Dental crowns are a permanent dental restoration procedure used to repair teeth that are damaged, decayed or weakened. They are one of the best and most reliable ways to restore the functionality and aesthetics of a severely damaged or decayed tooth. This article will explain how crowns work, the different types of crowns available, and what to expect during the procedure.
What are Dental Crowns?
A crown is a dental procedure that places a tooth cap over a defective tooth or dental implant after it has suffered some type of damage. The crown will not only protect your tooth but also restore it back to its original shape and function. After the tooth is shaved down or prepared to accommodate the crown, an impression (physical mould or digital impression) of the teeth will be taken and sent to a lab for fabrication. Upon completion, the crown will be cemented onto the tooth.
Crowns can be made out of various types of materials that are customized to different shapes and colors, making them extremely useful for a variety of situations. Below are some common reasons to get a dental crown:
- Tooth decay: In severe cases of tooth decay, a cavity that’s too big for a filling may require a crown instead.
- Extremely large filling: Old fillings that are extremely large and beyond repair should be replaced by crowns. If they are not, they become more prone to cracking and can cause you to lose the entire tooth.
- Broken tooth: Severe fractures within teeth may need stronger protection from a crown.
- Root canal treated: Standard protocol for back teeth that have been root-canaled calls for getting a dental crown afterwards to prevent brittleness and discoloration due to lack of blood supply.
- After an implant: Completion of an implant requires fitting a crown, bridge, or denture into it.
- Improve cosmetics: Crowns provide similar shapes and color which may not be possible for fillings. Some patients may request crowns on their front teeth to ensure that the tooth remains a uniform color.
- Severe teeth grinding: The official term for teeth grinding is bruxism. Bruxing crowns made of zirconia offer additional toughness when dealing with bruxism or extreme grinding habit.
What is a Dental Crown Made of?
A dental crown is typically made from one of five materials: ceramic, porcelain fused to metal (PFM), stainless steel, metal alloys such as gold or other precious metals, or acrylics. Your dentist will recommend the best material depending on your individual needs and preferences.
All ceramic crowns mimic the appearance of natural teeth and provide stronger protection than other types of crowns. Different types of ceramics are used for dental crowns, such as lithium disilicate, zirconia, alumina and leucite. Ceramic crowns are ideal for front teeth, as they look and feel the most natural.
Porcelain Fused to Metal (PFM)
PFM crowns have metal underneath them, with porcelain fused over them for aesthetic purposes. While these have been around for decades and provide strong protection from damage, patients have to be careful to properly maintain their teeth after receiving them. If they do not properly brush and floss, it may cause their gums to recede which can cause the metal portion of the crown to show through.
Stainless steel crowns provide an inexpensive but durable option to replace teeth. Because they are a completely different color from regular teeth, they are usually used for children. This type of tooth, commonly referred to as “silver teeth,” ensures that there is proper alignment when adult teeth start to come in.
A variety of metals can be used for adult dental crowns compared to stainless steel ones that are only used on primary teeth. These include gold and alloys such as cobalt chrome or nickel-chromium which provide superior strength compared to ceramics but lack aesthetics due to their metallic hue. Gold has higher biocompatibility than other metals but may cost more due to its weight.
Acrylic is only suitable for temporary dental crowns due to its lower cost compared to ceramics or metals; however, this material should not be left in place long-term due to its shorter lifespan when compared with permanent restorations formed from other materials.
Most crown procedures involve two visits to the dentist – in some cases, it may be possible to complete the procedure in one visit using CAD/CAM technology. This technology uses in-house scanners and software to fabricate a crown while the patient is still in the dental chair.
First Visit to the Office
The first visit to the office involves taking a dental impression of the tooth that needs to be crowned so that a final crown can be fabricated. In general it follows the following steps:
- Administer local anesthesia, if needed, to numb the tooth and gums for preparation.
- Shave down the tooth to the appropriate measurements.
- Take an impression of the teeth to send information to the lab for fabrication.
- Fabricate a temporary crown to protect the shaved-down tooth while waiting for a permanent one to be made.
- Pick a shade that matches your teeth so that you are completely aware of what the final product will look like in your mouth.
Second Visit to the Office
During the second visit, the permanent crown is checked for fit and placed on the tooth. If necessary, it can be adjusted to make sure that it fits properly. This visit generally follows the following steps:
- Administer local anesthesia again if not too sensitive.
