Dental Crown: Purpose, Procedure And More

There are numerous reasons for which your dentist may recommend a dental crown. Some of these reasons include to restore, protect or to strengthen a tooth that has been damaged or worn down. Also, it helps to improve the appearance of a patient’s smile by covering a dental implant to create the look of natural replacement tooth or by changing the colouror size of a tooth.

• Appearance

The look and appearance of the teeth are essential for most people because it plays a major role in the look of a person’s face and smile. It also contributes to a person’s overall confidence. Dental crowns are used to cover severely stained teeth or badly damaged teeth when partial coverage with veneer is not a suitable option. A dental crown can as well be used to cover and offer support to a tooth that has a large filling, and only a small section of the natural tooth is remaining. In such as situation, a veneer cannot be used since it cannot last long when only a small section of the tooth remains. Contrarily, a dental crown canoffer full coverage to fit the colour, shape and size of the tooth.

• Stabilisation

A dental crown can be used to stabilise and offer support toother dental prosthetics such as a denture or dental bridge. An example of this is when a dental crown is fixed to two healthy teeth, one on each side of the empty left by a missing tooth. This offers two anchor points where the bridge can be placed and held firmly in place. However, this technique is becoming less popular after the introduction of dental implants since they do not require any dental work on the adjacent healthy teeth.

• Protection and Restoration

A dental crown is used to mend and restore the appearance and function of a tooth that has been worn down or seriously impaired by tooth decay. For instance, a crown can be used to restore a tooth that has received an endodontic treatment or a root canal therapy. This procedure involves cutting off blood supply and nerves in the tooth such that it becomes devitalized and the space that initially held the blood vessels and nerves is filled to prevent infections from oral bacteria. This treatment procedure leaves the tooth weaker and fragile than the vital teeth such that it is susceptible to break or fracture. Therefore, the dentist places a dental crown on the tooth to prevent it from fracturing. A dental crown can similarly be used toclasp a cracked tooth together so that it does not end up breaking off completely hence protecting it from further damage and infection.

Dentists make useof several diverse types of materials when designing dental crowns for their patients. Eachof these materials come with different benefits for the protection of the tooth and the overall oral health.

– Porcelain

Dental crowns that are madeof porcelain or ceramic are mostly preferred for the front teeth since they provide superior aesthetics. These materials are translucent. Therefore, they are almost similar to your natural teeth, and also they can be precisely shaded.

Pros

• Strong and durable.
• Aesthetically appealing since they are natural looking.
• No metal means that the dentist can see through the crown in x-rays.
• It is an excellent option for those with metal allergies.

Cons

• Quality of the material is the key to the aesthetic success and durability.

– Porcelain Fused to Metal

This type of dental crown comes with numerous benefits of both metal crowns and ceramic crowns. Porcelain is used to design the visible part of the crown while the metal is used to create the remaining part which is fitted into the tooth that needs to be repaired. Porcelain fused to the metal dental crown is stronger than crowns made of porcelain only. They offer a good seal to protect against leakage and further tooth decay.

Pros

• Durable and long lasting.
• It is aesthetically appealing as long as the metal does not show through.

Cons

• Not suitable for patients with metal allergies.
• Metal margin below the porcelain may show through as a dark line thus making the tooth not quite as natural looking.

– All-metal

This type of dental crown is madeout of metal alloys such as gold, nickel, palladium or chromium. Over the past years, this type of crowns was popularly used for teeth that are expected to withstand heavy biting and chewing forces, usualmolars at the back of the mouth. However, with recent advancement technology in dentistry has provided an ideal alternative for teeth of this nature.

Pros

• Durable and long lasting.

Cons

• Not aesthetically pleasing.
• Not suitable for patients with metal allergies.
• Some patients experience cold/hot sensitivity with metal dental crowns.

– Stainless Steel

This material is often used for temporary dental crowns. They are prefabricated and are only meant tobe used while the permanent crown isbeing made. Also, it is common for children to have a stainless steel crown as they wait for their tooth to fall out naturally. Unlike other types of dental crowns, these crowns do not require multiple dental visits for them to be fixed or care for them.

– All-resin

Usually, crowns made out of this material are quite cheap. The material tends to wear down over time, and it is not very sturdy. Therefore, it can easily crack or fracture. All resin dental crowns need tobe replaced quite often,and this may lead to having the tooth permanently extracted if there is no sufficient material to fuse the crown.

