Does it surprise you to hear a holistic dentist with more than 25 years experience tell you to avoid dental crowns and caps? After all, crowns are the preferred treatment choice for most dentists. Capped teeth are believed by most to be the ultimate dental restoration. So what gives … why am I saying that caps are no good?
For those who have crowned teeth, this sequence of events may sound familiar:
* You develop a cavity
* Your tooth doctor repairs the hole with a filling … amalgam or composite
* After a while the restoration fails or the tooth fractures
* A cap (ceramic, metal or maybe ceramic fused to gold) will now be placed
* Many times the capping procedure is traumatic enough to cause the tooth nerve to expire
* A dead nerve causes pain and then you must have a root canal or an extraction
The procedure to crown a tooth is very aggressive and may kill the tooth’s nerve. Crowning involves grinding away all of the tooth’s enamel and a substantial amount of the inner, living dentin. The scientific literature reveals that up to 15% of all crowned teeth will eventually need root canals or extractions because of a dead nerve. Just because your crowned tooth did not need an extraction or root canal does not mean you’re free and clear of future problems.
Even though caps are often called „permanent“, they don’t last forever. In fact, the average life-span for a crown is actually around 10 years. Almost all dental insurance companies will pay to replace a new cap when it fails after only 5 years. Most dental customers cannot understand how the crown can decay … how can something composed of porcelain or metal get a cavity? No one wants to fork out another large chunk of capital to re-fix the tooth that they believed had been restored in a permanent way.
For the most part, your dentist won’t have good answers to why caps break down. They will often make analogies to repairing your pearly whites and fixing your auto … that absolutely nothing mechanical lasts forever. They may actually indicate that things that you did or did not do allowed the cap to break down. The most common justification is that your inadequate dental hygiene as well as sporadic dental hygiene cleanings are the cause. Some may convince you that because you permitted microbial plaque to amass along the gum line, decay developed and then the crown failed. However your other teeth are all right, so this does not make any sense–unless of course if you just forgot to clean this one tooth … the capped one.
If you are a thinking person, the warning flags should be soaring about now … this story does not entirely seem sensible. The key reason crowns fail after some time is because of a critical engineering mistake. Caps are made of materials that happen to be quite rigid … porcelain, gold or porcelain fused to gold. Surprisingly, your teeth are actually very flexible. There’ re intended to bend at the gum line under biting forces.
So each time you chew, the ensuing tug-of-war generates tension and strain at the gum-line, causing the seal between the tooth and cap to weaken. In the absence of a proper seal, harmful bacteria can get in between the tooth and crown–causing decay. The dentist will likely refer to this as a leaking crown. You call it a total bummer!
There’s a small division of dental art known as biomimetic dentistry that recognizes and tackles the issue of crown leakage. To start with, biomimetic practitioners rarely if ever install crowns on teeth. Second of all, these dentists never place unbending, inflexible materials at the gum-line when rebuilding your teeth. By simply restoring your teeth with techniques that mimic nature, leaking crowns and „surprise root canal treatments“ are generally prevented.
Biomimetic dental procedures are perfect alternatives to caps, mimic the un-restored teeth under function, provide very long-lasting dental treatments and significantly lessen the need for root canal treatment.
Curt Eastin DDS, ND is a holistic dentist and a naturopathic physician. He earned his doctorates at the University of Washington School of Dentistry and the National College of Naturopathic Medicine. His dental website is a rich resource for holistic dentistry.
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