Dental Crown Treatment

What is a dental crown?

Your last dental visit may have seen your dentist recommend a dental crown. And you probably have questions like: What is a dental crown?

The structure or anatomy of a tooth has two main parts:

• The root, which is the foundation of the tooth and, is hidden below the gum line.
• The crown, which is the part of the tooth visible above the gum line and usually covered by enamel.

A dental crown is a tooth-shaped cap placed over a tooth to restore its shape, size, strength, and appearance. When cemented into place, a crown fully or partially covers the visible part of a tooth hence the name.

Why do I need a dental crown?

Your tooth may require dental restoration using a dental crown/cap for various reasons, such as:

• Holding a cracked tooth together to prevent it from splitting and eliminate pain when chewing.
• To cover a tooth with a large filling to prevent it from fracturing.
• To restore a tooth excessively worn due to attrition, abrasion, or erosion caused by a gum disease.
• Improve the appearance of teeth that are misshaped, discolored, or have spaces between them.
• To cover a dental implant, which is used to replace missing teeth.
• To support a dental bridge, which is used to fill a gap in the dental arch caused by a missing tooth/teeth.

What types of crowns are there?

Various materials are used to make dental crowns, like:

Base metal alloys

Dental crowns made from base metal alloys are resistant to corrosion, considerably strong, and only require a small amount of healthy tooth to be removed before being fitted.

The metal alloys have a high content of non-precious metals like cobalt, chromium, and nickel.

Metal dental caps are quite conspicuous, which some people might consider a disadvantage. They are therefore better suited for out-of-sight molars.

Gold alloys

Dental crowns made from gold alloys contain gold and other metals like copper, palladium, and platinum.

These crowns neither fracture nor wear the underlying tooth. Moreover, they are biocompatible with gum tissue and are gentle on opposing teeth.

Ceramic/All-porcelain

All-porcelain dental crowns have a natural color that blends well with that of your teeth. For this reason, they are often used to restore front teeth.

They are however less suited for molars and premolars because ceramic is capable of breaking when exposed to high biting forces.

Porcelain-fused-to-metal (PFM)

Porcelain-fused-to-metal caps give you the best of both worlds. The porcelain part looks like a real tooth while the metal bit provides durability.

However, the metal part may sometimes become slightly visible at the gum line, appearing like a dark line.

Porcelain-fused-to-metal crowns are well suited for front and back teeth plus long bridges where strength is especially needed.

All-resin

All-resin crowns are the least expensive of all dental crowns. However, they wear down with time and are prone to fractures.

Stainless steel

Stainless steel dental crowns are temporary premade crowns. They are generally used to cover milk teeth in children.

When the baby tooth falls off to make space for the permanent tooth, the dental crown falls off with it.

What to expect when getting a dental crown placed

It usually takes a dentist two separate appointments to make and place a customized dental crown for a patient.

The first dental visit involves examining and preparing the tooth to be crowned, taking an impression of the tooth, and placing a temporary crown to protect it.

During the second visit, the dentist removes the temporary crown and cements the permanent one in place.

First visit: Tooth Preparation

During this visit, your dentist may take an X-ray of the tooth to be crowned and the surrounding jawbone.

If there’s extensive decay or other factors that could increase the risk of infection or injury to the tooth’s pulp, a root canal treatment may first be required.

The dental crown procedure will begin with your dentist numbing/anesthetizing your tooth and the gum tissue around it.

The second step will be reshaping the tooth by filing down its chewing surface and sides to make room for the crown.

The extent of reshaping will depend on the type of dental crown used. Metal-based caps tend to be thinner than porcelain crowns and therefore require the removal of less tooth structure.

On the other hand, if a large part of the tooth is damaged or decayed, your dentist will first use filling material to build up the tooth before reshaping it.

Once the tooth is shaped, your dentist will make an impression of it to ensure the crown made best fits the tooth. Most dentists use a thick liquid material like alginate to make impressions.

This material is poured into a U-shaped stock or custom impression tray and placed on to the upper or lower set of teeth. After a few minutes, the impression material sets and hardens becoming an elastic solid.

Your dentist will then remove the impression tray and sent it to a dental laboratory where your crown will be fabricated and designed.

