The price of gold, that’s what!
I am old school. We used to watch the price of gold like a hawk because the price of our work was dictated by the price of gold. Some doctors would make us feel bad when we had to charge a little more for a crown because of the volatile price of gold. So working with them was difficult because we always felt a little sheepish when delivering a heavier than normal gold crown or pfm. Through it all we were delivering the very best restoritive material that Dentistry had to offer. Those days are pretty much gone now and I’m not sure if it is for the better. But we have certainly improved on ceramics. The reasons we have done this supposed improving are slightly flimsy. There are two main reasons; One is pure vanity and the other is cost.
There are a few things that have brought us to this sad state of restorations in dentistry. The dental patient is demanding more and more aesthetic Restorations. Only because of pride and vanity. The dental profession is getting their prices cut and lowered from all directions. Corporate Dentistry is having an effect in most areas of the country in driving prices lower. The insurance companies are jumping on that and driving prices down. The dentist is looking for cheaper and faster materials and techniques to fulfill their patients needs.
Everyone seems to be ignoring the very best restorative material in dentistry which happens to still be gold. Gold is the standard that everything else has to measure against. The margins burnish and it can be super thin. Gold has the same wear characteristics as enamel and it will not break or chip or crack. Gold is highly biocompatible. Gold also has a track record in the mouth of over a hundred years. How can we ignore this?
In my experience, if a decision is made because of vanity or simply because of cost, the decision maker is usually sorry.