What’s a dental crown and why do I need one?
That’s a great question, and we hear it from patients regularly. Sometimes a tooth is damaged beyond what a simple filling can repair. A dental crown is simply a “cap” that is fit to the surface of the tooth to restore it to its normal shape and function.
Crowns are customized to perfectly fit the patient’s teeth. For various reasons, there might not be significant amounts of healthy tissue left in a tooth.
Most Common Reasons for a Dental Crown
Dental crowns are a tool that can be used for a variety of treatments, but these are the four most common reasons to get one.
- After a root canal. A tooth that has become irreparably decayed or infected may require a root canal. Following the root canal, a crown will restore strength back to the weakened tooth.
- After dental implants. A dental implant is the replacement for the root, and a dental crown is a replacement for the tooth. The crown is cemented to a stud in the implant, leaving an artificial tooth that is superior to regular teeth.
- Cosmetic dentistry. A discolored or misshapen tooth can be enhanced with a crown. Old fillings can be covered with a crown that will match the surrounding teeth.
- Damaged teeth. A tooth that is cracked or weakened often calls for a crown, as that tooth is at risk (and probably hurts). A crown will greatly strengthen the tooth and relieve symptoms.
Types of Dental Crowns
As crowns are tailor made to fit a tooth perfectly, a temporary crown is usually put in place for a few days while the permanent crown is being made. At Modern Dental in Boise, we have a variety of materials to use for crowns, depending on the specific need and patient preference. Here are some of the more popular crown options:
Steel is often the material of choice for temporary crowns, protecting a tooth or a filling while the permanent fixture is being made in the laboratory. We also use stainless steel crowns for children to protect decayed baby teeth. When the permanent tooth is starting to come in, the crown will come out naturally.
Metal alloys usually include valuable metals like gold or platinum, or use base metals like cobalt or nickel. Metal alloys are very strong and durable, able to withstand a lifetime of chewing. However, due to their color, they are typically used for molars.
Porcelain or Ceramic
Ceramic crowns are usually the best cosmetic choice for crowns. They can be matched to the natural color of your teeth, custom made to such a high quality that even a very close inspection won’t reveal the presence of the crown. For this reason, they are a great choice for front teeth that need restoration.
A solid compromise between strength and appearance is porcelain – fused to metal. A porcelain veneer is fused to a metal core with high heat, providing a crown with great compression and tensile strength, at a color that can be matched to fit in well. PFM’s have a long, proven track record.
All-resin crowns are constructed from a composite material. They are relatively quick and easy to make, and are a good compromise between strength, appearance, and affordability. While their visually good enough to work in the “smile zone”, they don’t have the durability of other materials. Dentists often use prefabricated resin for temporary placements until a ceramic or PFM can be installed.
What to Expect When Getting a Dental Crown in Boise
What happens when you need a dental crown? Here’s how you can expect the process to go at Modern Dental.
The Initial Appointment
When the dentist determines a crown needs to be placed (based upon any of the reasons mentioned earlier), the tooth needs to be prepared. Whereas a filling simply fills the empty cavity left in your tooth, a crown is meant to fit perfectly over what’s left of a damaged tooth.
For a perfect fit, the tooth is trimmed and smoothed down so that the crown can easily and perfectly fit on top. While a special cement will hold the crown in place, a perfect fit is required for long-term strength and durability.
Once the tooth to be restored has been shaped, we need to make an impression of it. We can use an impression tray with a special compound to get a perfect mold of the patient’s teeth or a high resolution digital impression, whichever will work best.
Before sending our impressions off to the lab (usually 1-2 weeks), a color match will be made so that the crown will match the patient’s teeth.
We wouldn’t want to leave someone hanging with a filed-down tooth, so we’ll place a temporary crown made from resin or steel. This will protect the prepared surface and provide functionality in the interim. While the temporary crown works, hard, chewy, or sticky foods should be avoided.
The Follow-Up Appointment
Don’t worry; most of the work is already done! This appointment is the “fitting” of the patient’s new crown, and it’s usually quick and easy.
Once the tooth is anesthetized, we’ll remove the temporary crown that was in place. We’ll then “try on” the new crown, making sure the fit is perfect and that the crown looks right. If adjustments are needed, we can usually make them then and there.
Once the Dr. Wagner or Dr. Royce is happy with the crown, it will be permanently cemented into place. We may have the patient bite down on something soft to help the crown set, and then all that’s left is to clean the tooth! Easy, right?
Home Care After a Dental Crown
If maintained properly, dental crowns can last for many years.
In addition to good oral hygiene (brushing and flossing), we recommend avoiding hard, chewy foods. These can already be tough on teeth, but they have the potential to damage or dislodge a crown.
Patients that struggle with bruxism should consider wearing a mouthguard. Over time, repeated grinding will wear down both teeth and crowns.
In the event that the “bite” of a new crown is uncomfortable or doesn’t feel right, let us know so we can make an adjustment.
In the event that a crown ever comes out, find the crown (if possible). We may be able to reattach the crown, preventing the patient from waiting for a new one. Gently clean both the crown and the exposed tooth, and call the practice immediately. A tooth missing the protective crown is fragile and is exposed to bacteria.
If you think a crown may be right for you, or if you’d like to learn more about the process, give our Boise dental team a call. They’re always more than happy to help out where they can!
~ Dr. Wagner