Dental Crowns

If teeth are severely damaged, dental crowns may be a highly effective treatment.  Grinding your teeth, bad bites, age, fillings, and tooth decay are all contributing factors in the wearing down, cracking, or breaking of the teeth.  Dental crowns, also known as “caps,” are restorations that fit over the natural teeth, covering the entire visible surface to increase the strength, durability, and stability of the tooth.

Crowns may be necessary due to old fillings, fractured teeth, chipped teeth, or sensitive teeth.  Crowns may also be used to improve the appearance of natural teeth that are mispositioned or discolored.  Dental crowns may also be used to anchor a dental bridge or to cover a dental implant abutment.

Your dentist may recommend a dental crown if:

• You have a tooth with a large filling. The existing tooth structure will weaken as a result, and will no longer be able to support the filling.
• Your tooth has sustained extensive damage from decay.
• Your teeth are discolored or cosmetically compromised.
• Your tooth has fractured.
• You have undergone a root canal treatment. Following a root canal, teeth tend to become brittle and may fracture.  If you have received a root canal, the tooth in question will need to be protected by a crown.
• If you are receiving a dental bridge. Teeth adjacent to the tooth being replaced require crowns in order to support the bridge.

Dental crowns may be made of several different materials.  The type of crown used by your dentist will depend on your specific needs and goals.

• Metal Crowns – Though the metallic color makes this type of dental crown a poor choice for highly visible teeth, metal crowns can be an ideal option for repairing decayed or damaged back teeth.
• All-Ceramic Crowns – This type of crown is made from ceramic material (such as Zirconia, or alumina) to create a natural-looking appearance. The tooth-colored material is nearly translucent, and the size and shade can be carefully matched to complement the rest of your smile.  All-ceramic crowns are typically used on front teeth, but may also be used on the back teeth.
• Porcelain Fused to Metal –  The metal shell may give the crown an opaque appearance, making it difficult to replicate the translucency of natural teeth.  Occasionally, a darker line will be visible at the edge of the crown, near to the gum when it recedes with age.  This can be avoided with consideration to tooth preparation.
• Gold Crowns – Gold crowns require the least complicated preparation, as there is minimal removal of the tooth structure. The biggest disadvantage of gold crowns is the cosmetic aspect, as these crowns are highly visible unless used at the back of the mouth.
• Porcelain Crowns – Porcelain crowns are considered to be the most aesthetically pleasing type of dental crown. They are easy to color-match to the surrounding teeth, and are very durable.

Dental crowns typically require two appointments to fit.  During the first appointment, your dentist will give you a local anesthetic.  Your tooth will be prepared to maximize the retention and esthetics of your new restoration.  After this preparation is complete, a retraction cord will be placed around the tooth to gently push the gums away from the tooth.  This will allow impression material under the gum line.  After the impression has been taken, a temporary crown will be placed to protect your tooth and gum tissues while you wait for your permanent crown.  A temporary medium is used to cement this restoration.

In the interval between appointments, please remember to take good care of your teeth and gums.  The health of your gum tissue and the success of your final restoration depends on the quality of your home care.  If your temporary crown or bridge becomes loose, you can place it back on your teeth using a drop of toothpaste.  If this does not work to keep your temporary restoration in place and make an urgent appointment, contact your dentist immediately.

During your second appointment, the temporary crown will be removed, along with the temporary cement.  Your dentist will fit the final crown, adjust it for any bite discrepancies, and evaluate the appearance of the restored tooth.  If you and your dentist are satisfied, the crown will then be cemented permanent to your tooth.