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Dentistry/Dangers from Metal Crown...?


I have been wearing a PFM crown  on an upper left premolar (I think that's number 8) for about seven years. It has been Ok until about a month ago when I noticed a dark area around my gum line. The area also feels slightly tender to the touch.

I am concerned about the exposed metal and the fact that saliva must be carrying some harmful substances into my gut which most likely will affect systemic health. My dentist tells me that I don't need to change it and that, in fact, it's Ok to have metals in the mouth. Is this true? Is it a difficult procedure to remove one crown and replace it with another? What is the possibility of causing damage to the tooth during this procedure?

I am also learning about galvanic currents. Based on the literature read, this happens with more than one types of metal but is it also possible to occur with only a single PFM crown?

Are my concerns about systemic health, justified?

Thanks very much for your response.


Dear Sandra:
Your question is a perfect example of the evils of the internet!
The ONLY concern that you should have is the aesthetic issue of the metal margin of the crown showing.  If it bothers you, it is a routine procedure to have the crown removed and replaced.  You can have it replaced by a regular porcelain fused to high noble metal (which will be gray on the inside), or a Zirconia based crown.  Zirconia is a Metal as well, but it is white.  I usually do not recommend an all porcelain crown for the back teeth, since the stresses are greater and they do tend to fracture under the stress.  E-max porcelain crowns do work well, but your dentist has to know how to design them properly. Of course, you will have to pay for a new crown.
The other issues are hype.  Galvanic action is a description of a battery, where ion exchange happens between two metals through a conducting medium.  This has to happen in a closed system and the distance between the metal poles has to be very close in order to generate current.  This IS NOT what happens in the mouth.  There are so many other factors. This is a theory proposed many years ago and unfortunately, people still talk about it on the internet.  Dentists do not think about this any more (and we haven't talked about it for over twenty five years).  Your crown ALWAYS had metal in it and the saliva was bathing it all along.  The only difference now is that the crown has been there for enough years and you are getting recession of the gums and now it is showing.
In short, forget about all the nonsense.  Listen to your dentist.  If the crown is OK and it is not an aesthetic issue and there is no decay, leave it alone.  If it does bother you aesthetically, talk to your dentist about getting a new crown.
Best of luck,  


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Zev Kaufman, D.D.S.


I can answer any question from simple routine dentistry to very complex dentistry with emphasis on reconstructive, cosmetic, and implant dentistry. My expertise is in co-ordination of very complex treatment plans with other dental specialists or as a one-man-team, since I have extensive training in Prosthodontics, Surgical Implantology, and orthodontics.


Over a decade in private practice of Surgical Implantology and Prosthodontics. Founder and owner of Prosthodontics & Implant Surgery of Manhattan, PC. Clinical Assistant Professor at the Post-Graduate Department of Periodontics & Implant Dentistry at New York University College of Dentistry. Lecture weekly since 1999 on advanced Implant Prosthodontics at New York University College of Dentistry Post-Graduate Program in Periodontics & Implant Dentistry. Former clinical assistant professor of Dental Radiology at the NYU College of Dentistry. Former clinical and lecture faculty at Lincoln Hospital, Dental residency program. Former clinical and lecture faculty at St. Barnabas Hospital (Bronx, NY) dental residency program. Lecture nationally on Prosthodontics and Implant Dentistry.

Memeber of the American College of Prosthodontics. Memeber of the Acacdemy of Osseointegration. Member or the Omikron Kappa Upsilon (OKU) Honors Dental Society. Member of the American Dental Education Association.

Graduated with Honors from New York University College of Dentistry. Post-Graduate training and certificate in the specialty of Prosthodontics. Post-Graduate training and ceritificate in Surgical and Prosthetic Implant Dentistry. Honors-program in Comprehensive and Applied Practice Management. Honors-program in Orthodontics.

Awards and Honors
NYU Cervice award to the community. OKU honor society. National Dean's List. National Who's Who.

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