Expert: Benjamin Schwartz, DDS FAGD - 2/11/2009

Question
Dr. Schwartz,
Last year I had 3 crowns replaced.
The first one was under the insurance plan and the price and description were different than the last two which were done as cash (due to loosing the insurance).
The first one state in the medical bill as"Porcelain fused to high noble metal".
The last two were described in the Dentist’s statement as "Porcelain to gold" and they cost almost double than the first one.
When the last two crowns arrived from the lab I took a look at them and I was confused that the inside material did not look gold to me; it was silver gray.
I asked the dentist and I was told that this is how the noble metal looks.
After this I did some researches about the possibilities of High-Noble Alloys and that is how I found that there are 3 subclasses: Gold-platinum; Gold-palladium; Gold-copper-silver-palladium.
My first question: How do you know what exactly they’ve been using for the crown?
Second question: Which type of alloys will be the best for me?
In order for you to answer to the second question, I need to tell you a little bit about my situation.
In 1989 and 1990 I have put on about 12 crowns; most of them on the upper part.
In 2004 and 2005 I went under Chemotherapy for T-cell lymphoma. Since 2006 I am taking Coumadin for DVT and PE. My gum is a mess; is very sensitive and bleeding a lot. I was told by two different dentists that the problem is the metal they’ve been using back in the '90. The only way to solve the problem with my gum is to replace these old crowns.
Since this is a major project and very costly too, I would like to know what are the best options for me.
Thank you for your considerations,
Meliza  

Answer
Hi Meliza,

It sounds like you've been through a lot.

Unfortunately, the only real way to know what type of crown it is, would be to ask the dentist or laboratory. It could be a gold crown internally, but if may not look like it.

I am not sure why the metal inside the crowns should be causing you any problems. However, if you do want to replace them, then gold-porcelain crowns (Captek) is believed to be a good solution. It is highly bio-compatible, easy on the gums, and repels bacteria while being esthetic.

I wish you good luck!
Please let me know if you need more help.