Why do I need a dental crowns?
Dental crowns are coverings that a dentist can put over a tooth. These restorations are one of the most common things dentists do. These restorations are made to restore everything that is broken or damaged. Crowns or caps are done when teeth have lost about 50% of its original volume to decay, old fillings, or other damage. They fully cover the damaged tooth that sits above the gum line. This is because what remains is so weak that if a new filling were placed it would be too weak and prone to fracture. They replace all that is missing and make everything stronger and can make it look better.
The procedure and materials used to make a cap can be relatively expensive. These restorations are custom made for fit and shape. They can be made of many different materials. The most common types are made of all porcelain, porcelain fused to metal, and metal or gold.
Uses of Dental Crowns:
- There are many situations that require crowns. The following are the most common:
- When there is decay or a missing section that is too large to be replaced with a filling
- The teeth are worn down, cracked a cusp off, or has erosion at the gum line
- When there is weakness after a root canal has been done from being hollowed out
- To improve your smile by changing the shapes or covering blemishes. This is more commonly done with veneers unless the tooth has been heavily restored.
- Most implants are restored by screwing a cap into them.
Why can’t I just get a filling?
Of course you can get a big filling. Some patients insist on it. The fact is that most are back in soon after. The large filling isn’t strong enough for most situations when the majority of the tooth is artificial. Unfortunately, more tooth structure is lost when trying to take this short cut. It also wastes money in the long term. In some situations, you risk the loss of the tooth. How do I know for sure? Ask your dentist.
Types of Dental Crowns
There are several types of caps. The American Dental Association suggests that there are pros and cons for each type. Your dentist will assess your specific dental situation and recommend which is best for you.
All porcelain crowns are usually the prettiest type. Porcelain has been developed that has the same optical characteristics as natural tooth enamel. The wear characteristics of porcelain has also been developed to roughly match enamel. This way they are not abusive to the opposing tooth. Ceramic is more bio-compatible than most metals used for other types of caps and the bone and gum tissue tends to be happier and healthier. All porcelain crowns can be used for both front and back of the mouth.
Porcelain fused to metal (PFM)
This is the most commonly done crown on the market today. A PFM has a metallic substructure that seals and protects the tooth underneath. Tooth colored porcelain is baked on top of the metal to give it a natural appearance. Next to all porcelain versions, these crowns are the most natural. Due to the metal support, they are generally stronger than all porcelain crowns.
Metal crowns are virtually indestructible. They are used when the patient is really hard on their teeth. Many people have bad habits like chewing ice or they grind and clench their teeth. Metal crowns are recommended under these circumstances to ensure an adequate service life of the restorations. Many alloys are used to make these crowns. A higher quality office will use gold as the metal choice. Gold is the most bio-compatible of the metals and usually fits better. These are the least attractive caps and are usually used only in the back of the mouth.
Which type is best for me?
Well, it depends on the situation. How does the dentist decide which types of dental crowns to use? Your dentist will consider many factors, such as:
Tooth location and function
A front tooth takes less biting pressure than a back tooth. It is more important for it to look beautiful. An all porcelain version is often the choice for front teeth. A PFM is more commonly picked for back teeth. If the patient grinds their teeth, then a metal crown might be placed on the last molar.
The position of the gum tissue
If the gum has receded, often the crown is not extended all of the way to the tissue. Only the all porcelain crown will have a good look in this circumstance. Porcelain caps can be designed to have ultra-thin margins that act like contact lenses at the margins. The interface margin is almost invisible. The PFM design always takes the margin up under the gum to mask the metal.
Is the crown supported by dental implants?
Dental implants are anchored solidly into the bone. There is no shock absorption for a tooth crown anchored to the implant. A natural tooth has flex to it and the root is held within the socket by ligaments which will stretch. Implants DO NOT BEND OR STRETCH. Implant crowns take heavy loads and need to be very strong. Usually PFM crowns are the best choice. A special type of ceramic crown is gaining popularity due to impressive strength. The porcelain is zirconium.
The patient’s preference
Yes, we actually try to please our patients. If our patient asks for a specific type of restoration, we give it to them.
Dental crown procedure | How are they installed?
When a dentist does a dental crown for you, there are several steps involved. Normally, it takes 2 visits to complete a crown.
Preparation of the tooth
The entire area near the tooth is numbed first. The thickness of a crown is 1mm around the sides and 2 mm on the top. The tooth needs to be reduced this much to make room for the crown. We don’t want the newly restored tooth to be any bigger than the original. Decay and any old filling material that is weak is then removed. Some dentists will build up the core of the tooth if more support is needed.
The dentist will then take an impression of the tooth. The impression can be made from a mold or by a digital scanner. This impression is sent to a dental lab to actually make the crown.
There is typically a waiting period of 2-6 weeks for the lab to make your new crown. During that period you will wear a temporary crown made by your dentist. Some dentists use stock temporaries and others will make custom fitting ones.
Temporaries have two very important roles. They prevent sensitivity and acts as a space maintainer for the other teeth. Teeth can move on their own in a day so the teeth next to and above the new crown need to be held in place. A well-made temporary will feel just like the original healthy tooth. Occasionally there is sensitivity with stock temporaries due to leakage.
Temporaries are made to be temporary. Normal chewing and brushing is fine but do not chew sticky stuff like gummy bears. If temps fall out, you must come in to have them re-cemented.
Receiving your new crown
When the crown comes back to your dentist, a special cement will be used to attach it. When the cement dries, it is firmly and permanently attached to the tooth.
Do tooth crowns last forever?
The lifespan of your crown depends on how well you take care of it. If you grind your teeth or chew ice or pencils, it won’t last as long as it could. Wearing a night guard if you grind your teeth at night will help. If you neglect good hygiene habits such as brushing and flossing, you are more likely to get decay under the crown. The average crown lasts about 10 years but if it is a high quality crown and you take good care of it, you can expect 20+ years of service.
Are you ready to fix that broken tooth?
Some people are intimidated or frightened by the prospect of having a crown restoration. There is nothing to be frightened of. The dental crown procedure is not only important, it’s really not scary at all. Dr. Fondriest and his team of dental specialists look forward to answering all your questions while providing you with quality care Contact us today at 847-234-0517.