I Clench My Teeth At Night. Do Metal-Backed Crowns Cause Less Wear Than Porcelain Ones?

Hi Mark. I need 6 front upper crowns (that are 25 years old and metal backed) replaced as one has chipped. Is it true that metal backed crowns cause less wear on opposing bottom teeth (which are quite worn) than fully porcelain ones? I thought having metal backed crowns was now dated? I also apparently grind/clench my teeth at night.

Also is a home whitening system over 2-3 weeks more effective than in surgery zoom as my dentist doesn’t offer zoom due to some EU regulations and says home kit is better?

Metal backed crowns that are very smooth and highly polished cause much less wear than rough or adjusted porcelain. Very rough porcelain can be very destructive to the opposing teeth so if they are ever adjusted for example to perfect the bite then they must be very highly polished by the dentist afterwards.

The other advantage of metal is that it can be kept very thin, and still be strong, whereas porcelain needs to be much thicker to have the best compressive strength and resistance to fracturing.

I therefore still sometimes use metal backed crowns in certain situations where it offers the patient an advantage. If a very good lab technician makes them, then the aesthetics can be as good if not better than porcelain crowns in some instances.

Having metal surfaces is an advantage for heavy grinding.

Home whitening is MUCH more effective than in surgery alone – the very best technique is to do both one after the other but this can be more costly. We generally prescribe this is the patient is in a hurry. Also whitening fades and needs top ups so if you just have in surgery then you cannot top it up and you need to return for further treatments at large cost.

EU regulations mean that the strength of whitening has been reduced so in surgery is much less effective than it used to be. In the past I always recommended in surgery, PLUS home to get the best results and to avoid disappointment.

I advise 2 weeks home whitening plus an ‘in surgery’ then a further 2 weeks at home with monthly ‘top ups’, for the very best results.

Best wishes, Mark.

Dr Mark Hughes Harley Street Dental Studio 52 Harley Street, London W1G 9PY Web: www.harleystreetdentalstudio.com Tel: 020 7636 5981 View My Profile Dr Hughes

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