An impression of the opposing teeth will also be taken to ensure the crown fits well to the other side of the mouth.

For porcelain dental crowns, your dentist will also determine the shade of your teeth using a shade guide or take pictures of the teeth to help the lab tech make a crown that matches your teeth’s color.

The process of making a crown usually takes two to three weeks. During this period, you will need a temporary dental cap to protect your tooth.

Temporary crowns are commonly made of acrylic and are held in place using a temporary cement.

Second visit: Permanent crown placement

During your second visit, your dentist will numb your tooth (not necessary), remove the temporary dental cap, and clean off any temporary cement residue. Next, your dentist will check for fit, shape, and color of the permanent dental crown.

Minor adjustments to ensure the restoration’s fit can be achieved through, trimming or buffing. After your dentist cements the crown, changing color and some shape modifications cannot be done.

You should therefore not let your dentist permanently cement your crown unless you’re satisfied with its appearance.

After the necessary modifications, your crown can now be positioned and fastened. Your dentist will add dental cement inside the dental cap before placing it on your tooth.

Once this cement begins to set, your dentist will scrape off the excess then perform a bite test. Your dental crown placement is complete!

How long does a dental crown take?

A dental procedure takes two-three weeks and two dental visits to complete due to the time taken to fabricate a dental crown.

The first visit which involves preparing your tooth and taking its impression takes about 50 to 90 minutes. While the second visit, during which the dental crown is placed and fastened, takes 20 to 30 minutes.

Thanks to advanced technology, crown placement can also be done in a day. Instead of taking impressions, a scanning device called a wand takes pictures of your teeth.

These images are then uploaded to computer software to create a 3D model of your tooth. The model is used to make a ceramic crown the same day.

This process is called computer-aided design and manufacture of dental crowns (CAD/CAM) and usually takes about 15 minutes.

How long do dental crowns last?

On average, dental crowns last 5 to 15 years. A crown’s lifespan mainly depends on how well you look after it. With proper care, it can even last 30+ years.

How much does a dental crown cost?

The cost of getting a dental crown depends on various factors such as the material used, the location of the tooth, your location in the country, the level of damage et cetera. But on average, dental crowns cost from $800 to $1700 or more per tooth. On average,

• Porcelain crowns cost between $800 and $3,000 per tooth
• Metal crowns made of gold alloy or base metal alloys cost between $830 to $2,465 per tooth
• Porcelain-fused-to-metal crowns cost between $875 and $1,400 per tooth.

To know the exact cost for the dental crown you need, be it the cost of a crown molar or an all-porcelain crown, consult your dentist.

How to take care of a dental crown

As mentioned before, during the first dental visit, your dentist may place a temporary dental cap on your tooth. Here’s how to care for it:

• Avoid sticky or chewy foods like caramel and chewing gum as they may pull out the cap.
• Avoid eating hard foods like raw vegetables which, could remove the crown.
• Chew most food on the side of the mouth without the temporary cap.
• Slide dental floss while cleaning between your teeth to avoid pulling out the dental crown.

As for the care of your permanent dental crown goes, here are some tips:

• For the first few days, avoid eating sticky or hard foods to give your crown time to heal.
• Use sensitivity toothpaste to help ease the sensitivity to cold food or drinks you might feel in the initial days.
• Brush and floss regularly and thoroughly.
• Use a fluoride rinse and fluoride paste to strengthen the underlying enamel and prevent root decay.
• Avoid chewing on ice or other materials that could chip or fracture your dental crown.
• Going for regular dental check-ups.

Dental Crown FAQs

[expand title =”References ⌵”]

• Dental Crowns (2019) https://www.animated teeth.com/dental_crowns/t4_dental_crowns_steps.htm.
• Dental Crowns guide(2017) https://www.webmd.com/oral-health/guide/dental-crowns
• How Much Does A Porcelain Crown Cost (n.d) https://www.colgate.com/en-us/oral-health/cosmetic-dentistry/bridges-and-crowns/how-much-does-a-porcelain-crown-cost-0617
• Types of Dental Crowns and Their Advantages (n.d) https://statelinedental.com/types-of-dental-crowns-and-their-advantages/

[/expand]