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Lara Coseo
Lara Coseo, Dentist (DDS or equivalent)
Category: Dental
Satisfied Customers: 201
Experience:  Awarded, licensed dentist with over 13 years experience
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I had a front upper left tooth crowned 40 years ago and the

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Hi I had a front upper left tooth crowned 40 years ago and the gold is starting to show threw with wear and tear , can I get it replaced ????
JA: Have you noticed any swelling in the gums? When was your last visit to the dentist?
Customer: No there is nothing wrong with the tooth but the gold starting to come threw at the bottom and I'm very self conscious of it . I went to the dentist 4 weeks ago !
JA: Anything else in your medical history you think the dentist should know?
Customer: No . I asked my dentist if I could have new crown and he was worried about doing it because of how the tooth under the crown was and was worried that if the gold crown was removed he wouldn't be able to fix a new crown on again .

Good afternoon! That's a great question. Do you think there's any way you could get a photo that shows me the area you're concerned about?

In general crowns can be replaced, but the fact that your dentist is concerned about what's underneath makes me question what he or she is seeing.

If you're unable to get a photo, can you describe the location of the tooth, and the appearance of the crown overall? Is it porcelain with a metal core? Or is it all gold?


Dr. Lara

Customer: replied 1 month ago.
The crown was porcelain but with gold at the back , the gold is just over the past 5 years started to show at the bottom of the tooth . My dentist has ant X-rayed my front tooth , I just think he is not very confident about doing it .

Do you mean the gold is showing at the edge of the crown where it meets the gums? Which tooth is it?

Dr. Lara

Customer: replied 1 month ago.
I don't won't to speak on the phone thank you !

That's fine. Did you receive a phone call request? I did not submit one.

It is just as good to continue chatting via the website.

I'm sorry if I've offended you in some way. Could we continue chatting so I can help you figure out what's going on with this tooth?

Dr. Lara

Customer: replied 1 month ago.
I did , did you get mylast message , you Havant offended me , you just didn't answer my last answer !

I'm sorry you received a phone call request. I'm not sure how that happened because I didn't not offer one. Sorry for the confusion. The last response I got from you before that was that the dentist has ant x-rayed your front tooth. I was just confirming that the crown you're concerned about is the front tooth, and was asking where the gold is showing, trying to clarify what you meant by bottom of the tooth. Do you mean the gum line or the biting edge?

Dr. Lara

Customer: replied 1 month ago.
There is not a problem I just am confused why the phone chat keeps coming up on screen, and I'm not getting answers to my questions ???

I am confused, too. I haven't had this issue before. I'm going to attach some screenshots of what I see of our conversation in hopes of regrouping where we both are in this conversation.

Screenshot of conversation from my end

Customer: replied 1 month ago.
Sorry about that the gold is coming threw on the biting edge . Thanks

2nd screenshot

And is it an upper or lower front tooth?

Dr. Lara

Okay, I think I have an idea of what's going on and why your dentist may be hesitant to replace this crown.

The gold showing through on the biting edge of the tooth is a sign of long-term wear, and the layers of porcelain that were covering the gold have been slowly worn away over time. This can be due to heavy biting forces, grinding your teeth at night, or a very abrasive material biting against this tooth (various other dental materials can be more abrasive than others and cause more wear over time).

Because this certain thickness of porcelain is now gone, it means that you've basically lost that amount of thickness in your bite as well. When the dentist removes this crown and goes to prepare what's left of the tooth for a new crown, it's likely that he will have to remove even more tooth structure to make up for that loss. When a tooth is already small to begin with, this removal of more tooth structure can leave very little tooth remaining to support a crown.

This does not mean that you can never have it replaced or get better cosmetics in this area. It just means it will be a little more complicated than simply replacing a crown.

If your dentist is not confident that he or she can do it well, you could ask for a referral to a specialist called a prosthodontist. They specialize in crowns and building up teeth where there is not enough room.

Does that answer your question?

Dr. Lara

Customer: replied 1 month ago.
Thank ou very much , that is very helpful will it take very long to do ? Also have you any idea of the cost ? I am in the U.K. Thank you again sorry for the mix up , I didn't give you a good rating as the phone chat was interfering with us talking and I wasant sure what was happening!

The actual procedure itself should not take very long. It is relatively quick to remove an old crown. Here in the states, we remove a crown by using the high speed drill to cut it in half and then separate the two pieces off of the prepared tooth. It sounds terrible, but it's actually a pretty easy procedure since most of the drilling is performed on porcelain and gold and not your tooth. There's no way to know what's underneath the crown until it's off, and that can determine how long the rest of the preparation takes. If it's simply being replaced for cosmetic reasons and not for decay, it shouldn't be very invasive. The dentist should just be very particular about your bite once the old crown is off. That's the most important thing in getting a successful new crown. A prosthodontist will be a pro at this, so you should have nothing to worry about.

As far as cost, here in the states crowns range from about $900-1200, depending on the office. Not sure how much they are in the UK. Less, I think?

I think you will have an option to change your rating of me if you would like and if you are satisfied with my answer. Thank you!

Do you have any other questions for me?

Dr. Lara

Lara Coseo and other Dental Specialists are ready to help you
Customer: replied 1 month ago.
Thank you once again and I will change my. Rating as in the end I found you excellent!!
Thanks again as the way my dentist responded I was worried I'd have to live with it forever lol. As I am very concious of it and have been for quite a few years ! Kind regards .

I'm happy to have helped! Your dentist is smart to be cautious. I'd be more worried if he thought it was going to be an easy fix. Then you could end up with some problems.

Thank you for using JustAnswer! Come back anytime you have dental questions. I'd be happy to help you again.

Dr. Lara