Why would you require a Dental Crown procedure?

A crown is basically a cap for a damaged tooth. It can be made from a variety of materials, including metal or porcelain.

You might have a crown over a molar that rarely shows, except when you yawn widely, or you might have crowns on your front teeth that were specifically designed to match your other teeth.

When would a dental crown be needed?

A dental crown may be needed to:

• Protect a weak tooth (for example, from decay) from breaking or to hold together parts of a cracked tooth.


• Restore a broken tooth or a severely worn down tooth.


• Cover and support a tooth with a large filling and not much tooth remaining.


• Hold a dental bridge in place.


• Cover misshaped or severely discolored teeth.


• Cover a dental implant.


• Cover a tooth treated with a root canal.

For children, a crown may be used on primary (baby) teeth in order to:

• Save a tooth that has been so damaged by decay that it can't support a filling.


• Protect the teeth of a child at high risk for tooth decay, especially when a child has difficulty keeping up with daily oral hygiene.


• Decrease the frequency of general anesthesia for children unable because of age, behavior, or medical history to fully cooperate with the requirements of proper dental care.

In such cases, a pediatric dentist is likely to recommend a stainless steel crown.

What are onlays and 3/4 crowns?

Onlays and 3/4 crowns are crowns that don’t cover as much of the underlying tooth as traditional crowns. Traditional crowns cover the entire tooth. These may be appropriate when solid tooth structure still remains. It is considered a more conservative approach to a full coverage crown. In this procedure your dentist removes the affected area, and performs a reshaping of the tooth to receive the restorative material.

What Types of Crowns Are Available?

Permanent crowns can be made from stainless steel, all metal (such as gold or another alloy), porcelain-fused-to-metal, all resin, or all ceramic.

• Stainless steel crowns are prefabricated crowns that are used on permanent teeth primarily as a temporary measure. The crown protects the tooth or filling while a permanent crown is made from another material. For children, a stainless steel crown is commonly used to fit over a primary tooth that's been prepared to fit it. The crown covers the entire tooth and protects it from further decay. When the primary tooth comes out to make room for the permanent tooth, the crown comes out naturally with it. In general, stainless steel crowns are used for children's teeth because they don't require multiple dental visits to put in place and so are more cost- effective than custom-made crowns and prophylactic dental care needed to protect a tooth without a crown.


• Metals used in crowns include alloys that have a high content of gold or platinum, or base-metal alloys (for example, cobalt- chromium and nickel-chromium alloys). Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, metal crowns rarely chip or break. The metallic color -- and the high price of gold -- is the main drawback. Metal crowns are a good choice for out-of-sight molars.


• Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown's porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown's porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth as well as long bridges where the metal is needed for strength.


• All-resin dental crowns are less expensive than other crown types. However, they wear down over time and are more prone to fractures than porcelain-fused-to-metal crowns.


• All-ceramic or all-porcelain dental crowns provide better natural color match than any other crown type and may be more suitable for people with metal allergies. All-ceramic crowns can be used for front and back teeth.


• Temporary versus permanent. Temporary crowns can be made in your dentist's office, whereas most permanent crowns are typically made in a dental laboratory. Typically, temporary crowns are made of an acrylic-based material or stainless steel and can be used as a temporary restoration until a permanent crown is constructed by a lab.

 

Dental crown procedure:

The process will depend on whether your dentist opts for a multi-day or same-day procedure.

Multi-day procedure with a temporary crown

With a traditional crown, you will need to visit your dentist’s office twice.

• The dentist examines and prepares the tooth that needs the crown. This might involve taking X-rays of the tooth.


• They also may take a mold of your tooth or mouth beforehand.


• Your dentist will file down and remove part of the outer layer of the tooth.


• An impression will be made of your trimmed tooth and the surrounding teeth.


• The dentist will put a temporary crown over your tooth to protect it.


• They send the impression to a lab that makes the crown. This step may take several weeks.


• When the crown comes in, you’ll return for the second visit, so your dentist can cement the crown to your tooth.

Same-day procedure

With a same-day procedure, you can skip the temporary crown step.

• The dentist takes digital pictures of your mouth.


• Using the digital scan from the photos, the dentist creates the crown right there in the office. You may have to wait about 1 to 2 hours until the crown is made.


• Once the crown is ready, your dentist cements it into place. The entire process takes about 2 to 4 hours.


• You might even be able to head back to work while you’re waiting, depending on your specific situation.

Not all dentists have the technology to make same-day crowns. Ask your dentist if this option is available and the estimated cost, especially if you don’t have dental insurance.

What problems could develop with a dental crown?

• Discomfort or sensitivity. A newly crowned tooth may be sensitive immediately after the procedure as the anesthesia begins to wear off. If the crowned tooth still has a nerve in it, there may be some heat and cold sensitivity. Your dentist may recommend that you brush your teeth with toothpaste designed for sensitive teeth. Pain or sensitivity that occurs when you bite down usually means that the crown is too high on the tooth. If this is the case, call your dentist. He or she can easily fix this problem.


• Chipped crown. Crowns made of all porcelain can sometimes chip. Small chips can be repaired and the crown could remain in the mouth. The crown may need to be replaced if the chip is large or when there are many chips.


• Loose crown. Sometimes the cement washes out from under the crown. Not only does this allow the crown to become loose, it allows bacteria to leak in and cause decay to the tooth that remains. If your crown feels loose, contact your dentist’s office.


• Crown falls off. Sometimes crowns fall off. Usually this is due to an improper fit or a lack of cement. If this happens, contact your dentist’s office immediately. He or she will give you specific instructions on how to care for your tooth and crown until you can be seen by your dentist. Your dentist may be able to re-cement your crown in place; if not, a new crown will need to be made.


• Allergic reaction. Because the metals used to make crowns are usually a mixture of metals, an allergic reaction to the metals or porcelain used in crowns can occur. However, this is extremely rare.


• Dark line on crowned tooth next to the gum line. A dark line next to the gum line of your crowned tooth is normal, particularly if you have a porcelain-fused-to-metal crown. This dark line is simply the metal of the crown showing through.