– Zirconia or milled Crown

Dental crowns made from these materials are conveniently made in the dental office, without the need togetting a temporary crown or having to wait for the usual two weeks. Normally, these crowns are comfortable,and they can be made from a wide variety of colours. Therefore, they can blend well with all the surrounding teeth without showing a huge difference.

The steps that are involved in the procedure of getting a dental crown depend on the reason the crown is needed in the first instance. Getting a dental crown installed is not a decision that should be taken lightly since it requires major tooth adjustment to make space for the new crown. The total of space that needs to be generated depends on how your teeth bite together and the material used to make the crown.

Step 1- Preparation

Usually, the preparation process may take the first two visits to the dental office; this visit involves preparation of the tooth to make it ready for a crown to be fitted onto it. A tooth under normal circumstances needs several alterations for the new crown tobe fitted.

Before any alterations are made to the tooth, your dentist will first take an x-ray and assess the condition of the teeth. This helps to make sure that the existing tooth is healthy and can carry a crown and that no complications will arise after fitting a crown. Mostly this step is performed as part of the consultation and the decision-making process.

During this process, the dentist will first numb the affected area using local anaesthesia so that you donot have any pain or sensitivity. Then, using special tools, the dentist will grind down the surface of the tooth. And in case the tooth already has a dental filling then there are no nerves left, and so this step may not be necessary. Additionally, if there are lost or loose dental fillings, the dentist will first need to build up the tooth structure to restore its height, shape and the space for the crown.

For a crown to stick on the tooth, there needs to be at least 2mm of the natural tooth all the way around. Without this, the crown will most likely snap off under pressure because it is only attached on to the dental filling. Most materials need to be at least 1-2mm thick so that they can offer maximum support to the crowns. Also, this offers enough depth for the crown to last longer in the mouth and to with stand pressure it will be exerted to without it cracking or breaking off. As a result, the affected tooth needs to be trimmed down by the same amount for fitting. The trim is normally 1-2 mm to make sure that the crown is designed to replace the natural crown and it will fit perfectly. The amount of trimming done may not seem like that much. However, this is quite invasive especially when you consider the thickness of a tooth. The thinning process involves removal of a large amount of, if not all of the enamel.

Once the enamel is removed, the process of shaping the tooth begins to provide a perfect surface on which the artificial crown will be placed. The surface of the tooth is shaped in a way that it is either straight or thinner towards the biting surface of the tooth. This will help in preventing the crown from slipping off once it has been struck down.

After the dentist is done with the preparation of the natural tooth, an impression of the tooth is taken so that the final crown can be custom made. An impression of both arches of the jaw will be taken so that it can allow a perfect crown tobe made. The arches of the jaw need tobe considered when designing the crown because when you do not want any problems or complications when you bite down, close your mouth or eat. Also, it is at this point when the colour of your teeth will be examined to make sure that they match with that of your crown.

Once all of these is done, the moulds are taken to the lab so that the crown can be made. In the meantime, the dentist will fit you with a temporary crown to protect your sensitive tooth and send you home for a couple of weeks.

Step 2- Fitting

After a couple of weeks on from the preparation stage, your final dental crown will be ready to be fitted. This second step is much faster, and it is less involving. However, it is still very essential as the crown needs tofitproperly so that it can stay in place for many years to come. Like your previous visit, you may be administered with anesthesia to numb the area while the dents do what they need to do.

Once the area has been numbed, the temporary crown will be removed, and the stump of the remaining tooth will be cleaned. The dentist will also test the position of the crown by checking its fit, assessment of your bite and the alignment with the other teeth before it is cemented in place. The dentist will also ensure that you are contented with the color of your crown.

It is possible for your dentist to make some minor adjustments to the stump of your tooth or crown. In other rare cases, this process may have to be stopped simply because the final crown does not fit perfectly. When this occurs, new impressions are taken, and the temporary crown will be put back again.

If they are no changes to be made and the patient is happy with the final crown, the dentist will place the crown over the prepared tooth using dental cement. Pressure will then be applied onto the crown to help form a seal and remove any excess dental cement. Usually, this step takes about 20-40 minutes to complete.

– Pain, Sensitivity and Discomfort

Most patients tend to experience some discomfort or pain around the affected area of the mouth after a dental crown has been placed. Usually, this improves after some days, but it may go for weeks without any assigned treatment. Many people choose to use simple pain medications to help in managing the pain. For instance, ibuprofen is mostly recommended to help reduce the pain thus making the patient feel comfortable.

