What is it? | Consultation | Procedure | Recovery

What are Dental Crowns?

A crown is a type of dental restoration which completely caps or encircles a tooth or dental implant.Crowns are often needed when a large cavity threatens the ongoing health of a tooth. They are typically bonded to the tooth using a dental cement. Crowns can be made from many materials, which are usually fabricated using indirect methods. Crowns are often used to improve the strength or appearance of teeth. While unarguably beneficial to dental health, the procedure and materials can be relatively expensive.

Types of Dental Crowns

Permanent crowns can be made from all metal, porcelain-fused-to-metal, all resin, or all ceramic.

- Metals used in dental crowns include gold alloy, other alloys (for example, palladium) or a base-metal alloy (for example, nickel or chromium). Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum. Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, metal crowns rarely chip or break. The metallic color is the main drawback. Metal crowns are a good choice for out-of-sight molars.

- Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown’s porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown’s porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth.

- All-resin dental crowns are less expensive than other crown types. However, they wear down over time and are more prone to fractures than porcelain-fused-to-metal crowns.

- All-ceramic or all-porcelain dental crowns provide the best natural color match than any other crown type and may be more suitable for people with metal allergies. However, they are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.

- Temporary versus permanent. Temporary dental crowns can be made in your dentist’s office whereas permanent crowns are made in a dental laboratory. Temporary crowns are made of acrylic or stainless steel and can be used as a temporary restoration until a permanent crown is constructed by the dental laboratory.

* Information has been taken from different online sources. Mostly from www.webmd.com/ and http://www.simplestepsdental.com

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Consultation

During your first consultation the dentist of your choice will ask you a number of questions and discuss the following health related topics, desires and lifestyle to evaluate your medical record:

1. Your medical condition, drug allergies and previous medical treatments.

2. If and what kind of current medications, vitamins, herbal supplements, alcohol, tobacco & drugs you use.

3. If and which previous surgeries you have already realized.

4. Your general health status and any pre-existing health conditions or risk factors.

5. Define if you´re a candidate for the specific procedure.

Your Dentist will also inform you where your procedure will be performed. This facility, like an office-based surgical center, outpatient or ambulatory surgical center, or a hospital, is accredited and regularly audited by FlyClinic®.

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Procedure

To place a dental crown, your dentist will file down the tooth to make room for the dental crown.If you are receiving an all-metal dental crown, less of the tooth needs to be removed because these dental crowns can be made thinner than PFM or ceramic ones.

After filing down the tooth, there are two ways to make permanent dental crowns.

Most dental crowns require two visits to the dentist. You receive a temporary dental crown at the first visit and wear it while your permanent crown is made.

Some dentists have a machine that makes a dental crown in one visit.

With the traditional approach to making a dental crown, your dentist first will use a piece of thread or cord to push the gum away from the tooth. Then the dentist will make an impression (copy) of the tooth using a rubber-like material. The impression material sets in about five minutes. Then it is removed.

Your dentist will also take an impression of the teeth above or below the tooth that will receive the dental crown. The purpose is to make sure the crown will fit into your normal bite. The impressions are sent to the lab, where the dental crown is made. During that time, you will have a temporary crown placed. These crowns are usually made of plastic. They can be made in advance by the laboratory or made by the dentist during your preparation visit. Then the dentist fits the temporary crown to your tooth. These dental crowns are not meant to last for a long time. In some cases, however, a temporary dental crown can stay in place for a year or longer. If it needs to last longer, a lab-made plastic dental crown is best. It is stronger and will last longer than a temporary plastic dental crown that is made by the dentist.

Temporary cement is used to keep this dental crown in place. It is special cement that is designed to be weak. This allows your dentist to easily remove the temporary dental crown so your permanent dental crown can be placed. At a second visit, your dentist will remove the temporary dental crown and test the permanent one. Sometimes dental crowns need more polishing or glazing or some other adjustment before they are placed.

Once the dental crown is ready, it is permanently cemented on your tooth. If your dentist owns a Cerac or CAD-CAM unit, a dental crown can be made in one visit.

First, a 3D image of the prepared tooth is fed into the unit. Then a computer makes the dental crown from a block of porcelain. The dentist places the dental crown during the same visit. to be filled to restore the tooth to its original form and function.

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Recovery from the Procedure

It is FlyClinic®´s concern to provide you comprehensive information about the procedure you want to choose, as well as important facts about the safety and risks of the procedure you selected.

You shouldn’t feel any discomfort or sensitivity after a dental crown is placed. However, if your tooth has not had a root canal it will still contain the nerve. You may therefore have some temporary sensitivity to cold. If you notice pain or sensitivity when you bite down, contact your dentist. Usually this means that the crown is too high. This can be adjusted easily.

You may notice a thin, dark line next to the gumline on your crowned tooth if you look very closely in the mirror, particularly if you have a PFM crown. This dark line is the metal of the crown showing through. This is not a concern unless it appears on your front teeth and is visible. An all-porcelain crown, with no metal base, may be required to replace this crown.

A crowned tooth is protected from decay, except for the gum line. Your dentist may prescribe a high-fluoride gel for you to use every night if you have a high risk of developing cavities. A crown does not protect against gum disease. You should continue to brush twice a day and floss daily.

Dental crowns, especially all-porcelain ones, can chip. This can sometimes be repaired in the mouth. Your dentist will etch the porcelain with a special agent and then bond a composite resin to it to fix the chip.

Porcelain repairs often don’t last long. If there’s a lot of chipping, you may need a replacement crown. If the crown does not fit well over the prepared tooth, it’s possible that the cement will wash out from under the crown. However, the dental crown may not fall out right away. Under these conditions, bacteria will leak in and cause decay. If your dental crown seems loose when you chew, or if you have an unusual odor around the tooth, discuss this with your dentist. Your dentist will check your crowns at your regular visits.

Dental crowns sometimes fall out. This can be caused by washed-out cement or an improper fit. If this happens, place the dental crown in a secure, zip-top plastic bag. Then bring it to your dentist. Most of the time a new dental crown needs to be made. The old dental crown can be used as a temporary crown. If you are in no discomfort and your appearance is not affected, don’t try to put the crown back in place yourself. If you do need to put it back in your mouth, clean it well on the inside. Use a toothpick to loosen and remove any cement or debris that is stuck to the dental crown. A wet cotton swab can finish the cleaning. You can replace the dental crown temporarily using denture adhesive or temporary cement. This is sold in many pharmacies. Contact your dental office right away and try to schedule a visit for the next day.

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