overnight in a hotel, get the dental work done at your place in WI, and still come out ahead financially from what the pay rate is over here....

DrBuster

I got 3 gold toofeses. Last one was in the spring. 3 in the span of about 5 years as I have my grandmothers brittle teeth and I break them. I hope I don't have to get another one but I'm not betting money on it.

Last one I paid zilch for as this year and next I have double insurance - mine and wifeys. Last 2 after single coverage insurance were about a grand out of my pocket.

I asked doc about using a 1/10 AGE or a dos peso to make the 2nd one a few years ago, he laughed but said that would be neat.

ricko

I still have large silver fillings in molars that were put in while I was in the Navy....many, many years ago. Dentist says they are still fine - and complimented the Navy dentists...Cheers, RickO

BAJJERFAN

<< <i>My Dentist will trade for coins and such.....I don't have insurance and crowns (porcelain) are a grand+.

Gold is quoted at $1,300.

Ask your dentist for a trade for coins. I give them to him at 10% back of retail and do a printout for him of a very
recent auction or eBay sale so there's no problem with valuation.

Since I've had the coins for decades, in most instances, it makes my dental visits much less.

bob

Edited to add that he says, like fishteeth said, that gold is much easier on the surrounding and opposing teeth. >>



Just go to a local dealer and sell your gold unless the dentist has a reason for wanting it. A 5 piecer is about 5 grand or so and with my chitty insurance, I'd be stuck for about $4 grand of it. I don't think it can be done piecemeal.