If one or more of your teeth are affected by decay, chips, cracks, or other forms of damage, dental crowns may provide an ideal solution. Crowns offer both cosmetic and oral health benefits, reinforcing the structure of a tooth while helping to make a smile look whole and natural again. Crowns are typically custom-made to blend seamlessly into each patient's unique smile. They are carefully crafted to complement the surrounding natural teeth in terms of color, size, shape, and texture and to restore integrity to the patient's bite.
In order to create a custom crown, the patient's tooth must first be prepared and a mold must be taken. A temporary restoration is then used to protect the tooth until the permanent crown is ready to be placed.
In some cases, dental crowns are used to secure artificial teeth as part of a dental bridge. In other cases, crowns are attached to dental implants to replace missing teeth. The dental crown procedure generally involves two visits to the dentist over the course of two to three weeks, although many practices now offer same-day crowns.
While dental crowns can provide a significant cosmetic improvement to your smile, they can also provide strength and protection for damaged or weakened teeth. Your dentist may recommend a dental crown if:
- Your teeth are severely discolored and unlikely to respond well to professional teeth whitening
- Your teeth are misshapen or disproportionally small
- Your teeth are cracked or chipped
- Your teeth require additional support and strength
- Your teeth are severely decayed or otherwise damaged
- You are unable to comfortably chew food
- Your bite is not aligned properly
- The chewing surfaces of your teeth are worn down due to bruxism (teeth grinding)
- The damage to your tooth is too extensive to support a filling, inlay, or onlay
- You have undergone root canal therapy and need to protect the remaining tooth structure
- You are replacing a single missing tooth with a dental implant
A suitable candidate for dental crowns must also have healthy gums, because the restorations will work in tandem with the remaining healthy portion of the tooth or dental implant to provide support for the crown.
The concept of a dental crown covering a damaged tooth or restoring a dental implant is simple enough, but the variables involved in the process make it a unique experience for every patient, and no two price tags are alike. The preparation required, the number of dental crowns needed, the material used to make the crown, and other factors can cause the price to vary from patient to patient.
Although most insurance carriers cover at least part of the cost of dental crowns, the price of treatment may be a factor when reviewing your options for care. The surest way to find out how much you can expect to pay for dental crowns is to schedule a consultation with a reputable dentist. Be wary of choosing the cheapest dentist and crown material, as this may reflect a lower quality of service and cost you more time, discomfort, and expense in the long term.
In addition to the crown itself, there are other expenses associated with treatment. On average, patients can expect to pay the following amounts for each specific service:
- Dental exam: $40-$120
- Dental X-rays: $20-150
- Dental crown materials and treatment: $500-$2,500 per tooth
- Root canal: $750-$1,000 per tooth
- Dental implant: $1,500-$2,000 per tooth
The cost of treatment can be significantly reduced with dental insurance.
Because dental crowns are typically used to restore a damaged tooth, dental insurance will usually offer partial or full coverage for the cost of treatment. Crowns used for strictly cosmetic purposes will often not be covered, since this would not be considered a medically necessary procedure. Some insurance providers limit the number of restorations a patient can receive in a given year, so you should call your insurance company for clarification if you need multiple crowns.
In cases in which patients do not have full coverage, they may have to pay more out-of-pocket for all-porcelain and all-ceramic crowns versus porcelain-fused-to-metal and metal crowns. Many dental practices offer outside or in-house financing options for patients who cannot afford to pay for their crowns up-front.
Typically, you will need to pay for your dental crown in full before it is placed unless you have opted for monthly financing (which will usually include interest). If your dental insurance covers a portion of your crown, the company may send you a bill for your share of the cost after your procedure. Regardless of how you have chosen to pay for your crown, make sure you receive a complete, itemized receipt; this will help you determine whether there are any erroneous charges, and you should keep it as a record of your dental work in case it needs revision at some point.
How to Choose a Dentist
If you have a general dentist that you go to for routine cleanings and exams, he or she may be able to treat your tooth and place a crown, depending on how severe and complicated your dental issue is. You may be referred to a prosthodontist, a professional with further training and expertise in the replacement of missing teeth, especially if you choose to support your crown with a dental implant or your particular case is more complex.
