Crowns have been used in dentistry for more than 100 years, with more than 37 million more placed each year in the United States, according to the Academy of Supra-gingival Healthy Dentistry. Yet they often require dentists to cut away about 75% of the tooth structure, the Academy adds, and may lead to a host of negative issues. The Academy’s website, however, provides patients with information about potentially healthier treatment options.
“Deep subgingival margins and the associative restorative work leads, in many cases, to unpredictable and inferior results, often causing further problems for the patient and clinician alike,” said Jose-Luis Ruiz, DDS, founder of the Academy. “These unhealthy deep restorative margins can severely affect the periodontal health of our patients.”
Sub-gingival dental procedures such as crowns leave material below the gums, the Academy reports, opening patients up to increased pathogen levels, inflammation, and gum disease. Cutting teeth for crowns also increases the chance that the teeth will require a root canal. Instead, the Academy provides education about supra-gingival, minimally invasive dentistry, which keeps restorations such as fillings, crowns, veneers, and onlays above the gum line.
“I believe supra-gingival dentistry is better for the patient because it makes the maintenance of the restoration easier. The gums are always healthier when the restoration is away from the gums. The preparations tend to be more conservative,” said Narpat Jain, DMD. “I have almost no complaints of discomfort after the procedure, and the restorations tend to last longer because there is less leakage with supra-gingival dentistry.”
The Academy does note that these techniques are newer and require additional training. They also sometimes require more expensive materials and equipment. Still, the Academy says, they maintain as much natural and healthy tooth structure as possible for better durability. They also decrease the chances of gum disease caused by subgingival margins. The tooth’s nerve is much less traumatized as well, preventing unnecessary root canals.
“Using these techniques, I noticed that the conservation of the tooth and structural strength are preserved,” said Roland Elzaegui, DMD. “The method of reducing the preparation and eliminating the retraction cord results in less insult to the soft tissue and less bleeding during impression, meaning the procedure is easier and more accurate. With less reduction, it is also less likely for the possibility of tooth sensitivity, recurrence of decay, and root canal treatment.”
The website offers information about these procedures, such as the differences between veneers and crowns, as well as a forum where patients can ask more questions about treatment options. Plus, it lets patients search for and communicate with dentists in their area who practice supra-gingival, minimally invasive dentistry.
“Practicing supra-gingival dentistry whenever possible, along with the implementation of modern restorative techniques, can help prevent and, in some cases, even reverse the damage caused by traditional subgingival restorative margins,” said Ruiz.
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