- Remove the temporary crown before the permanent one is placed, making sure to clean the residual cement.
- Try on the permanent dental crown, adjusting the bite if necessary before gluing it in permanently once it fits well and you like how it looks.
Recovery and Aftercare
It’s important to take good care of your crowned teeth at home by brushing twice daily with fluoride toothpaste and flossing once daily to get rid of plaque around each crowned area.
Additionally, eating hard or sticky foods should also be avoided as these can cause further damage to your new crown. This goes the same for any teeth, regardless of if they have a crown or not. Your new crown should be able to weather this damage, so long as you are careful and mindful of the foods you consume, but why not be safer rather than sorry?
If all goes according to plan, your crown should last you anywhere from 10 to 20 years. Some even last for up to 40 years, but this depends on how well you take care of your teeth and the crown.
Alternatives to Dental Crowns
Although dental crowns are typically one of the most effective and longest-lasting ways to restore broken or damaged teeth, a common detractor is the cost of dental crowns. As such, dentists often have a few alternatives to meet patient needs:
- Inlays and Onlays: These are basically like fillings, but with a customized shape for the affected area. They’re typically made in a lab and then cemented onto your teeth.
- Fillings: Standard fillings can be used to repair tooth decay if the cavity isn’t too large. The material used depends on the severity of the damage.
- Veneers: If the issue is cosmetic, veneers might be an option. They’re thin shells that fit over existing teeth and should last up to 15 years with proper care.
- Bonding: This is similar to veneers, but it uses composite resin materials instead of shells. It works best if you need minor repairs or slight reshaping of your teeth but won’t hold up as well as veneers or crowns for long-term protection.
- Dental Implants: If you have missing teeth, implants could be the solution for you. A titanium post is implanted into your jawbone with a custom crown attached at the end, making it look just like your original tooth.
- Bridges: When several teeth in a row are missing, bridges can help close the gap by attaching artificial teeth in place of those that were removed or lost due to decay or damage.
- Dentures: Removable dentures can replace multiple missing teeth while providing an aesthetic solution for patients looking for something natural looking.
- Extractions: In some cases, severely damaged or decayed teeth can be extracted if they cannot be saved with other procedures such as crowns or inlays/onlays. They are also a relatively cheap option, although should only be used as a last resort.
Risks and Complications
Though typically effective and safe, there can be complications when using dental crowns. These include:
- Tooth Sensitivity: While the crown is being put in place and for a period of time afterwards, it’s possible that you may experience some pain or discomfort due to sensitivity.
- Infection: Crowns are designed to fit snugly on your tooth, but if bacteria is able to get underneath it then it may lead to an infection that requires medical attention.
- Allergy Reactions: Some materials used in crown manufacturing can cause allergic reactions. Make sure you talk to your dentist before getting a crown so they can provide the proper materials for the procedure.
- Misalignment: If your crown isn’t properly aligned with the surrounding teeth, it could cause more wear and tear on them than normal, leading to additional damage down the road. This is why it is super important for dentists to check the bite of your teeth once the crown has been placed.
- Chipped Crown: The crown can chip or crack if it’s exposed to too much pressure or force. If this happens you should go back to your dentist for repairs.
- Loose Crown: A loose crown can be caused by a number of different factors, from gum disease to improper fitting when the crown was first installed. It is important to have it checked out as soon as possible in order to prevent further damage.
- Different Color from Other Teeth: Even with custom-made crowns, it’s possible that the color may not match precisely with other teeth nearby. Your dentist should be able to adjust the crown accordingly in order to make sure it looks natural and blends in well. However, it may still discolor at different rates from your other teeth.
Dental crowns are an effective solution for restoring damaged teeth and providing protection from further damage. There are a variety of materials that can be used to make a crown, such as porcelain, metal, or composite resin. Depending on the severity of the damage, different types of crowns may be recommended in order to restore your tooth with the most appropriate solution. However, it’s important to note that there are some risks and complications associated with the procedure, such as infection or misalignment. Make sure to talk to your dentist about all of the possible risks before undergoing this procedure.
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No two mouths are the same, and each oral situation is unique. As such, it isn’t possible to give comprehensive advice or diagnose oral conditions based on articles alone. The best way to ensure you’re getting the best dental care possible is to visit a dentist in person for an examination and consultation.