Dental Crowns: A Detailed Briefing

A crown is a cap that’s placed over your tooth to cover it so you can restore the tooth to its shape, size, strength, and improve its appearance.

They are cemented into place to cover the tooth’s visible portion at and above the gum line.

Why would you need a crown?

You can find yourself needing one for any of these situations:

  1. Keeping a weak tooth from breaking or keep a cracked tooth together.
  2. Repair and restore a broken or worn down tooth.
  3. To keep a large filling safe and supported if the tooth couldn’t be saved in its majority.
  4. Keep dental bridges from moving.
  5. Hide teeth that are misshaped or discolored.
  6. Protect a dental implant.
  7. Modify cosmetic look.

For children, you may see crowns on baby teeth because:

  • Keep a baby tooth that’s been too damaged by decay for a filling.
  • Save teeth that could be ruined by tooth decay, especially from poor oral dygiene.
  • Prevent the frequent usage of general anesthesia for young children based on age, behavior, or history to improve their dental care.

In these instances, stainless steel crowns are typically recommended by a pediatric dentist.

What types are used?

You’ll find that there are five different types of permanent crowns: stainless steel, all metal, porcelain-fused-to-metal, all resin, or all ceramic.

  • Stainless steel – Usually used as a temporary measure, these crowns are prefabricated to protect teeth or fillings until the new crown is made from some other material. You can see these types of crowns in children for temporary fittings for baby teeth. It’s made to cover the tooth and protect it from more decay. The crown will come out with the primary tooth when the new, permanent tooth is ready to come in. These are typical for children because children don’t need to come back for multiple visits to get them put in place and are cost-effective measures compared to other types of crowns or dental care to keep a tooth safe without a crown.
  • Metals – These include gold alloys, other alloys, or even a base-metal alloy. With these crowns, you’ll find that you don’t need to lose a lot of your tooth to fit one of these crowns and the wear of other teeth is minimal. These are the best for higher biting and chewing forces and hold up to overall wearing. They don’t usually see many chips or breaks. The only drawback is the color, but you can find them valuable for back molars that are rarely seen.
  • Porcelain-fused-to-metal –These are matched to the color of your other teeth nearby, but you’ll see more wear and tear to other teeth with these crowns. The porcelain can chip or break though they look like real teeth. The metal underneath can be seen, however, as a dark line seen at the gum line or if your gums were to recede. They are great choices for front or back teeth because they look like your real teeth.
  • All resin – One of the lesser expensive types of crowns that can wear down with time and can fracture more than even the porcelain-fused-to-metal crowns can.
  • All ceramic or all porcelain – If you want the most natural looking crown, these are great for their color and even suitable for those with metal allergies. Though, you’ll find they aren’t as strong as the porcelain-fused-to-metal because of their lack of metal and they can wear down other teeth more than metal and resin crowns. These are perfect for front teeth.
  • Temporary versus permanent  – You will find temporary crowns are made right in your dentist’s office while you’ll have to wait for a laboratory to make your permanent ones. Temporary crowns are typically made from acrylics or stainless steel, which are placed over your tooth until your permanent one is being made.
  • Zirconia or milled crowns – For these crowns, you can find some dental offices capable of making them because they have the necessary software and hardware to digitally produced while others will be made in the lab. You can even have them made with one office visit without needing a temporary crown. What’s more is the dentist doesn’t need to make impressions for the crown.

How do you prepare a tooth for a crown?

This is usually a two-step process on separate visits to the dentist’s office: the first being the examining and preparing the tooth and the second involving the actual placement of the crown.

First Visit: Examining and Preparing the Tooth

With your first visit, you may want to prepare yourself for some X-rays your dentist will want to take so he/she can see the roots of the affected tooth and its surrounding bone. Depending on what your dentist finds, he/she may suggest a root canal prior to receiving your crown.

You’ll be anesthetized before your dentist does anything pertaining to your future crown so that your tooth and the gum tissue around it is completely numb. Then, he/she will filed down the affected tooth along the surfaces used for chewing and the sides so there is room for the crown when it’s placed permanently. You’ll find that the amount of tooth filed will depend on the crown you’re receiving. All metal crowns need less room than those of all ceramic ones, for example. Should you be missing a large portion of your tooth, your dentist will actually take time to fill this area of the tooth so it’ll support your permanent crown.

Once your tooth has completed its reshaping, your dentist will then take an impression of your tooth with either a paste or putty. Your dentist will also need impressions of the teeth above and below so they can keep your crown from affecting your bite.

