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Dental Crown

Authored by:
Reviewed by: Paul Amato, DDS
 

Dental crowns, also known as caps, are placed over a tooth or dental implant, completely covering it to restore function, form, and color. Crowns are necessary to restore functionality to a cracked, chipped, broken, or decaying tooth. Dental crowns can be made of metal, porcelain-fused-to-metal, resin, or ceramic (all porcelain). Dental crowns can last from five to fifteen years before they need to be replaced due to decay, fracture, or wear.

Types of Dental Crowns

There are four types of dental crowns:

Porcelain-Fused-To-Metal Crowns: The porcelain is fused to a substructure of metal, often a white gold alloy. As you age, gum recession can occur, exposing the metal substructure of porcelain-fused-to-metal crowns. This could give your teeth a very unnatural look as a dark line appears close to the gums.

Metal Crowns: Metal crowns can be made of a yellow gold and white gold alloy or an alloy of base metals such as nickel and chromium. It is best to avoid base-metal alloy crowns, as some people have sensitivities to those metals. Patients who need crowns on their second molars (the last tooth in the arch) are the best candidates for metal crowns. Gold crowns are the longest-lasting cast restoration known to dentistry. They are extremely strong, not prone to fracture, and they wear at the same rate as enamel.

All Resin Crowns: These are the least expensive, but they are very prone to breaking and wear down much faster than any other type of dental crown. These crowns can be used on teenagers to buy time until they are adults or on adults undergoing orthodontic treatment such as braces. You may want to discuss the pros and cons with your dentist if he or she offers you this type of crown.

All Ceramic Crowns: These dental crowns are also known as all-porcelain crowns, since they are made of 100% porcelain. They are the best option for those who want to most closely match the natural look of their teeth, but there are a few drawbacks. They are more brittle than porcelain-fused-to-metal crowns or metal crowns, but they are an option for anyone who has metal allergies.

Who Needs Dental Crowns?

Anyone who has a damaged tooth is a candidate for a dental crown. Reasons why a patient might need a dental crown include:

  • Weak teeth need protection due to decay or worn-out old fillings
  • Restores a broken tooth to its proper working function
  • Holds dental bridges in place
  • Covers dental implants
  • Covers discolored or unattractive teeth
  • All posterior teeth with a root canal need crowns in order to protect the tooth from fracturing and needing to be extracted

The Dental Crown Procedure

dental crown

A dental crown can be daunting if you’ve never had one, but they are very common and routine. It typically takes two visits to install a crown. Technology exists that in some cases allows a crown to be prepared and cemented in only one visit. One example of this is a system called Cerec.

Prior to recommending a crown for a tooth, your dentist will examine the tooth, nerve, and surrounding bone and tissues both clinically and radiographically (with x-rays). In some circumstances, if the nerve of the tooth is infected and painful, or if the tooth has extensive decay that extends to the nerve, a root canal may be performed first.

If a root canal is unnecessary, the crown procedure can begin. The soft tissue and tooth will be anesthetized, and the area will be isolated with a rubber dam. The old filling will be removed, and a build-up will be performed to replace the missing tooth structure. The tooth will then be prepared for the crown. Once the tooth is prepared, an impression will be taken of the prepared tooth. The dentist’s assistant will make a plastic, tooth-colored temporary crown, which will be fixed in place with temporary cement. The dental impression is sent to an expert dental lab technician, who will fabricate the crown. The dental lab takes two to three weeks to complete the process, during which time the patient will have the temporary crown.

During the second visit, the dentist removes the temporary crown and replaces it with the permanent one. He or she will check to make sure that it fits correctly, that it doesn’t affect your bite, and that it blends in nicely. If the patient and dentist agree on the appearance and feel of the new crown, the tooth is numbed and the permanent crown is cemented.

Caring for Your Dental Crown

A dental crown needs to be taken care of similarly to your natural teeth. It is recommended that you continue your normal hygiene habits, brushing two times per day, flossing once per day, and seeing your dentist at regular intervals. Keep in mind that even a tooth that is entirely covered by a crown or cap can decay if it is not well cared for. Eat a well-balanced diet to ensure that your teeth and gums are getting the nutrients they need to stay healthy and strong. If possible, try to avoid sticky foods like taffy that may cause the crown to loosen.

Talking to Your Dentist

  • Which type of dental crown would benefit me most?
  • What are some of the pros and cons with this type of crown?
  • Will I be able to bite into hamburgers, apples, and other favorite foods?
  • What should I do if I think my crown is loose?
  • Is a dental crown my only option to fix my teeth?
  • Will the crown improve my smile and facial structure?
  • How long will I need to wear my temporary crown?

Page updated September 2012

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