Lowell Cosmetic Dentistry Blog

I’m highly allergic to nickel. My dentist is recommending 2 porcelain fused to metal crowns for back teeth. I am concerned about having a reaction to the metal. My dentist said that I don’t need to worry. Should I be concerned? Can I get a zirconia crown instead? Thanks Rachel C. from Delaware

Rachel,

About ten percent of women have nickel allergies. The allergic reaction is more common in women than men. An allergic reaction to cheap jewelry or needing hypoallergenic earrings indicates a nickel allergy. In their medical history questionnaire, many dentists ask if you have metal allergies.

Base metal (non-precious), noble metal (semi-precious), and high-noble metal (precious) are the three categories of metal used in dental crowns. The metals are either used as the only component of the crown, or as the foundation of the crown.

Base metals are stiff and very likely to contain nickel. Forty percent of the noble metal will contain precious metals—gold, platinum, and palladium. The remaining composition will be silver, tin, copper, and other metals. Noble metals are softer and easier to manipulate than base metals. High-noble metals contain at least sixty percent noble metals, mostly gold and platinum. High-noble metals are the most pliable.

A noble or high-noble metal should present no problem with your nickel allergy. Your dentist can present you with an ldentalloy certificate before the porcelain crown is placed. This certificate is provided by the dental laboratory for every crown that is made. If the crown contains nickel, you can refuse it and find a dentist who is skilled in placing a zirconia crown.

This blog post is sponsored by Lowell cosmetic dentist Dr. Michael Szarek

My eight upper front teeth have a bridge. I am trying not to get overly anxious about this, but I just moved from Maine and I don’t have a dentist yet. The second from my left front tooth chipped. Can it be fixed without having to re-do the entire bridge?

The same techniques that repair a porcelain crown can be used to repair the broken tooth in your bridge.

The chipped porcelain must be cleaned and prepared for bonding. If the bridge is porcelain fused to metal, it will then be rinsed and carefully etched with hydrofluoric acid or with a microetcher that is used to blast fine aluminum oxide particles.

The porcelain will be primed with a silane coupling agent and coated with bonding resin. A metal bonding agent and an opaquer will be used to treat any exposed metal. Composite resins that are translucent and that can be highly polished will be layered to match the properties of the porcelain.

You will need to take care of the composite repair. Extensive alcohol consumption softens composite, and smoking and extensive coffee drinking tend to stain it.

We recommend that you find an expert cosmetic dentist to repair the tooth. He or she will have the necessary material and equipment to properly repair and bridge. You won’t be able to tell that the tooth was broken.

The blog post is sponsored by Lowell cosmetic dentist Dr. Michael Szarek.

When I was a kid my parents made me to go the dentist. That went on until about the 10^th grade. I moved out early and since then I have taken care of my teeth myself. I brush one or two times a day and floss pretty regular. So I guess maybe its been about 7 yrs since my last dental appointment but I really did a good job on my own. No cavities it feels like and my teeth are perfectly straight but since the past few months I started to notice that my gums are sensitive and painful and swollen. Last week a couple of my teeth started feeling lose and since last Monday I haven’t eaten on that side of my mouth because it feels like the teeth are going to fall out. This is getting scary and I am wondering how bad I have messed up by not going to the dentist. – Chris T from Delaware

Chris,

You didn’t tell us your age, but based on the time you stopped going to the dentist and how long you said it’s been since you’ve seen a dentist, you’re likely in your mid- to late twenties. Your age will help your treatment to be less expensive, and give you a good chance to recover. Although you definitely need an examination by a dentist to confirm it, it sounds as if you have gum disease, and it’s serious. You should see a dentist promptly.

When your teeth are not cleaned professionally, you are not able to control the buildup of tartar on your own. A dentist is able to give your teeth the deep cleaning that they need, or gum disease is very likely to occur.

Gum disease often doesn’t cause pain. Teeth can get loose, spread apart, and fall out without warning signs. You are fortunate that the pain and swelling alerted you to the problem. If you ignore it, your teeth can fall out or need to be extracted. The gum disease will continue to spread and affect more teeth. If all of your teeth fall out dentures or dental implants will be the solution. Letting the problem progress will be very costly. Don’t put off getting help.

This blog post is sponsored by Lowell cosmetic dentist Dr. Michael Szarek.