Gold restorations (full crowns, inlays, and onlays) are a long-standing and highly effective method for repairing damaged teeth. While modern dentistry often focuses on tooth-colored ceramic materials, gold remains a viable and often superior choice for specific clinical applications. These restorations restore a tooth’s form, function, and strength, especially when decay or fracture has compromised a large portion of the natural structure. Finding a dental professional who values gold’s unique performance benefits is necessary when choosing this material.
Types and Material Advantages of Gold Restorations
Dental gold is a high-noble alloy, not pure gold, typically containing gold, copper, silver, palladium, and platinum for necessary chewing strength. This composition makes the restoration highly biocompatible. The alloy is known for its superior marginal integrity, allowing the crown to be cast with a precise fit that tightly seals the tooth margin against microleakage and decay.
The material’s strength and malleability allow the dentist to remove less natural tooth structure during preparation compared to ceramic options, which is a significant biological advantage. Gold exhibits a wear rate similar to natural tooth enamel, preventing excessive abrasion or damage to opposing teeth during chewing. This characteristic makes it a preferred choice for posterior teeth, such as molars, that endure the highest occlusal forces. Gold also shares a coefficient of thermal expansion similar to the tooth structure, allowing it to expand and contract with the tooth in response to temperature changes, further protecting the seal.
Identifying the Right Dental Professional
Finding a dentist who regularly places gold restorations requires focusing on experience with advanced restorative techniques. While many General Dentists (GPs) can perform a crown procedure, a Prosthodontist is a specialist with three additional years of post-doctoral training focused on complex restorations. This specialization often means they have a deeper understanding and appreciation for the biomechanical benefits of cast gold.
To find a suitable practitioner, ask specific questions about the materials they use for posterior crowns and their experience with “cast gold” restorations. Also, inquire about their relationship with their dental laboratory. High-quality gold crowns require a lab technician with specialized training in casting and finishing precise restorations. Dentists who routinely offer gold work often maintain a long-standing relationship with a specific laboratory to ensure quality and fit.
The Process of Receiving a Gold Crown
Receiving a gold crown typically involves two separate appointments spaced two to three weeks apart. The first visit begins with tooth preparation, where the dentist reshapes the tooth by reducing its outer surface to create space for the crown material. Since gold requires less bulk than ceramic, this preparation is often more conservative, preserving more healthy tooth structure.
After preparation, a precise impression of the prepared tooth and surrounding teeth is taken using a putty-like material or a digital scanner. This impression is sent to the dental laboratory, where the custom gold restoration is fabricated to exact specifications. Before the patient leaves, the dentist places a temporary crown over the prepared tooth to protect it from sensitivity and maintain proper bite spacing while the permanent crown is made.
The second appointment involves fitting and final cementation. The temporary crown is removed, and the permanent gold crown is carefully placed onto the tooth to check the fit against the margins, contours, and the patient’s bite. Once the dentist confirms the fit is precise and comfortable, the crown is bonded permanently using a strong dental cement.
Cost Considerations and Lifespan Expectation
Gold crowns are often more expensive than other crown types, primarily due to the fluctuating market price of the gold alloy and the specialized laboratory skill required for casting. The cost generally falls in the range of $800 to $2,500 or more per tooth, depending on the alloy’s gold content and case complexity. This financial investment is balanced by the material’s unparalleled longevity.
Insurance coverage for gold crowns varies, but most dental plans only cover a portion of the cost, treating it as a standard restorative procedure if medically necessary. The patient is responsible for the difference between the material cost of the gold and a less expensive alternative. Gold restorations often last 20 to 30 years or even a lifetime, significantly outperforming other materials in long-term survival studies. This exceptional duration makes gold the most cost-effective solution over a patient’s lifetime.