 An Ohio local news station has found lead in a dental crown that was outsourced to China. We take a brief look at this sensational story, and examine your personal risk. Let's separate the facts from the fears.
There has been a lot of news atttention on lead-tainted toys that were manufactured in China. It was only a matter of time before someone tested crowns made in China. A great part in the interest of the story is that it plays a lot into people's fears. Many have come to the conclusion that the Chinese sprinkle everything with lead, and make cheap products with no regard for safety or quality. While great caution has been paid to the toy industry, the average Orange County patient has very little to worry about.
We believe that this story is a sensationalized story designed to generate quick ratings for a local news station. First of all, the news story sampled eight Chinese made crowns, and found only one to contain traces of lead. This metal is harmful, and has no place in a dental office. Period. But one crown out of eight, while unacceptable, is not necessarily a trend. Also, the news station could not have possibly sampled a statistically significant number of crowns from a statistically significant number of Chinese dental labs. This news story is all about fear-mongering; you can't condemn an entire country's industry on the basis of eight samples taken at only one time.
We agree with the ADA that if lead in dental crowns was truly common, we would have heard about it long before this. Millions of dental crowns are placed every year. Most are made in local dental labs, but a significant portion are outsourced across the border or across the ocean. If there was significant amounts of lead in dental crowns, there should be an epidemic of lead poisoning; but there isn't.
What's more, adding lead to dental crowns does not make any sense. Lead is not used in any dental procedure. Its metallurgic properties make it a bad choice for dental crown alloys. (an alloy is a mix of different metals) When dental labs "price engineer" their crown alloys, they'll add several other metals to the mix before lead. While I'm not a fan of communist China and its suppression of human rights, a news story like this is unwarranted without further confirmation. The ADA has assured its members that independent investigations are underway to confirm or deny these claims.
What about your office?
We believe in supporting the local economy: Every crown prescribed at this office has been made in a Southern California lab under supervision of a certified dental technician; the farthest we outsource is Long Beach. Our regular other labs are close by in Tustin, San Juan Capistrano and Irvine. How a crown is made is more important that where, but all things equal, we like to support our friends and neighbors. We have never outsourced are crowns over the border, and have no plans to ever do so.
We believe in using the highest quality alloys: We do not prescribe "base metal" crowns to save money. Even though the overwhelming majority of our crowns are tooth colored, a significant number are PFMs: porcelain fused to metal. The metal coping underneath gives the porcelain superior strength, and a better seal around the tooth. Wherever possible, we use "high-noble" metals in our crowns: at least 60% noble (non-corroding) metal by weight, of which 40% must be gold. In the face of skyrocketing gold costs, we will continue to place high quality metal alloys in our crowns. High-Noble alloy crowns provide a great balance of strength, durability and resistance to corrosion, at a very small price premium over "base-metal" and "semi-precious" crowns.
How Can I Minimize my Exposure to Lead?
Let me re-iterate this important point: there is no corroborating evidence that any ADA certified dental alloy contains lead.
There is no corroborating evidence that overseas dental labs do substandard work. There are plenty of good and bad labs in every country of the world, including the US. A sign of a good lab is one where the dentist has a long standing relationship with them. That generally means the lab is producing high quality work at an affordable price. Most dentists are smart enough to realize that poor quality work only saves money in the short term. If crowns from the same lab keep failing, or people develop reactions to them, most dentists will discontinue the services of that lab very quickly.
If you're still concerned about lead exposure in crowns, (or have a true allergy to common crown metals) then perhaps you should consider a metal-free crown. All-ceramic crowns, such as Empress, eMax and Lava, are proven alternatives. While none offer the fracture resistance of a cast gold crown, I can guarantee they all look better. All-ceramic crowns are also not as strong as their metal-reinforced PFM predecessors--though that gap keeps getting smaller. Because there is no metal understructure, you can be sure that there is no lead mixed in. The compromise is generally in the higher cost, though many of patients will tell you it's worth the small difference.
For the vast majority of our patients, the tried and true PFM crown remains a great balance of low cost, high durability and good esthetics, particularly in the molars. For the most cosmetic crowns, or true metal allergy problems, all-ceramic crowns are an excellent option, also.
Source: American Dental Association
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