Dental crowns, often referred to as dental caps, are custom-made coverings that fit over a damaged or decayed tooth. Functioning much like a helmet protects your head, a dental crown shields your tooth, restoring its shape, size, strength, and improving its overall appearance. If you’re experiencing tooth issues and wondering about solutions, understanding dental crowns is a great first step.
Understanding Dental Crowns
What is a Dental Crown?
A dental crown is essentially a tooth-shaped cap that your dentist meticulously designs to encase your entire visible tooth surface, starting from the gum line. These aren’t one-size-fits-all; each crown is individually crafted in a dental laboratory to precisely fit your tooth. Dental crowns are constructed from a variety of durable materials, each with its own advantages:
- Porcelain: Known for its natural look, porcelain crowns are a popular choice for front teeth due to their ability to closely mimic the color and translucency of natural enamel.
- Zirconia: A type of ceramic, zirconia is exceptionally strong and biocompatible, making it a robust and aesthetically pleasing option, suitable for both front and back teeth.
- Gold Alloys: Gold crowns are incredibly durable and long-lasting. While not tooth-colored, their strength and biocompatibility make them an excellent option, especially for back molars where strength is paramount.
- Porcelain-fused-to-Metal (PFM): These crowns offer a blend of strength and aesthetics. A metal base provides durability, while an outer porcelain layer offers a natural tooth-like appearance.
Why You Might Need a Dental Crown
Dental crowns are versatile restorative solutions, recommended in various situations to protect and enhance your teeth. Your dentist might suggest a dental crown if you:
- Have a Broken or Cracked Tooth: When a tooth is fractured or chipped, a crown can hold the damaged pieces together, preventing further damage and restoring functionality.
- Have a Severely Decayed Tooth: If tooth decay is extensive and a filling isn’t sufficient to restore the tooth’s structure, a crown can cover and protect the remaining tooth after the decay is removed.
- Have Undergone Root Canal Treatment: Following root canal therapy, a tooth can become more brittle. A crown is often placed to protect and strengthen the treated tooth, preventing future fractures.
- Need to Protect a Weak Tooth: For teeth weakened by large fillings or cracks, a crown acts as a reinforcement, preventing the tooth from breaking down further.
- Require Support for a Dental Bridge or Denture: Crowns can serve as anchors to securely hold a dental bridge in place, replacing missing teeth. They can also improve the fit and stability of partial dentures.
- Want to Cover Stained or Misshapen Teeth: For cosmetic purposes, crowns can effectively conceal severely discolored, poorly shaped, or teeth that are significantly smaller than average, enhancing your smile’s appearance.
The Dental Crown Procedure: What to Expect
Getting a dental crown typically involves two dental visits. Here’s what you can expect during each appointment:
Step-by-Step Procedure
First Visit: Tooth Preparation and Impression
- Examination and Preparation: Your dentist will first examine the tooth to ensure a crown is the appropriate treatment. They will then prepare the tooth by reshaping it. This involves removing a layer of the outer tooth surface to create space for the crown to fit properly. The amount removed depends on the type of crown material used.
- Local Anesthesia: To ensure your comfort throughout the preparation process, a local anesthetic is administered to numb the tooth and surrounding gums, eliminating any pain or discomfort.
- Taking Impressions: Once the tooth is prepared, an impression of your tooth is taken. This can be done in a couple of ways:
- Traditional Impressions: Using a putty-like material placed in a dental tray, your dentist will create a mold of your teeth.
- Digital Impressions: Increasingly common, digital impressions involve using a scanner to create a 3D digital image of your teeth, offering greater precision and patient comfort.
- Temporary Crown Placement: While your permanent crown is being custom-made in a dental lab (which usually takes 2 to 3 weeks), a temporary crown is placed to protect the prepared tooth. Temporary crowns are typically made of plastic or aluminum and are fitted using temporary cement.
Second Visit: Permanent Crown Fitting
- Temporary Crown Removal: At your second appointment, the temporary crown is carefully removed.
- Permanent Crown Fitting and Adjustment: Your dentist will then try on the permanent crown, checking for fit, shape, and color match with your adjacent teeth. They will make any necessary adjustments to ensure a perfect fit and comfortable bite.
- Permanent Cementation: Once the fit is verified, the permanent crown is cemented into place using a strong dental adhesive or cement, ensuring it is securely bonded to your prepared tooth.
Illustration of a dental crown procedure.
Same-Day Crowns (CEREC)
For some patients, the convenience of a same-day crown is available through CEREC (Chairside Economical Restoration of Esthetic Ceramics) technology. CEREC utilizes CAD/CAM (computer-aided design and computer-aided manufacturing) technology. In a single visit:
- Digital Impression: A digital impression of your tooth is taken.
