Earlier this year, I had porcelain crowns put on my two front teeth, but one of them came loose and fell off. I went to my dentist, and he cemented the porcelain crown back on my tooth and then ground down the porcelain to correct the bite after it was placed. It wasn’t even a week later when the backside of my crown broke off where the dentist had ground down the porcelain. What would your opinion be? Does grinding down the porcelain crowns weaken them?

– Rachel from New Mexico

Rachel,

First, I’m going to assume that you’re talking about an all-porcelain crown. With a porcelain-fused-to-metal crown, the crown wouldn’t break if it was ground too much—it would just be ground down to the metal, which wouldn’t be a problem on the back side of a front tooth.

When a dentist puts on a new porcelain crown, they will sometimes have to adjust the crown to your bite and will sometimes do that by grinding it down a little. That isn’t that uncommon and should be nothing to worry about. With that being said, something isn’t right with your experience. These things bother me:

• The first thing is that your crown shouldn’t have come loose. Something was done wrong for a new permanently cemented crown to fall off so soon. There are dentists who never have permanent crowns just fall off. If they’re properly prepared and properly cemented, that should be a very rare event.
• Second, your dentist should’ve adjusted your bite right away after the first placement. It is odd, and something must’ve gone wrong that the bite needed to be adjusted after it was recemented. If your bite felt okay after the first placement, the only explanation I can think of for the adjustment after recementing is that the recemented crown wasn’t put on straight.
• Third, the only reason that the back of the crown would break off would be if they ground the porcelain so much that it made it too thin. That could happen if the tooth wasn’t prepared properly—not enough space was allowed for the porcelain. Or, as I mentioned above, the crown wasn’t fully seated the second time.

Of course, you’re going to need a new crown, but I would recommend that you go to a different dentist for the procedure. It concerns me that your dentist couldn’t get this right, and I would definitely ask for a refund. Unfortunately, you did not get what you paid for.

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