Dental crowns

“All you need to know about the dental crown……….”

Have you heard about dental crowns? If your dentist is concerned about tooth decay or other issues affecting your tooth structure, dental crowns may be an option .This guide can help you learn about dental crowns and what to expect after the dental crown process. Before differentiating between the different types of the dental crowns, consider the functions they serve.

1.      What exactly is a Dental Crown?

A dental crown, commonly called a “cap” is a tooth – shaped restoration that is placed over a tooth to restore its shape and size, strength and improve its appearance. The crowns when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line. It is made by a machine usually in a dental laboratory.

1.      Why is a Dental Crown needed?

There are different reasons why your dentist may recommend a crown for one of your teeth:-

-          To protect a root canal treated tooth.

-          To hold a dental bridge in place.

-          To cover a severely discoloured teeth.

-          To cover a dental implant.

-          To make a cosmetic modification.

2.      What are the benefits of a Dental Crown?

Having Dental crown gives the following benefits like:-

-          Strengthens the damaged tooth

-          Improves the aesthetics of your smile.

-          Returns broken teeth their natural chewing function capabilities.

-          Conceals previous procedures including fillings, implants and root canals.

3.      Will the Crown be noticeable?

No. the crown will be made to match your other teeth exactly. The shade of the neighbouring teeth will be recorded to make sure that the colour looks natural and matches the surrounding teeth. A temporary crown usually made in plastic will be fitted at the end of the 1^st appointment to last until the permanent one is ready. These temporary crowns may be more noticeable but they are only in place for about a week.

4.      What’s the difference between a Temporary and Permanent Crown?

The name says it all here! Temporary dental crowns can be made in your dentist’s office whereas permanent dental crowns are made in a dental laboratory. Typically, temporary dental 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 laboratory.

5.      Does a Crown protect the underlying tooth from decay and or gum disease?

No! It does not, and this is a common misconception that people have. Hence it’s important to brush and floss the crowned tooth just as you would any normal tooth especially around the gum line.

6.      Will I need to get a root canal for getting a Crown?

 No! Root canals are not required to place a crown but all teeth that have undergone root canal treatment should be crowned.

7.      Is there an alternative to a Crown?

Yes, but only for a front tooth - A dental veneer may be an alternative to having a front tooth crown.

8.      What types of Crowns are available?

Crowns are made of a variety of materials and new materials are being introduced all the time. Here are some of the options available at present:-

-          Metals used in crowns include alloys that have a higher 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 colour is the main drawback. Metal crowns are a good choice for out of sight molars. Stainless steel crowns are prefabricated crowns that are used on permanent teeth. The crown covers the entire tooth and protects it from further decay. Stainless steel crowns are more cost-effective than custom made crowns and prophylactic dental care needed to protect a tooth without a crown.

-          Porcelain – fused – to – metal (PFM) dental crowns can be colour matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown types compared with metal or resin crown. The crown’s porcelain portion can also chip or break off. PFM crowns look most like normal teeth. However, sometimes the metal underlying the crowns 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 – ceramic or all – porcelain dental crowns provide better natural colour 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.

9.      What steps are involved in preparing a tooth for a Crown?

Placing a permanent dental crown typically takes 2 dental office visits:-

-          During the first visit:-

1.       Your dentist will anesthesize (numb) the tooth and surrounding gum tissue and then shape the biting surface and sides of the tooth.

2.      Impression of the prepared tooth and jaw as well as the opposite jaw is taken.

3.       If the tooth is very decayed or otherwise too small to hold the crown, the dentist may “build up” the tooth to hold the crown.

4.      If the dentist is placing a porcelain or PFM crown, he or she will also determine the shade of porcelain to match the surrounding teeth.

5.       During this 1^st office visit the dentist will make a temporary crown to cover the prepared tooth until the permanent one is ready. The temporary crown is held in place using temporary cement.

-          At the second visit:-

1.      Your dentist will remove the temporary crown and check the fit and colour of the permanent crown.

2.       If everything is correct, then the dentist will place the permanent crown.

6.      What problems could develop with a Dental Crown?

Some of the common issues are:-

-          Discomfort or Sensitivity

-          Chipped Crown

-          Loose Crown

-          Crown falls off

-          Dark line on crowned tooth next to the gum line

7.      How long do Dental Crowns last?

Dental crowns don’t last forever. But with good care they can last a long time! More than 90% of crowns will not require major treatment within 5 years and 50 – 80% of crowns will last between 15 – 20 years. The lifespan of a crown depends on the amount of “wear and tear” the crown is exposed to. The crown itself cannot decay, but decay can start where the edge of the crown joins the tooth. It is very important to keep this area as clean as your other teeth or decay could endanger your crown. Properly cared for crowns will last for many years .

8.      Does a Crowned tooth require special care?

While a crowned tooth does not require any special care, remember that simply because a tooth is crowned does not mean the tooth is protected from decay or gum disease. Therefore, continue to follow good dental hygiene practices including brushing twice a day, flossing daily especially around the crown area where the gum meets the tooth and rinsing with an antibacterial mouthwash at least once a day, seeing your dentist on a regular basis. If you tend to clench or grind your teeth, ask your dentist how this could affect your crown. In general, you should try to avoid chewing hard or sticky foods, chewing ice, biting fingernails and using your teeth to open packaging which may cause your own crown to break or become loose.

Dr. Krinita Motwani

Khar west, Mumbai.

Mbl : 9819002288 / 9820280343

Email : drkrinitamotwani@gmail.com