Even if you already have a dentist or prosthodontist who can place your crown, it is important to do proper research and consider all of your options. After all, crown placement is often an expensive and involved procedure that needs to be done correctly. You may ask friends and family who have dental crowns for recommendations. You can also check online review sites to learn more about a dentist's skills and demeanor. Once you have narrowed your search down to a few options for your crown, you should ask the following questions either in person or over the phone:
- How frequently do you place dental crowns? Some dental practices focus more on family or cosmetic dentistry over restorative treatments. It's often better to work with a dentist who regularly performs this treatment.
- What crown materials do you offer? There are many crown material options, all of which have their pros and cons. Ideally, your chosen dentist will offer a wide range of crown materials so that you can choose which is right for you. However, you shouldn't necessarily disregard a dentist who doesn't provide metal, porcelain-fused-to-metal, all-porcelain, all-ceramic, all-resin, stainless steel, and solid zirconia, so long as he or she uses the material you prefer and can clearly explain why he or she doesn't carry other options. In addition, some dentists may have more experience with one material or another, so if your prospective dentist specializes in the material you're interested in, this is a good sign.
- Do you provide same-day crowns? Many dentists now have in-office digital manufacturing equipment so that you don't have to wear a temporary restoration while you wait. If your prospective dentist doesn't offer same-day crowns, ask how long the fabrication process typically takes.
- What dental lab do you use? Where is it located? If your dentist doesn't have in-office crown fabrication equipment, he or she will work with a partner lab to create your crown. You should get the name of the lab that will be making your restoration so that you can research the quality and accuracy of their products. In addition, you should ask about the location of the lab, since some dentists use offshore laboratories, which may be prone to more errors or use lower quality materials.
- Do you place dental implants? Dentists often pair crowns with dental implants (artificial tooth roots placed in and integrated with the jaw) to replace a missing tooth. Even if you don't need a dental implant, dentists that are able to place them are likely to have more training and expertise in restorative dentistry.
- Are you a board-certified dentist? This may seem to be an obvious question, but it is always a good idea to check that your practitioner is actually certified to practice dentistry.
- What types of anesthesia or sedation do you use? Most crown preparation and placement procedures require only local anesthesia, but if you suffer from dental anxiety, a low pain threshold, complications, or a more severe issue, having access to intravenous sedation, nitrous oxide, or general anesthesia may be important. If your prospective dentist offers more advanced sedation, ask if he or she works with a trained anesthesiologist.
- Does your practice accept my insurance? This is an important question for many patients, since dental insurance often covers a portion of the crown materials and treatment. You may not want to take on the additional expense of working with a dentist who does not accept your insurance.
- Do you provide financing options? If you don't have insurance or your insurance company will not cover the full cost of your treatment, having financing options may be important to you. Some dentists provide in-house financing, loans through outside corporations, or both. Ask about the interest rates for these options so that you can plan accordingly.
- What continuing education training have you completed recently? Most dentists have to attend continuing education courses to maintain their licenses and certifications. If your prospective dentist has recently completed continuing education classes or seminars in crown preparation or placement, he or she may use the latest techniques during your procedure.
- What do crowns typically cost at your office? Each patient's crown will have slightly different costs based on the preparation needed for the crown (tooth shaping, root canal therapy, dental implant placement, etc.) and the material of the restoration (for example, all-porcelain is more expensive than metal), but your prospective dentist may be able to provide you with an estimate.
- What diagnostic tests do you perform? The answer to this question can help you understand what to expect in terms of the cost of your treatment. As for your oral and dental health, your prospective dentist should provide thorough preparatory assessment and care. This should typically include a visual exam, periodontal (gum) health assessment, and X-rays.
- How long will my initial consultation last? Ideally, your dentist should plan to spend about an hour performing diagnostic tests and discussing your questions and concerns at your first appointment. If your prospective dentist does not allow adequate time for examination and discussion, this could be a negative sign.
- What professional organizations and groups are you a member of? Many professional organizations and societies hold their members to high standards, so if your prospective dentist is a fellow or member of a particular group, this may reflect his or her skills and quality of service.
- Do you provide emergency dentistry services? Repairing a damaged tooth carries certain risks. Your crown might not fit properly, your body might reject the material, or an infection in one tooth might spread to another, to name a few. Working with a dentist who takes emergency calls is a definite benefit and can make you feel more secure about your treatment.
- What type of impressions do you use for crowns? Traditionally, dentists make models of your teeth (used to craft your crown) using PVS, a clay-like substance you have to bite into. Many patients do not enjoy this process and it can sometimes be faulty. While not the most important factor in choosing a dentist for your crown, having one who does digital impressions, which take less than five minutes and typically require no material to be put on your teeth, is often preferable. In addition, dentists that use more up-to-date digital technology are likely to be better practiced in improved crown preparation and placement techniques.
