DS needs filling - $638 for porcelain, worth it???

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My 13 yr old DS needs a filling on one of his permanent back molars. Our insurance does not cover a porcelain crown, which my dentist is recommending. Is it not a tooth that is visable, so we are debating the need for this and are seriously considering going with a regular silver resin filling...any opinions out there???
 
My 13 yr old DS needs a filling on one of his permanent back molars. Our insurance does not cover a porcelain crown, which my dentist is recommending. Is it not a tooth that is visable, so we are debating the need for this and are seriously considering going with a regular silver resin filling...any opinions out there???

Are you talking about a filling or a crown? They are two different things.

My dentist recommends the amalgam fillings for the molar surfaces. They take alot of stress and the porcelain does not hold up well. They end up needing to be replaced alot sooner. I think your dentist may be trying to pad the bill a bit by convincing you to spend the extra money.
 
My 13 yr old DS needs a filling on one of his permanent back molars. Our insurance does not cover a porcelain crown, which my dentist is recommending. Is it not a tooth that is visable, so we are debating the need for this and are seriously considering going with a regular silver resin filling...any opinions out there???


I'm a dental hygienist. Your post is a bit confusing since you say he needs s filling but the dentist is recommending a crown. Also, the tooth colored filling material is composite resin, and silver fillings are amalgam which basically means it's an amalgamation of different types of metals.

We don't typically do porcelain crowns for 13 year olds. We would do a silver temporary crown until he was 16-18 in an effort to make sure the entire tooth is fully erupted, then do a permanent crown later so the margin (edge next to the gumline) of the crown would be healthy for the tooth and gum. Also, if orthodontia is involved, we typically like to wait until the teeth are moved and then do the permanent crown. It's possible the dentist thinks your son's tooth is fully erupted and ready for permanent crown placement. In a case like that, I'd advise you to think about how much you'll be able to see the crown when he speaks and laughs. Sometimes we have no choice about the type of crown and have to do a silver one. You seem to have a choice on the aesthetics. They are both strong and have a history of lasting the same length of time.

If we are talking about a filling, which I kind of doubt since you say it will cost $683, then while amalgam fillings can be stronger, they also do not ADHERE to the tooth like a composite resin filling does. Amalgam stays in place by removing more of the natural tooth surface doing undercuts and wedging the material in. Porcelain actually bonds to the natural tooth surface and holds it all together. Research shows that amalgam tends to have a longer life span, an average of 10 years, while composite is an average of 8. However depending on the size of the amalgam, it can be more likely to fracture or crack the tooth by pushing it apart since it acts like a wedge.

As a parent and a professional, I would recommend a composite, if we are indeed talking about a filling, however as I said, I think you are probably talking about a crown due to the expense you listed.
 
Not on a back tooth. Porcelin is softer than the metal ones. I have porcelin on my two front teeth (car accident) and they are amazing.....on the back, I get silver or gold, whatever insurance pays for.
 

I had very soft teeth that were very prone to cavities as a child, so I had lots of amalgam fillings. As an adult, I've eventually had porcelain crowns put on my molars and it looks sooooo much better. I would do the porcelain if it were me. I like that when I look in my mouth I see white, rather than the dark silver.
 
Yes, it is actually a crown that he needs, not a filling...sorry for the confusion.
 
I have several Porcelain Onlays on molars, they were $938 each about 2 years ago. Used when not enough tooth structure for a filling but a crown isn't necessary yet. My dentist would charge much more for a Porcelain crown. Its amazing how much prices vary.
 
I had the same experience. I think that the added cost of the porcelein is absolutely worth it merely for self-esteem reasons.

I had very soft teeth that were very prone to cavities as a child, so I had lots of amalgam fillings. As an adult, I've eventually had porcelain crowns put on my molars and it looks sooooo much better. I would do the porcelain if it were me. I like that when I look in my mouth I see white, rather than the dark silver.
 
I had a "tooth colored" crown on my very back molar. Insurance would not cover it because it wasn't "necessary" to use that material that far back. It completely fell apart in less than 5 years. A different dentist replaced it with a gold one, which seems to be wearing pretty well.
 
I went with a gold crown for the back tooth, the cost as well as the fact that porcelain is harder and can actually wear on the opposing tooth causing issue with the one down the road. If it were a front tooth then yah go porcelain but not for molars…
 
I just had all my amalgam fillings replaced with porcelain. They can and do cause health issues because of the mercury in them! If it was myself or my child, I definitely would go with the porcelain.
 
