I have had a dental crown before where the dentist files down most of the natural tooth and then puts a porcelain crown over top of it. But, I am missing a tooth so there is nothing left to bond or glue it on. The dentist I just saw told me about a metal tooth, I think he called it a PFM. But, I really want porcelain instead of metal. I want to have something that looks natural and the metal doesn’t seem like it will look good. So, is there any way to use all-porcelain to replace a missing tooth?
-Jeff in Indiana
Thank you for your question. The good news is that there are a couple options to replace a missing tooth with an all-porcelain crown.
The best solution to replace a missing tooth is a dental implant for many reasons. Dental implants are a permanent solution and they look, feel and function just like your natural tooth does. The implants are made of titanium and they are implanted by an oral surgeon. The implant is placed in your jaw bone and it ends up serving like your natural tooth root. Then, an abutment is used on that anchor to attach a crown to the post. The abutment piece can be made of either metal or porcelain. Metal is stronger, but depending on the dentist, there may be a strong porcelain material that can be used. In some cases, there may not be enough bone left at the implant site, so bone grafting may be required, which can be an extra expense.
Even if the metal post is used, it will be covered by a porcelain crown, so the visible portion will blend in naturally with your surrounding teeth. However, if you are dead set on all-porcelain restorations, you need to consider the strongest porcelain available to prevent issues down the road. Some issues that could put stress on the all-porcelain restoration are grinding, a cross or under bite, or if the dental treatment is on a back molar. It is also important to consider the teeth surrounding the replacement crown as well.
The best thing to do is to talk with an experienced implant dentist and explore the best options for your particular case. With dentistry, you don’t necessarily want to tell the dentist you want a certain treatment. You need to find the best dentist who is comfortable and has success with dental implants. This is important because implant dentistry is not a regulated field of dentistry, which means any dentist can say they are an implant dentist without any additional training. So, it is far more important to research the best implant dentist than to go in with a preconceived dental plan to tell the dentist.
Dental implants are indeed the ideal solution. However, it is an expensive procedure. So, another option you may be interested in learning more about is a three-unit dental bridge. This treatment requires the two neighboring teeth to be prepared (filed down) for crowns because they will be used to support the missing tooth restoration that sits between them. The dentist takes an impression of the area, and it will then be fabricated and cemented into place. This is also a permanent restoration, but if the surrounding teeth are otherwise healthy, it is not the best treatment plan.
Here is an example of the comparison between what a dental bridge looks like and a dental implant.
Hopefully, this information is helpful to you as you consider your options.
This post is sponsored by Petaluma dentist Dr. Rick Lane.