Metal Free Crowns:
All porcelain crowns and porcelain veneers are cosmetic in nature. Dental porcelain is continually improving and will someday be the most common type of restoration provided. That time is not here at this point as most porcelain crowns have some distinct disadvantages.

Disadvantages of all porcelain crowns:

1. Porcelain crowns can and do break, just like anything made of porcelain from toilets to dishes. There are millions of chipped or broken porcelain crowns in people’s mouths. Just because they are chipped does not always mean that they must be replaced, however if they are chipped in between the teeth they may create a food trap that requires flossing after each meal.
   
2. Porcelain crowns do not wear. They wear whatever they oppose and work against. If a porcelain crown on an upper tooth opposes a natural tooth on the lower, the natural tooth will wear down since porcelain essentially does not wear and enamel does.

The shortest lasting porcelain crown I have ever made lasted only one night. The patient was (and is) a bruxer (he grinds his teeth at night). We replaced the crown at no charge. But for his new crown we created a metal surface so the porcelain portion could not be contacted by the opposing tooth. The problem was solved.

Disadvantages of porcelain veneers:
My opinion is that porcelain veneers generally are the weakest restorations in dentistry. They are beautiful but very thin structures which can lose their bond with the tooth structure and are subjected to very strong forces when eating. Sometimes people use their teeth as a tool for just an instant and the porcelain breaks.

This is not to say that I don’t make them or recommend them but patients should always be mindful of how they use them.

Some cosmetic procedures are very simple and inexpensive. Reshaping and contouring natural teeth can be done in minutes and can yield dramatic results.

Simple bonding of front teeth with tooth colored filling material to close spaces or repair broken edges can often be performed. (See Example Below)

Bonding of front teeth with tooth colored filling material to close spaces or repair broken edges can often be performed. This is less costly than veneers. See examples below.

Before
After

Picture on left above is an example of a tooth with a major fracture treated by doing a simple bonded filling instead of a porcelain crown.

Picture on right above is an example of filling in spaces by using a composite bonding material.

In this case we placed six upper veneers to close spacing and give the upper teeth a uniform color.

Pictured here above is a patient on whom we placed composite fillings on four of the teeth and porcelain veneers on two of the teeth, the lateral incisors. The result was excellent, the treatment was conservative, the cost was far less that placing porcelain veneers on all teeth, and the result yielded stronger teeth with only two veneers (The photograph is of poor color but the actual result is perfect).

I always try to be conservative in my approach, I plan treatment based on what I would want done for myself.

Nightguards are always excellent insurance for protection of porcelain crowns, veneers, and for natural teeth.