I just had all my amalgam fillings replaced with porcelain. They can and do cause health issues because of the mercury in them! If it was myself or my child, I definitely would go with the porcelain.

Do you mean you had them replaced with a composite filling (white)? Crowning all the teeth to get rid of amalgam is extreme and very expensive, a lot of people go with a composite filling which isn't as strong as amalgam, but it doesn't have the mercury. As for a porcelain crown 13 is very young for a crown. But I would think that is what the dentist means if it's in the $600 range. Get a second opinion.
 
Yes, it is actually a crown that he needs, not a filling...sorry for the confusion.

I have a crown that is over 25 years old. I paid for gold and it is still in great shape. The dentist never expects to replace it in my lifetime.
 
Tink and Meeko... add me to your club.. I have a lot of porcelain onlays. My teeth are soft and then chemo did them in. I agree on a permanent tooth porcelain really looks much better. Dh and I have not had any problems with our crowns or onlays (my dentist called them inlays) most of mine have been in my mouth for around 8 years, and hopefully a lot longer!:hippie:

HEY THIS IS MY 1000th POST!
 
Do you mean you had them replaced with a composite filling (white)? Crowning all the teeth to get rid of amalgam is extreme and very expensive, a lot of people go with a composite filling which isn't as strong as amalgam, but it doesn't have the mercury. As for a porcelain crown 13 is very young for a crown. But I would think that is what the dentist means if it's in the $600 range. Get a second opinion.

Hi sorry I guess I worded that wrong. I just had 6 crowns done and in some of those teeth there were previously amalgam fillings. They were failing, plus, I just did not want them in my mouth anymore. I got all porcelain crowns (though I think they have a gold base covered in porcelain?), at $938 each. I also had a few of the amalgams replaced with composite fillings (the white ones, I think that is composite) because I did not want the amalgam in my body any longer.

I was born with enamel issues in my teeth so I'm constantly having to have work done. I had a ton of amalgam put in when I was younger, and it's caused me a lot of issues. After I was pregnant with my two kids and nursed them both to age 2, my teeth were in very bad shape (I didn't want to have work done while pregnant/nursing). So now I am just trying to repair everything, so that is why I'm having so much done at once. :)
 
Yes, it is actually a crown that he needs, not a filling...sorry for the confusion.

How much of his tooth is "lost" to this cavity?

I had a filling done when I was pre-teen/early teen and it ended up falling out b/c the cavity wasn't completely taken care of. A different dentist went and cleaned it out--and it was safe to say that 75% of my tooth was a filling.

I did end up getting a crown about 10 years later, as there was no way the darn thing was going to hold up forever.

I would say if he needs a crown, get the crown. But if I'm not mistaken--those don't last forever either. But they are far more durable than a filling if the tooth is so far gone.

My crown would have been done sooner--but I had sought orthodontia first and took care of that. When it was determined that the tooth needed a crown, I had to wait until I was out of braces. The orthodontist later had to carve out a little bit of my retainer to accomodate the crown.


Couldn't tell you the material--I'm guessing it is porcelain, but don't quote me on that. I have had the crown since 1998/99 sometime. So going on about 12 give or take a few months.

My tooth was only a partial molar at that point--I remember distinctly that since so much of it was filling, that it really wasn't the full size tooth it should have been.
 
I think the OP is referring to fillings? I have about 8-9 fillings in my molars, not because I didn't take care of my teeth but because when I was a kid all of my molars grew in with deep impressions causing me to much more susceptible to cavities. They were all filled with amalgam. This was about 25 years ago. In the last 2 years I have had all of them replaced with clear/porcelain fillings.

I could have done amalgam as they were all molars, however having delt with 8-9 grey "scars" on my molars for 25 years I am happy I no longer have to look at them! I would definitely recommend clear fillings as opposed to amalgam. You may not have to look at their teeth and see the fillings, but the child/patient WILL, everyday. Something to remember. From a personal point of view, I would avoid amalgam for that very reason.

I also have two porcelain crowns on my two front upper teeth, (a kid at a skating rink with a concrete floor ran into me when I was 6 years old) They have been in my mouth 15 years, I would not recommend getting a crown until atleast 21, or until a child is done growing.
 












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