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How long will this last?

So there I sit, next to my patient. I’ve removed their temporary crown and am getting ready to place our beautiful new porcelain crown. It’s finely adjusted and exquisitely polished. We’re ready to rock and roll. Then…the question.

“Doc, how long is this crown going to last?”
“How long do you think it should last?” I ask.
“I don’t know. For as much as it costs, it should probably last forever!”

I’ve had some variation of this conversation many times before. I’m asking the patient to spend a bunch of time and money for the work I’m placing. Why shouldn’t it last forever? Or at least a really long time?

In a perfect world, the dentistry that I place will last forever. In this same perfect world, you wouldn’t have to change the oil in your car. Or replace your roof. Or change the filter in your furnace. Or mow your lawn.

Actually, that crown we just placed would love to switch places with your roof. The conditions that your roof has to put up with are a cake walk compared to your crown. A little snow, wind and rain and some gradual temperature changes? Pffffft. Nothing to it!

Let’s do the math.

Let’s say you chew each bite of food 10 times before you swallow it. (A very conservative estimate, but it makes the math easier) Then let’s say each meal you eat has about 20 bites.

You just used that crown 200 times while you ate lunch. Multiply that by 3 meals and you’re working on 600 times per day. If you don’t eat snacks. And don’t even get me started on chewing gum!

So yeah, you use your teeth for chewing a lot. But most restorations will handle everyday chewing pretty handily. Leaving out the unpopped popcorn and olive pits, chewing isn’t the real problem. The real problem is the environment that we’re placing this crown in.

  • Your new crown will have to tolerate temperatures ranging from 150-170 degrees F (hot coffee) to 20-30 degrees F (ice cream). Sometimes within seconds of each other.
  • Most crowns will have to tolerate acid attacks throughout the day.
  • Your crown will be almost constantly covered with bacterial biofilm that resists efforts at removal.
  • Many crowns will find that their owners grind their teeth throughout the night while they are sleeping.
  • Some crowns will need to resist bad habits of their owners like ice chewing and lemons sucking.

The bottom line is, the mouth is a pretty tough place for this beautiful new crown to have to survive!

What’s a realistic estimate for a crown or filling to hold up? The unsatisfying answer: it really depends. In a person who avoids sweets and sodas, who takes exquisite care of their mouth (brushing and flossing), who doesn’t take any medications that might dry their mouth, who doesn’t grind their teeth at night and sees a dentist regularly in an effort to catch problems while they’re still small…you could easily see a restoration last for 15-20 years or longer. Regular wear and tear, even in the most “low risk” patients will probably do in any dental work placed if you live long enough.

How can you make your dental work last as long as possible?

  • Brush 2-3x a day with a soft bristled brush and floss once a day.
  • Chew sugarless gum or suck on sugarless mints after meals to stimulate saliva flow. Preferably flavored with xylitol.
  • Drink lots of water.
  • Avoid sugary foods and reduce between meal snacking.
  • Keep up with regular dental appointments. At least twice a year and more if you have risk factors like taking medications or having conditions that create a dry mouth.
  • If you have problems, get to the dentist for treatment right away!

So, back to my conversation with my patient.

“Doc, how long is this crown going to last?”
“How long do you think it should last?” I ask.
“I don’t know. For as much as it costs, it should probably last forever!”
“The only way I know how to make this crown last for that long is to store it in box. In a really safe place.”
“Um. O.K. Let’s just put it on the tooth and I’ll try to take care of it.”
“Alrighty then!”

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