Crowns

 

A dental crown is a form of tooth repair which partially or completely covers the existing tooth. There are various reasons why a tooth may require a dental crown or "cap".

• Very large sections of the tooth have been lost to decay, breakage, or wear.
• The tooth has had a root canal which leaves a tooth more susceptible to breakage.
• Covering discolored or malformed teeth.
• Restoring a bad bite or "malocclusion".
• Teeth with partial or incomplete fractures
• Teeth used as anchors for a bridge which replaces a missing tooth.
• Restoring a dental implant

The placement of a crown usually requires two appointments at the dentist. CEREC crowns may be finished in the same appointment while some cosmetic crowns may involve an extra appointment to evaluate appearance before the final crown is made.

1. At the first visit, the dentist will numb your teeth and the gums around them. The remaining tooth will be shaped and contoured to make a shape which allows enough space to place the crown and has a shape which will make the crown "stick".
2. The dentist will make an impression or mould of the tooth. This will be sent to the dental laboratory for fabrication of the crown. The fabrication process may take two to three weeks. The dentist sends instructions to the lab regarding tooth shape and color to guide the technician.
3. A temporary crown will be placed on your tooth. This will protect the tooth during the wait and can also serve as a guide for the shape and color of cosmetic crowns. While wearing a temporary crown you should be very careful brushing and flossing. Pull the floss out to the side if possible. Avoid sticky or very hard foods. Avoid eating on the crown as much as possible. If your temporary should come off or break, call your dentist's office. You may be able to seat the temporary crown back on the tooth with vaseline or toothpaste until you can seek attention. Note that it is not uncommon to have sensitivity, bite problems, and sore gums surrounding a temporary crown. It's always a good idea, however, to check with the dentist if you are having a problem.
4. At the second visit, the new dental crown is tried in and minor adjustments to the fit and bite may be made. The dentist should ask you if the appearance of the crown is satisfactory. Finally the dental crown is filled with sealer/cement and seated on the tooth. The excess cement is removed and your new crown is ready for action.

If the dentist recommends a crown for your tooth and you decide not to have it done, you may experience the following results:

• Nothing may happen.
• The tooth may break, but cause no further problems.
• The tooth may break and cause pain and further damage.
• The tooth may be lost.

As with most dental problems, if you wait until you are aware of the problem it may be to late to do anything about it.

Following the placement of a dental crown, you may experience a number of things.

• Sensitivity. This is the most common problem seen following crown placement. Usually time (a few days to a few weeks) will allow the tooth to settle down. The dentist may elect to place a desensitizing gel on the tooth. You may also try one of the many desensitizing toothpastes available. Also note that, in some rare instances, a tooth which has been restored a few times over the years and then prepared for a crown may have permanent nerve damage that was not evident before and require a root canal. This doesn't happen often, but be aware of the possibility.
• Bite. The dentist checked the bite when the crown was placed, but occasionally, the bite will feel different after the numbness has worn off. This is something you should have the dentist take care of as soon as possible. The fix is easy, but if you let it go you could have pain in the tooth from the bite and even nerve damage.
• If your crown comes off, don't panic. If the tooth doesn't hurt, you may just leave the crown off until you can see the dentist. You may try to line the crown with vaseline or toothpaste and stick it back in there. Just be careful not to bite hard on it or swallow it. Oh yes, if you should swallow your crown or bridge, don't worry, this too shall pass...in about 24-48 hours. You can choose to wait on it or see your dentist for a new one.

Dental crowns can be made from metal, porcelain, or a combination of the two. Porcelain crowns are the most esthetic, but may not last as long as their metal counterparts. Crowns can last indefinitely, but generally they have a life of 7-15 years. Contrary to popular belief, a crown can get decay around the edges and can wear or break. They may also develop visible edges and may not always match their neighbors in shade and shape.

The cost of crowns varies widely across the country generally in the range from $600 to $1,200. As with anything you can always find it for less and generally get what you paid for. If your tooth needs a crown, but you are unable or unwilling to undergo the procedure, you can wait awhile, perform a temporary procedure to prevent further tooth loss, or seek financial assistance. Some might seek to have the tooth removed, but this choice often leads to far worse problems in the future.