- Crown Design: The CEREC software creates a 3D model of your tooth, and your dentist designs the crown digitally.
- On-site Milling: The design is then sent to an in-office milling machine that precisely crafts your crown from a ceramic block while you wait.
- Fitting and Cementation: The newly milled crown is then fitted, adjusted, and cemented, all within the same appointment, eliminating the need for a temporary crown and a second visit.
Caring for Your Dental Crown: Maintenance and Longevity
With proper care, a dental crown can last for many years, often 10 to 15 years or even longer. Treat your crowned tooth as part of your natural teeth with consistent oral hygiene practices:
Oral Hygiene is Key
- Brush Twice Daily: Continue to brush your teeth at least twice a day using fluoride toothpaste and a soft-bristled toothbrush. Pay particular attention to the area where the crown meets the gum line to prevent plaque buildup.
- Floss Daily: Floss daily, especially around the crowned tooth, to remove food particles and plaque from areas your toothbrush can’t reach.
- Fluoride Mouthwash: Consider using a fluoride mouthwash to further protect your teeth and crown.
Regular Dental Check-ups
Maintain your regular dental check-up appointments. Professional cleanings and examinations are crucial for monitoring the health of your crown and surrounding teeth and gums. Your dentist can identify and address any potential issues early on.
What to Avoid
- Hard and Sticky Foods: Avoid chewing on very hard foods, such as ice, hard candies, or nuts, as they can potentially damage or fracture your crown. Sticky foods can also dislodge a crown.
- Teeth Grinding (Bruxism): If you grind your teeth, especially at night, talk to your dentist about a nightguard to protect your crown from excessive pressure.
Benefits and Potential Downsides of Dental Crowns
Dental crowns offer significant advantages for restoring and protecting damaged teeth, but it’s important to be aware of potential drawbacks as well.
Advantages of Dental Crowns
- Protection and Strength: Crowns provide robust protection to weakened or damaged teeth, preventing further breakage and restoring their structural integrity.
- Restored Functionality: They enable you to chew and speak comfortably and confidently, restoring your bite and overall oral function.
- Improved Appearance: Crowns can dramatically enhance the appearance of teeth, correcting discoloration, shape, and alignment issues, leading to a more attractive smile.
- Durability: When made from appropriate materials and properly cared for, dental crowns are durable and long-lasting restorations.
Potential Risks and Complications
- Sensitivity: You might experience some temporary tooth sensitivity after the crown preparation, particularly to hot and cold temperatures. This usually subsides within a few weeks.
- Chipped or Broken Crowns: Although durable, crowns can occasionally chip or fracture, especially if subjected to significant force or trauma.
- Crown Loosening or Falling Off: In some cases, the cement securing the crown can weaken over time, causing the crown to loosen or detach.
- Allergic Reactions: Although rare, some individuals may experience allergic reactions to the materials used in certain types of crowns, particularly metals.
- Gum Disease: If the crown margin isn’t properly placed or if oral hygiene is inadequate, it can increase the risk of gum disease around the crowned tooth.
Dental Crown Alternatives: Exploring Your Options
Depending on your specific dental needs and situation, there might be alternative treatments to consider instead of a dental crown:
Alternatives to Crowns
- Dental Fillings: For smaller areas of decay or damage, a filling might be sufficient to restore the tooth without needing a full crown.
- Dental Veneers: Veneers are thin shells placed over the front surface of teeth, primarily used for cosmetic improvements, correcting minor imperfections, chips, or discoloration on front teeth.
- Dental Bridges: If you have a missing tooth, a dental bridge can be used to fill the gap, anchored to adjacent teeth. While bridges often involve crowns on the anchor teeth, they are a different approach than crowning a single damaged tooth.
- Dentures (Partial or Complete): For more extensive tooth loss, dentures, either partial or complete, are removable appliances that can replace multiple or all teeth.
- Dental Implants: For missing teeth, dental implants are a more permanent solution, involving surgical placement of a titanium post into the jawbone, upon which a crown is then placed.
Choosing the Right Option
The best course of treatment is highly individual and depends on the extent of tooth damage, location, your oral health, and cosmetic goals. It’s essential to have a thorough consultation with your dentist or a prosthodontist (a specialist in restorative dentistry). They can assess your specific situation, discuss all suitable options, and help you make an informed decision about the best way to restore your smile and oral health.
Dental crowns are a reliable and effective solution for restoring damaged teeth, offering a blend of protection, function, and aesthetic improvement. Understanding what a dental crown is, the procedure involved, and the care required will help you feel confident and informed if this treatment is recommended for you. Always consult with your dental professional to determine the most appropriate treatment for your individual needs.