With the successful impressions, your first visit is over as they are sent over to the lab where your crown will be made. It usually takes up to two or three weeks for the lab to send your completed crown back to your dentist. Porcelain crowns will need be shade-matched so the crown will match your teeth closest to it. While you’re waiting for your permanent crown, your dentist will fit you with a temporary one so your tooth will remain protected and prepared for the crown when it arrives. You’ll typically find these temporaries made from acrylic and only cemented in temporarily.

Second Visit: Receiving the Permanent Crown

When you return to your dentist, you’ll have the temporary crown removed and the permanent crown will be placed to check the overall fit and color. If it’s done correctly, you’ll have your tooth numbed once again and the new crown will be cemented onto your tooth permanently.

Taking Care of Your Temporary Crown

Since temporary crowns are as the name implies, there are some precautions you’ll want to follow as you wait for your permanent crown, including:

  • Stay away from sticky or chewy foods that can stick to your crown and pop it off the tooth.
  • Chew on the opposite side of your temporary crown to keep usage to a minimum.
  • Stay away from hard foods as well since they could crack your crown or even dislodge it.
  • Don’t lift out your floss when cleaning your teeth. You should actually slide it out to prevent popping the crown off your tooth.

Dental Crowns and Potential Problems

  • Discomfort or sensitivity – You may find the tooth is sensitive after your tooth’s sensation returns from the numbing medication. If the nerve is still attached, you can even find yourself sensitive to hot and cold temperatures in foods and drinks. You may find yourself using a sensitivity toothpaste for your teeth. If you’re feeling pain when you’re biting down, your crown is sitting too high, which means calling the dentist so he/she can file down the crown to the correct height.
  • Chipped crown – Chipping can happen with some crown types. Depending on the size of the chip, your dentist may either fill in the chip with a resin, keeping the crown intact, or pulling the crown for replacement if the damage is too extensive.
  • Loose crown – You can find that the cement has come out from under the crown. This is problematic for two reasons: your crown can loosen and you can become vulnerable to bacteria getting under your crown and decaying your tooth further. Call your dentist if your crown feels loose.
  • Crown falls off – It can happen. Basically, if your crown doesn’t fit right, doesn’t have enough cement, or there’s only a small amount of tooth holding your crown in place, you can find yourself with a crown that’s fallen off or out of its space. Should this happen, you need to clean the crown and your tooth. If you have some adhesive at home for dental needs, you can fix your crown temporarily or even through tooth cement you can purchase in store. Then, you’ll want to contact your dentist right away. While you’re waiting to get into his/her office, he/she will provide you with the right care procedures for your tooth and crown. He/she may be able to save the crown through re-cementing it or they may need to replace it with a new one depending on the situation.
  • Allergic reaction – You may find yourself allergic to your crown because of the materials used to make it. Some have a mixture of metals or even porcelain that can cause this reaction, but it’s pretty rare this happens.
  • Dark line under crown next to gum line – If this dark line appears, it’s actually pretty normal, especially if you have a porcelain-fused-to-metal crown. It just means that the metal is showing itself from under the porcelain. Though there isn’t anything typically wrong, your dentist may replace the crown for cosmetic purposes.

What are “Onlays” and “3/4 Crowns?”

These are two variations on dental crown techniques. Their difference lies in how they cover the tooth beneath them. While the traditional crown covers 100% of the tooth, these two only cover the tooth to a certain extent.

Length of Life for a Crown

Depending on your crown, you can expect your crown to last anywhere between five and fifteen years. It all comes down to the wear and tear one places upon said crown in its lifetime, your overall oral hygiene, and your personal habits, such as teeth grinding, ice crunching, and/or package opening with your teeth.

Any Special Care for Crowns?

Not really. Though you should remember that good oral health can help prevent decay and/or gum disease, to which crowned teeth aren’t impervious. So, brush your teeth twice a day minimally as well as floss once a day, getting the area where the crown meets the gum. You can also use an antibacterial mouth rinse to kill off more germs.

Overall Cost of a Crown

It depends actually on where you live and the type of crown being placed. You’ll find porcelain crowns cost more than gold ones, which are actually more expensive than porcelain-fused-to-metal crowns. In general, you can expect to spend anywhere between $600 to $1500 (or more for some) per crown placed. If you have insurance, you’ll find that some of the crown is typically covered, but you’ll want to double check with your insurance first.