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I have written for many years about the unnecessary and abusive use of crowns to 'protect and strengthen' teeth.
Crowns destroy healthy tooth structure and weaken teeth. Today, I cut off two crowns that I placed 18 years ago and 23 yeras ago respectively. Years ago, we had few options but to remove large amounts of healthy tooth structure to help retain a tooth in the mouth.
Alas, this is no longer true as we have many restorative techniques to conserve irreplaceable tooth structure.
What was so bad about crowns that lasted a combined total of 43 years? All dentistry and all dental materials will FAIL given a sufficient amount of time and often when the dentistry fails, the tooth has been so weakened that it is truly not worth the effort or the cost to place a new crown. This means that we are making dental implants a certainty when we place crowns in 20-40 year old patients.
Many dentists have become so used to removing healthy tooth structure for crowns that they no longer even feel badly about doing it. Dr. Richard A Powell*, Associate Dean at SUNY/Buffalo Dental School told our class on the very first day of classes that tooth structure is living tissue and that everything possible must be done to preserve it. And yet every dentist measures their 'success' by how many crowns they place in a day, a week or a year.
This is, in my opinion, both unethical and indefensable. Your dentist must learn how do place fabulous direct bonded posterior resin restorations using a rubber dam that strengthens and protects natural tooth structure. When your dentist tells you that a tooth cannot be saved with a resin, then find a dentist who is informed enough and talented enough to place well done, tooth conserving direct resins. I am in my 20th year of placing these fillings and I can tell you with the highest degree of certainty that well done resins last a very long time.
*I was the first winner of the Richard A Powell award during graduation from Dental School.
