We receive this question often. The patient goes to the dentist and is told that the crown will not be strong enough if they don’t put a metal core under the porcelain. This type of porcelain fused to metal or gold has been used in dentistry for over 50 years. In our practice it is rare for us to use this type of crown. All-ceramic crowns with no metal have been available for years. In my own mouth I have an all porcelain bridge and all porcelain crowns that have been in my mouth for 18 years. We now have new generation of all-ceramic crowns that are even stronger than the ones I have in my mouth. I did not want metal because of the esthetics and biocompatibility issues. When porcelain to metal crowns are used, more tooth has to be ground away so they can cover the metal. Even then patients complain about the dark line at the gum. I also notice red, inflamed gums, which is often caused by allergy or sensitivity to the metal. Another reason I don’t like the porcelain to metal is galvanism. Galvanism is an electric charge that is generated when two or more dissimilar metals are together with moisture. One Russian study showed an increase in bone damage around teeth with galvanism. I have had a virtually metal free practice since the 1980’s so I know they are strong, beautiful and biocompatible.