What is a Dental Crown and When are They Necessary?

Do you have a missing or cracked tooth from dental decay or an accident? If so, it could be time to replace it with a crown. But what is a dental crown? Here, I answer some common questions about these nifty tooth replicas.

I know it can feel like a bummer to have a missing or cracked tooth, and even more of a bummer to have it replaced by a fake one.

But, like I tell my patients, even kings and queens have crowns!

Understanding what crowns are made of, what the procedure is like, and how you should care for them will probably make you a bit less wary about having one.

Below, I answer five common questions about dental crowns to help you choose which one is best for you.

1. What is a dental crown?

A dental crown is a tooth-shaped cap that is placed over your cracked or missing pearly whites. It restores the size, strength, appearance and functionality of the original tooth.

2. When is a dental crown needed?

A dental crown is needed when there is not enough stability in the tooth’s structure to support the functionality of the tooth.

You may need a crown:

  • When the tooth needs support to remain in one piece after becoming worn down or weak from dental decay
  • To restore a broken, missing or severely worn down tooth
  • To cap a dental implant
  • To support a dental bridge
  • To cover a disfigured or discolored tooth (from enamel erosion, for example)
  • In cosmetic surgeries

3. What are the most popular types of crowns?

All-porcelain or all-ceramic. Need a crown, but worried about how it may look? These crowns allow dentists to choose a shade of white that most closely matches the patient’s teeth.

While they are not as strong as porcelain-fused-to-metal crowns, all-porcelain or all-ceramic are the most aesthetically pleasing, making them a great option for replacing front teeth.

This type may also be more suitable for patients with metal allergies.

Porcelain-fused-to-metal. Besides all-ceramic crowns, these look the most like normal teeth.

However, sometimes the metal laying underneath the crown’s porcelain can show a dark line down by the gums, especially if gums start to recede.

Gold. These crowns are typically made of gold alloy. Gold crowns have the most longevity, as they rarely chip or break.

Gold crowns are good for replacing or covering out-of-sight molars, as molars need to be strong to bite and chew hard foods.

Because they are metallic in color, they are rarely used to replace front teeth.

Gold crowns are indicated when patients’ biting or severe TMJ habits greatly increase the risk of breaking the porcelain on the back molars.

A porcelain crown is a more brittle material and less malleable than an all gold crown.

Stainless steel. These types of crowns may be used as temporary replacements while the patient’s permanent crowns are manufactured in the dental lab.

I fabricate a tooth-colored custom temporary crown for my patients while waiting for the permanent crown to be completed.

4. What does the procedure look like?

Fabricating a dental crown typically involves two visits to the dentist.

During the first visit, your dentist will examine and prepare your tooth for a crown. He or she may take X-rays to examine the original tooth’s roots and surrounding bone.

Then, your dentist numbs the tooth and gum tissue surrounding it. Your original tooth is filed down along the chewing surface and sides to accommodate the crown.

If a significant portion of the tooth is missing due to decay, your dentist will use a cement-like substance to build up the tooths missing structure. This way, it can support and retain the crown.

After he or she reshapes your tooth, your dentist will use a paste or putty to make an impression of the original tooth. Then, he or she will use that putty to impress surrounding teeth. This ensures the crown does not alter your bite.

These impressions are sent to a dental lab and the crown will be ready within an average of two weeks. In the meantime, a temporary crown will be placed over the original tooth.

During the second visit, your dentist will replace the temporary crown with your permanent one. The permanent crown will be checked for color and fit before it is cemented in your mouth.

5. Do dental crowns need special care?

Yes! Just like any other tooth, you need to brush, floss and take good care of it. Read here about how I establish a dental health routine with my children.

Overall, crowns last five to fifteen years, depending on how well you maintain it. This means having good hygiene, like brushing your teeth when you are supposed to. It also means ending habits like teeth clenching and chewing ice.

With porcelain crowns, be careful not to bite into hard things, especially ice. These types of crowns are more susceptible to cracking and breaking.

If you clench and grind your teeth, a splint or nightguard may be indicated to protect your new porcelain crown.

For temporary crowns, avoid sticky or chewy foods – like caramels or chewing gum – as these may stick to and pull off the crown. Hard foods, like carrots, can displace or break the crown.

If you have a temporary crown, chew and bite to the other side of your mouth as much as possible.

A dental crown is a common procedure, and I perform these procedures often. However, I advise patients to take good care of their original teeth by brushing, flossing and developing good habits to avoid getting a crown altogether.

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