Caries and Discolouration in Anterior Teeth with Aesthetic Gold Inlays

INTRODUCTION: Gold is used for restoration of carious teeth due to its strength, durability, malleability,wear resistance, and ease of manipulation. Colour was a negative feature, but recently aesthetic gold inlays have become popular amongst South African youth. These may have detrimental side effects being placed on virgin teeth destroying sound enamel and using destructive cutting techniques. Additionally, ill fit, leakage, poor cementation, or rough margins lead to plaque accumulatio, caries and discolouration of teeth. OBJECTIVES: To investigate the extent of caries and discolouration in anterior teeth with aesthetic gold inlays. MATERIALS AND METHOD: Twenty six patients with anterior gold inlays were questioned and teeth examined clinically, radiographically and photographically. Inlay design was recorded, amount of discolouration around the margins measured, and extent of decay determined. Inlays were evaluated for smoothness, fit, marginal integrity and presence of overhangs. RESULTS: Two thirds of the restorations were placed by dentists or therapists, but 26.9% were done by untrained persons.Only 13.8% of teeth were sound, caries free, vital and not discoloured. Twenty two percent were discoloured,caries free and vital. Sixteen teeth (44.4%) were carious and vital. One tooth was carious and non-vital, while another was discoloured, non-vital but caries free. Three teeth (8.3%) were carious, non-vital and had peri-apical pathology. Clinically there were leaking margins, rough edges, interproximal overhangs, and plaque retention. Almost all (96%) the remaining anterior teeth were sound and caries free. Three quarters of the patients had sensitivity or pain, 44.4% were happy with their restorations and 22% wanted them removed. CONCLUSIONS: Since most remaining anterior teeth were sound, the high caries and discolouration of inlaid teeth could be attributed to the restorations rather than poor oral hygiene, or cariogenic diets. Ethically, should dentists provide these restorations? However, their refusal may lead to untrained persons doing them with dire consequences.