Is It Customary to Be Charged for "Por Margin" in Addition to the Cost of a Crown?

The answer to this question is easy in my office and it is NO!  Our crowns are all porcelain so all of the margins in my office are made of porcelain.  Why would I charge you extra for what I do on every crown in our office.  In your case, my guess is that you went into a managed care office where the base crown is porcelain-fused-to-metal.  This means that you end up with the dreaded "dark line" at the top of your crown.   They will charge an extra fee to make the metal "all porcelain".  You can't fault them for this as they run on extremely thin profit margins and must charge this due to lower limits insurance companies pay on HMO plans.  Insurance is not a factor in our office, therefore we have the ability to charge a fee and give the patient the best quality product that dentistry has to offer without the extra "porcelain margin" charge. 

What you had placed is a Porcelain-fused to high noble metal. This is the most common and long term proven crown we use in dentistry. If done properly it can last for many years due to the noble metal support under the porcelain.

The Porcelain margin means that in the front part of the crown (the part that faces the lips/cheecks) at the gum-line is made of pure porcelain to enhance the esthetic look. It minimizes that gray line that some crowns show. The lab technicians that make the crowns charge extra for this.

A porc fused to metal crown without a porcelain margin ( called porcelain-to-metal margin)means that the metal and the porcelain finish at the same point and a slight gray line may be visible from the metal if it is not well hidden by the gum.

I see nothing wrong with this charge but you should have been told about it before it was done.

Hope this helps

Dr. T

Sometimes, depending on your gumline and where the tooth is located that is to be crowned, your dentist will request that the lab extend the porcelain past the metal work of the crown.  This is done so the metal margin of the crown will not be visible creating an unattractive black line at the gum area. It looks a lot more natural and you will have no black line a long your gum. This is more involved for the dental lab to do and they charge the dentist more and consequently, the cost is past on to you. If it were my mouth, I would be happy to pay considering you want the crown to look natural when you smile

This could be an Insurance issue as mentioned by the other dentist as sometimes payments are so poor from insurance carriers this is how they let the dentist recoup costs.  Wish this was'nt so. Most of us dentists include this in the normal cost of the crown.  The costs should all be explained to you and if their are choices then that should also be explained.

You have a great question about the billing portion of cosmetic dentistry.

In highly visible areas, this type of margin can be one of the most natural looking. If you have ever seen a black edge to someone's crown, then this is what it looks like when you DON'T do this.

There are many different types of dental crowns, some more aesthetic than others, some stronger than others. If you have questions you may want to discuss this with your cosmetic dentist to see what is the best for YOU.

In summary, this is not an unusual code or cost. 

 

 

Nowadays an all porcelain crown is as strong as any crown made of metal, and extremely  aesthetic . So when you get an all porcelain crown, you do not have to worry about such issues.

Now, I am sorry if I am not being diplomatic enough , but theses issues usually come up with the need to recover the cost of lower insurance reimbursements. Meaning , if you have a HMO insurance, the clinic/dentist will lose money doing a crown for you. So in order to recover the expense, they nickle and dime you for everything they do such as type of metal, type of porcelain ,margin placed above the gum, below the gum , porc. margin, metal margin, etc...

In short you will pay the same if not more for the same crown in a HMO office than you would  going to a Fee for service or an private practice where they only accept  PPO insurances. So, my advice? Stay away from HMO insurance, and HMO providers as much as possible.

Having said that , I am sure there are exceptions out there . Hopefully one day healthcare in general will be between the doctor and the patients and the third party can disappear forever !!!?