Metal crowns for teeth are a type of dental crown that is made of all metal, which means they don't have any porcelain at all. They are definitely not the most aesthetically pleasing type of restoration in the mouth.
They are definitely not the first choice by dentists and patients when it comes to full coverage restorations to restore a tooth. However, that doesn't mean that they don't serve a purpose in dentistry.
Today we'll go over what metal caps on teeth are and when they're necessary. That way you'll understand why it was even offered as a restorative option by your dentist. Most dentists won't even mention it unless they have to.
Table of Contents:
Overview
A metal cap on a tooth is a full coverage indirect restoration that is placed over a tooth to protect and strengthen it. Although before you can get this, your tooth will need to be shaved down in order to fit this metal cap over it.
Most people are familiar with what a crown is for a tooth so understanding what this is should be fairly straight forward. Most tooth caps are have tooth colored porcelain over it such as PFM crowns or they can be made of pure porcelain such as ceramic crowns (zirconia or emax).
However, these metal tooth crowns are made of pure metal without any porcelain. That is essentially their defining characteristic that differentiates them from all the other materials.
Types of metal dental crowns:
Cast metal. This is your prototypical all metal cap.
Gold tooth crown. A gold dental crown is a type of metal crown except it is made of the precious yellow metal called gold. They are the priciest type of metal to be used on teeth.
Stainless steel. These are pre-fabricated metal tooth crowns that are generally used on children because they're not meant for adults. Since they are pre-made they don't require a dental lab for fabrication.
When they're needed
Patients do not want metal crown teeth unless they're absolutely necessary.
Conditions requiring a tooth crown made of metal:
Large cavity. Cavities which encompass more than 50% of the entire tooth will require a crown because a filling would be inadequate.
Cracked tooth. A large fracture or chip that decimates a big portion of your tooth will require a full coverage restoration like a crown.
Insufficient interocclusal space. Sometimes if you don't have enough space in between your jaws, your dentist may not be able to make a porcelain crown. You may have no choice but to get a metal one because these can be made thinner than ceramic.
Realistically speaking, the most common reason to use a metal crown for teeth is due to inadequate interocclusal distance. This is the space in between your upper and lower jaw.
Ceramic tooth caps need to be a certain thickness or they'll be prone to breaking. Cast metal tooth caps on the other hand can be made thinner but still retain a lot of strength. If you don't have enough space, your dentist may be forced to choose a metal as the material.
What to expect
The procedure to get metal teeth caps will take approximately two separate visits.
First appointment will be tooth preparation and taking an impression.
Second appointment will be trying on and cementing the crown.
First appointment:
Local anesthesia. Numbing gel along with a Lidocaine injection.
Tooth preparation. Shave the tooth down to an appropriate size to fit the new cap.
Pack cord. Place a small cord around the gums to push them down and reveal the prepared margins for a more accurate mold of the teeth.
Take an impression. Take an impression of the prepared tooth and adjacent teeth. This gets sent to the lab for fabrication of the permanent restoration.
Fabricate a temporary crown. A temporary crown is made to protect the shaved down tooth while you wait for the permanent one. The temporary cap will be glued in with temporary cement so it can be removed more easily next visit.
Second appointment:
Administer local anesthesia.
Remove temporary crown. Otherwise you can't try on the permanent one.
Clean cement residue. Old glue on the tooth needs to be removed prior to fitting.
Try in the permanent crown. The try-in process is to make sure that it fits before it gets glued in. If it doesn't fit, it will need to be sent back for a do over.
Adjust the crown. If the new cap feels too tight, the contacts need to be adjusted. If the bite feels uneven, the occlusion will need an adjustment. Both of these can be done chairside by your dentist with a fine diamond football bur.
Polish. Polishing the metal tooth cap after adjustments will make it smooth.
Permanently glue it in. Permanent cement will be used.
Appearance
Metal crowns for teeth look like crowns except for the fact that they are not tooth colored because they are metal. Yes, they're pure metal without an ounce of porcelain in them.
Below are photos of what they look like on a tooth model from various points of view.
Notable characteristics:
Pure metal with no porcelain.
The metal is reflective so whoever is looking at it will see their reflection.
Very shiny appearance.
They are made in the shape of your tooth and will match adjacent tooth shapes.
Video
We've provided a lot of images of what metal caps on teeth look like but seeing it in a video with 360 degree views really helps with the visualization.
Pros & Cons
The main disadvantage for metal tooth caps would be its metallic appearance but it does come with some advantages as well.
Pros:
Least expensive crown option
Durability (very strong)
Special situation use (not enough interocclusal distance)
Margins can be burnished
Cons:
Metal tooth color
Potential allergy
A unique use case for metal crowns on teeth is when there isn't enough space in between the upper and lower arches. These cast metal caps can be made very thin and still be very strong unlike ceramics which require a certain thickness or it'll break.
Think about it. Is it easier for you to break a porcelain plate or a metal object? Metal is definitively stronger than all types of ceramics.
Side effects
The most prominent adverse effect of metal tooth caps would be an allergic reaction to the metal that is in it. These restorations often contain gold, nickel, and cobalt which are common allergies.
Metal allergies prevalence:
Subjects in one study had a 9.5% chance of being allergic to gold.
Nickel allergies were found in 28.5% of the population that was examined.
Those with nickel allergies often had a concomitant allergy with cobalt.
If you're allergic to any of these materials, you should opt for a ceramic crown instead.
Compared to other crowns
A metal cap tooth is unlike any of the other crown materials since this is made from pure metal without any regard for the cosmetics. We'll be doing a comparison of what it is like compared to a ceramic (emax) and gold crown.
Metal vs ceramic
When compared to a ceramic (porcelain) crown, the latter is significantly more desirable because the porcelain is tooth colored. However, the former is much more durable and can withstand much heavier chewing forces if you eat very hard foods.
The video above shows you the difference in how they look when compared to an emax crown that is made of lithium disilicate. That is but one type of ceramic material, the other but more popular one would be zirconia.
Metal vs gold
The gold tooth crowns are considered metal tooth caps except for the fact that it is made of a precious metal, yellow gold. Since gold is still desirable and of value, they're given their own category.
Costs
The average cost of a metal crown is $1300 and that is without dental insurance. That is a ball park figure of what you should expect to pay out of pocket.
Insurance coverage | Average Cost | Cost Range |
|---|---|---|
Metal crown without insurance | $1300 | $1000-$1900 |
Metal crown with insurance (50% coverage) | $650 | $500-$950 |
Please be aware that the cost of living greatly affects the overall price of your crown. Lower costs of living areas will be on the lower end of the cost range while higher costs of living will be on the other end.
Cost with insurance
The average cost of a metal crown on teeth with insurance is $650 and that is based on 50% coverage. Most insurances typically cover half of this dental procedure. Although if your plan has very good coverage, it can potentially cover more than 50%.
