Why are gold crowns so expensive? A comprehensive guide
If you‘ve been told you need a crown, you may be shocked when you hear the cost of gold crowns. With prices ranging from $600 to over $2,500 per tooth, gold crowns come at a steep premium. Why does a tiny cap made of metal demand such a high price?
In short – gold crowns are expensive because gold itself is a precious metal with inherent value. But there are other important factors that make gold crowns the "Cadillac" of dental crowns.
As your friendly neighborhood dentist, let me walk you through everything that goes into making gold crowns worth the investment for some patients. I‘ll explain the pros, cons, costs, and alternatives so you can make the best choice for your dental health.
Why gold? The lowdown on gold alloys for crowns
Pure 24 karat gold is much too soft to create durable dental crowns. But mixed with other metals like silver, copper, and platinum, it forms strong, resilient alloys perfect for withstanding years of wear. Here‘s a quick chemistry lesson!
Gold is naturally corrosion resistant. Gold doesn‘t rust or tarnish due to its electron configuration. This means crowns stay polished and lusterous.
Gold is biocompatible. Pure gold is hypoallergenic and won‘t cause reactions. This makes it safe for crowns.
Gold has flexibility. Crowns flex slightly during biting. Gold‘s malleability provides the right amount of "spring."
Gold is tooth colored. Alloys with high gold content match natural tooth shades.
The typical gold alloy for crowns contains about 40-60% pure gold, with 16 karat (67% gold) being most common. So where does the high price tag come from? Let‘s break it down…
Cost driver #1 – High market value of gold
Gold prices fluctuate daily but have risen over 600% in 20 years. Here is the average price per ounce over time:
| Year | Price per ounce |
|---|---|
| 2001 | $271 |
| 2005 | $445 |
| 2010 | $1,225 |
| 2015 | $1,160 |
| 2021 | $1,800 |
Data source: goldprice.org
With skyrocketing gold prices, the base cost for the raw materials is significantly higher than metals used in cheaper crowns.
A typical gold crown uses 0.2 – 0.4 oz of gold, worth $370-$740 at today‘s prices.
Compare that to base metals like nickel ($14 per oz) or chromium ($1.50 per oz). For single crowns made with cheaper metals, material costs can be under $20.
So right off the bat, gold crowns start with a higher baseline price driven solely by gold market values. But there are other factors that make them expensive as well…
Cost driver #2 – Durability and longevity
Gold crowns last much longer than every other type when cared for properly:
- Gold crowns: Over 20 years
- Porcelain fused to metal: 10-15 years
- All-ceramic: 5-10 years
Why does gold last so long? It is extraordinarily durable and wear resistant:
- Gold won‘t rust, corrode, or tarnish due to corrosion resistance
- Gold doesn‘t erode from chewing forces like ceramic
- Gold doesn‘t crack or chip like porcelain
This durability means you avoid repeat dental work. While gold crowns have a high upfront cost, they can save money in the long run.
Data sources: Creekside Dental Arts, Journal of Prosthetic Dentistry
Cost driver #3 – Complex fabrication process
Gold crowns aren‘t simply molded. They require an elaborate 12-step lost-wax casting process:
- An impression is taken of the prepared tooth
- A plaster model is poured from the impression
- A wax pattern crown is sculpted on the model
- Sprues are attached to the wax pattern
- The wax crown is embedded in investment material
- The investment is fired, melting the wax away
- Molten gold alloy is injected into the mold left by the wax
- The gold casting is cooled and divested
- The sprues are cut off the crown
- The crown is polished and smoothed
- The interior of the crown is sandblasted
- Final fitting and adjustments are made before cementing on the tooth
This technique requires advanced skills and around 2-3 hours of bench time per crown. Costs add up due to the labor intensity and amount of chair time.
General dentists often outsource fabrication to dental laboratories charging $200-$500 per unit. Many labs exclusively work on gold restorations.
Cost driver #4 – Expert skill required for ideal placement
Gold crowns entail more upfront prep work for the dentist:
- Teeth must be reduced 1-2 mm circumferentially to allow room for metal thickness
- Reduction must be precise to avoid exposing the pulp or perforating undercuts
- Premolars may require root canal therapy first due to small size
Thicker gold crowns demand a high level of technical skill and training to place without damaging adjacent teeth. Doing it right takes time.
Like dental techs, dentists charge more for expertise needed for gold crowns compared to simpler techniques like filling cavities. Their fees reflect years of education and practice.
Cost driver #5 – Gold allergy and limitations on use
A small subset of the population is allergic to metals containing nickel or copper often mixed with gold in dental alloys. For these patients, gold isn‘t an option.
More expensive metal-free choices like zirconia or layered porcelain must be used. These specialized crowns cost more for the dentist to fabricate and place.
Gold crowns are also only recommended for back teeth. They are avoided on front visible teeth unlike porcelain which offers natural aesthetics. Again, this limits their usefulness for some cases.
Cost driver #6 – Insurance coverage and out-of-pocket fees
While insurance helps offset the cost of crowns, coverage often falls short, leaving patients responsible for the remainder.
Typical dental plans cover about 40-50% of crown costs, but maximum annual benefits may cap reimbursement.
For example, if your plan‘s annual maximum benefit is $1500, you could end up paying more out-of-pocket for a $2000 gold crown versus a $1200 porcelain crown.
Always discuss costs with your dentist beforehand so you understand your insurance breakdown and payment responsibilities.
Now you understand all the reasons why gold crowns come at a premium. While expensive, they offer exceptional longevity and require expert care both in fabrication and placement in the mouth.
For patients wanting an optimal long-term restoration, the extra investment upfront may pay off. But more affordable options can also perform well when properly cared for.
Talk to your dentist about the right crown material for your needs. Be sure to consider costs your insurance won‘t cover. With this knowledge, you can make the ideal choice to protect your smile.
Let me know if you have any other questions!