Is a gold dental crown a bad idea if I am allergic to metal alloys?

Question

My dentist wants to put a white gold crown on my very back molar because she says my small jaw won't allow her much room to work with porcelain. The problem is that I am allergic to all metals but silver. Gold chains make my neck break out in hives, and gold pierced earrings cause my ear lobes to swell and eventually become ulcerated if I leave the earrings in for more than a week. I have been told it is the nickel alloy. Even the hypoallergenic earrings do the same thing.
I have a porcelain crown on the other upper back side of my jaw and the dentist didn't seem to have a problem with placing it. The other issue cosmetically is that I am an internet model and frequently my teeth show such as if I am laughing. I don't want a big ugly tooth showing. Does any one see any reason why I shouldn't get porcelain? Do I need a second opinion? Does any of this sound like the dentist is just trying to jack up my dental bill?

Answer 1

Gold is typically the most friendly material a dentist can use in your mouth. People very rarely have allergies associated with it. Most allergies are indeed due to nickel as you've mentioned. That being said, it seems as though you have a higher sensitivity to metals. You might ask your dentist if you could use a temporary cement to hold the crown in place for a few days to make sure it won't cause problems.



When a dentist prepares a tooth for a crown they have to shrink it down in size. The amount they trim it down depends on the material they use. The material may fracture if it is not an adequate thickness. For a gold crown it only requires about 0.5 mm. For a porcelain crown it can require 1.5 mm or more. If your tooth is very short, 1.5 mm of reduction can make things very tricky. You might end up with a crown that doesn't have a very good chance of staying on. It's like wearing a hat - somebody that pulls their hat down as far as they can ensures that it stays on. Somebody that lightly sets the hat on their head is going to have it easily blown blown off by a gust of wind. One possible way around this is to trim down the opposing teeth. You could also carefully evaluate your smile - does that tooth show at all when you smile? Maybe take some photos doing various poses to see.



As far as price goes, you might want to ask how much a porcelain crown costs. I work in a dental office that charges the same amount for any type of crown. In fact, gold is so expensive nowadays, that the porcelain crown can be more profitable for the dentist. Hope that helps!

Answer 2

You dentist is acting appropriately and she is not trying to "jack up" your dental bill. Gold is the most biocompatible metal on the planet and it is extremely rare to have an allergy to gold but from what you say, it appears that you are allergic to gold. Nickel allergies are very common especially in females and the metal is common in jewelry. Your problem is a lack of adequate clearance in the back of the mouth for a cosmetic restoration. An all metal crown can be made very thin and yet have adequate strength and be durable. Porcelain on the other hand must have a certain thickness to have the same amount of strength and durability. Unfortunately, to obtain the desired thickness a lot more tooth must be ground away and it appears that you do not have the room to give. If the prep is too short, retention will be a problem. In layman's terms that means if the tooth to have a crown is ground down too much and it does not have enough height, a crown will be keep falling off. The further back the mouth one goes, the less room or height is available. Non metal porcelain crowns have been known to fracture from chewing stress and there are even newer porcelain crowns that claim to be as strong as metal crowns. Dental manufacturers have a tendency to over stretch the truth at times. One that comes to mind is saying that white color fillings are as strong as amalgams (silver fillings). Commonsense will tell you that plastic can never be as strong as metal yet many patients and dentists alike fall for that sort of nonsense. There's nothing wrong with having an all porcelain crown but you need to be aware of the drawbacks as well as the advantages.

Answer 3

Gold Dental Crown Problems

Answer 4

A second opinion is a great idea. I would not pull out the tooth. I pulled mine and am very sorry now. Perhaps your dentist can sell you a samply small piece of white gold alloy, or yellow gold alloy to hold in your mouth to see if your gums inflame. I am very allergic to all metal, but I love my gold crowns. (4 front teeth covered with porselein so they look white. I like white gold better than yellow gold. I would think if you have ceramic on on side, you could have it on the other. I wish you good luck.

Answer 5

The best suggestion is that you get a second opinion.



Also: Have you voiced your concerns to this dentist? Have you told her about the appearance factor as well (the modeling)?