Additionally, it is common for the patients to experience some sensitivity around the gums and teeth following the dental crown procedure. The gum and teeth sensitivity is common as a result of irritation from the dental cement. A topical anesthetic gel that is often readily available in most drug stores helps in relieving the sensitivity more effectively than oral pain medications such as ibuprofen. A tooth paste that is intended for sensitive teeth can also be helpful.

If the pain becomes severe or continues for several weeks after the dental procedure, it is recommended that you seek immediate dental advice to find what may be the cause. And as much as the dental crown may feel quite strange before the patient gets used to it in their mouth, in some instances, it may need some slight adjustment for it to fit the shape of the mouth properly. Also, if the bite is uneven and uncomfortable after several days, you may seek dental advice to find out whether it needs some adjustment.

– Numbness from Anesthetic

In case the dentist used a local anesthetic during the dental crown procedure, your mouth may still feel numb for several hours after the dental appointment. During this period, most patients are susceptible to bite or burn themselves unknowingly since they are unable to feel the heat or pain sensations as normal. It is recommended that you avoid taking any hot fluids or chewing hard foods to avoid any injury during this time.

The site of the anesthetic injection particularly on the lower jaw may experience some bruising and inflammation after the procedure. However, this will go away spontaneously without the need for treatment after several days.

Since temporary crowns are only meant to be a temporary fix until a final crown is ready. Below are several guidelines on how to care for them.
– Do not chew hard foods such as raw vegetables. Such foods can break or dislodge the crown.
– Minimize using the side of your mouth which has the temporary crown. Change the bulk of your chewing to the other side of the mouth.
– Keep off chewy and sticky foods such as chewing gum and caramel which have the potential of pulling off and grabbing the crown.
– Your gums may feel sore for a while after the procedure. Keep the affected area clean as possible; you can soak your mouth by holding water in your mouth for 1-2 minutes and rinse gently using warm salty water.
– Since temporary crowns are not strong, they tend to break off occasionally. When this happens, contact your dentist as soon as possible and bring your crown with you so that it can be replaced. If you cannot reach to your dentist immediately, buy some dental adhesive to fix the crown as you wait to visit the dental office.

– Crown Falls off

Some tooth stumps are not as retentive as others. If you have divergent walls or a short stump, it is possible for your dental crown to fall off. However, this can be prevented by making changes during the design process. Additionally, if your crown is placed too loosely, it will tend torely a lot on the dental cement for retention.

– Chipped Crown

Crowns that are made of porcelain may sometimes crack or chip. If a tiny chip appears on the crown, a composite resin may be used to repair it without replacing the entire crown. However, if the chip is extensive, then the crown will need to be replaced.

– Crown Develops a Cavity or Starts to Decay

Like natural teeth, dental crowns need to be smooth and fitted properly so that it is easy to keep them clean. Also, there is a need to brush regularly, floss and visit your dentist at least twice a year to keep your crown margins cleaned.

– Discomfort, pain or sensitivity

Your tooth may feel sensitive following the dental crown procedure since the anaesthetic will start wearing off. Also, if the newly crowned tooth still has the delicate nerves in it, then it is possible for you to experience some heat and cold sensitivity. You may brush your teeth with Sensodyne toothpaste to reduce the sensitivity.

– The color of your Crown does not match that of your natural teeth over time

Unfortunately, the color of your newly crowned tooth may not match the color of your natural teeth 5 or 10 years to come. Usually, this is because your natural teeth tend to discolor while your crown will not. A good way of maintaining the same color your teeth is to invest in teeth whitening every year so that you can maintain the color of your natural teeth from permanently getting stained.

– Dark Line on the Crowned Tooth next to the Gum Line

It is normal to have a dark line next to your gum line especially if you have a porcelain-fused-to-metal crown. This dark line is the metal of dental crown showing through from the root.

– Crown Collects food remains around it

Usually, dental crowns are designed in a way that they fit the sides of your adjacent teeth firmly to avoid any food from getting stuck while eating. However, sometimes these contact points can widen thus trapping food,and this can occur when your teeth shift or move.

What may seem to be just an artificial cap for your tooth is a complex piece of art that is designed to serve you for many years. A smile is one of the main things people notice about you and with well-maintained teeth, you can feel more confident,and your overall well-being is improved.

While you have to make the best decision based on your dental condition and budget, we hope that this article offers you some insight and awareness on what is involved so that you can make an informed decision.