Halloween is almost upon us, with fun and silly costumes of ghosts, goblins, witches, and pirates. Thinking about pirates may conjure up entertaining images of eye patches, treasure chests and swashbuckling battles on the high seas. But have you taken a good look at their teeth?

Crooked, rotting, pirate teeth are ugly and unhealthy, but gold crowns can provide strength and flair. Could a pirate with a black eye patch, a hook, a peg leg and a gold tooth be healthy? Arrrrgh!

Gold crowns for pirates and landlubbers
A crown (sometimes called a cap) is an excellent solution to restore a damaged tooth. The crown completely covers and holds a tooth together to prevent a tooth from fracturing. Crowns also prevent plaque and bacteria from easily attacking the tooth. A crown gives strength to the remaining tooth structure, and gives the tooth a smooth, natural shape.
Gold crowns have been available since at least the mid-1700s, a time coinciding with the "golden age" of piracy between the 1680s and 1730s. But you don't have to be a pirate to need one.

Porcelain crowns are a much more recent phenomenon from the 1960s, and they are continually changing and improving with new technologies. Porcelain crowns have become stronger and more esthetic over the years. Gold crowns are basically unchanged except for the techniques used to prepare the tooth for the crown, including vast improvements in the drilling and impression methods.

Crowns are recommended to:

• Replace a filling, especially if there isn't enough remaining tooth structure to support a new filling.

• Prevent a decayed tooth from breaking easily.

• Protect and hold a cracked tooth together.

• Restore a tooth after root canal therapy. Root canal teeth become brittle and can fracture.

• Cover a dental implant or hold a bridge in place.

• Provide an alternative for covering discolored teeth.

• Rebuild overly worn, ground down teeth.

Advantages of gold crowns
Gold crowns are still functionally the best and last the longest of all dental materials. Porcelain crowns are beautiful and natural looking. I usually recommend gold on back teeth and porcelain toward the front, but each patient must make their own decision after learning the advantages and disadvantages.

Many of my patients don’t want the bling of gold anywhere, others want gold on the back teeth for strength and a few others want the “bling, bling” of gold on front teeth – arrrgh, the pirate.

Gold has the advantage of being easily shaped into a precisely fitting crown. It has the amazing property of being malleable, which is why gold has been used to make beautiful jewelry for centuries. Also, less of the tooth structure needs to be removed for gold crowns because gold has great strength even when thin. This great strength allows gold crowns to withstand the forces of biting and chewing. Gold is very durable and does not chip, break or wear down easily. With proper care, a gold crown should last longer than porcelain. I have seen gold crowns that have lasted more than 40 years.

A gold crown puts less wear against the opposing tooth, as compared to a harder porcelain crown, making it a good choice for a person's hard-working molars (back teeth). Gold is slightly softer than tooth enamel. So over a long time period, the top of a gold crown will slowly wear down, rather than wear away the opposing tooth.

Gold is also biocompatible, which means tissues love gold. An allergic reaction to gold is extremely rare. In the mouth, gums around a well-fabricated gold crown are extremely healthy, when accompanied with proper cleaning habits. A study even showed cells in a tissue culture would go out of their way to collect and store gold dust for no apparent reason.
So pirates are not the only hoarders of gold!

Pirate teeth for Halloween
Pirates and other people who neglect their teeth are only postponing the inevitable. The situation will only get worse. An untreated tooth becomes more susceptible to bacteria, which can invade the tooth pulp and cause increasing decay, infection and pain. If the tooth breaks or needs to be extracted, this can escalate into problems with shifting teeth, a receding jawbone, gingivitis, periodontal disease, and even more serious problems.

The best ways to minimize your chances of having teeth looking like a pirate's are to brush and floss daily, maintain a healthy diet and have regular dental checkups. However, masquerading your healthy teeth, as dark ugly pirates’ teeth, can be fun for a Halloween costume party. Look for my gnarly slipover front teeth, Austin Power’s teeth, on Halloween.

Dustin Hoffman’s crowns
An actor can take advantage of temporary, cosmetic procedures to bond veneers to his real teeth, making them look dramatically different. Prior to the advent of veneers in the 1980s, some actors would have crowns made for acting parts. Dustin Hoffman had his front teeth ground down to look his part of a 120-year-old man in the 1970’s movie “Little Big Man.”
He then had cosmetic crowns made that could be removed and changed for different movie roles. That is dedication to a job.
I don’t know about you, but it bothers me when I see an actor playing the part of a nasty pirate or vicious bad guy with perfect white, obviously fake teeth.

Of course, I always zero in on teeth and smiles. What can I say; I am a passionate dentist. I admire Hoffman’s dedication to dental detail, though his painful role in “Marathon Man” set dentistry back about 10 years. If you're not in the movies but would like to join in the fun, you might want to participate on Halloween with some fake teeth or big lips. Arrrgh!
Enjoy life and keep smiling.

George Malkemus has had a Family and Cosmetic Dental Practice in Rohnert Park for over 27 years at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@ malkemusdds.com. Visit Dr. Malkemus’ Web site at http://www.malkemusdds.com.