- What alternatives to crowns do you offer? If you are suffering from symptoms of a severely decayed tooth or an infected tooth, you may very well need a dental crown. However, it is possible that you may be able to restore your tooth with a different treatment, like a smaller dental filling, inlay, or onlay. If your concerns are primarily cosmetic, your dentist may recommend porcelain veneers instead. Choosing a dentist that offers a wide array of treatments will allow you to pursue a different treatment if it may be better for you.
This is a very comprehensive list of questions and, depending on your circumstances, you may not need to ask all of these questions in your quest to find the right dentist. However, a dentist who is willing to discuss these concerns with you is likely to work personally with you from start to finish.
The Initial Consultation
During your initial consultation, your dentist will assess your tooth to determine if it needs a crown, discuss your options with you, and answer any questions you may have about the process.
Preparing for Your Appointment
To prepare for this appointment, make a list of the questions you have about your dental crown treatment. This can also help save time because you may discover that you have a question that you can easily find the answer to elsewhere, so you never need to ask your dentist about it.
Before your appointment, you should also have a clear idea of what you can afford for your procedure and materials so that you can ask any questions about financing or insurance when you see your dentist. If you are not using your general dentist for this procedure, you should make sure your regular practitioner sends your dental records to your dentist or prosthodontist. This will give him or her all of the information he or she needs to make an informed diagnosis.
The first step in the dental crown process is diagnosing the issue causing damage to your tooth. To do so, your dentist will complete a detailed oral and dental health exam, looking for signs of decay or infection. If you are already missing a tooth and looking to get a dental implant, your dentist will assess the condition of your jawbone, as well.
In addition to a visual exam, he or she may also take X-rays to look at the underlying structure of your tooth roots and bones. Based on the information he or she collects during examination, your dentist will make a recommendation for your treatment plan, which could include removal of decay, root canal therapy, dental implant placement, or, in severe cases, even tooth extraction.
Once the dentist diagnoses your condition, he or she will consult with you about the crown preparation and placement process. In addition to going over whatever procedures you may need before your tooth is ready for the crown, your dentist will discuss the material for your crown with you.
Many dentists have a crown material that they prefer to use, so he or she may have a recommendation for you, but you can also voice your concerns and preferences regarding the appearance, durability, and expense of the crown type. For example, if you have a lower budget and are putting a crown on a back tooth, you might not want to spend the additional money on an all-porcelain crown. If you do choose a tooth-colored crown material, you and your dentist will determine which shade of crown will match your enamel at your consultation.
This is also the time for you to discuss your anesthesia and sedation options with the dentist. He or she will numb your tooth and surrounding gums during the shaping process and while placing the crown, but you may also request sedation if you are particularly concerned about treatment. This will typically come at an additional cost.
Before leaving your consultation, you should also speak with the front office staff about your financing and insurance information. You will also schedule the crown preparation appointment at this time.
Dental implants are synthetic tooth roots, typically made of titanium or ceramic, that your dentist, prosthodontist, or periodontist (gum specialist) places under the gums of the missing tooth and into the jawbone. Over time, this post integrates with the jawbone, acting much like a natural tooth root.
At the top of an implant is an attachment onto which a crown, bridge, or even denture can be placed. Implant-supported crowns can replace a single tooth or serve as an anchor for a dental bridge, a larger prosthetic held in place by sturdy teeth on either side of the missing tooth or teeth.
Dental implants are advantageous for restorations because they are very durable and often prevent jawbone deterioration, since the synthetic root exercises the jaw whenever you chew, speak, or smile with your restoration.
The Implant Placement Procedure
The process for placing an implant-supported dental crown is longer than that to place a traditional crown. First, your dentist will assess your gums and jawbone to determine if they are healthy enough to hold an implant. This usually involves a visual exam, review of your dental history, and X-rays. If you lack sufficient jawbone to hold the titanium or ceramic post, your dentist (or other dental professional) may be able to perform a bone graft or sinus lift to build up the bone.
Once your mouth is healthy enough for an implant, your dentist or oral surgeon will make an incision in your gums, place the implant in your jawbone, and suture. This procedure usually takes less than one hour and is typically performed under local anesthesia and sedation or general anesthesia.
After implant placement, your dentist may attach a temporary bridge or crown to it. Within several months, your mouth will heal and the root will fuse to the bone, at which point your dentist will place your permanent restoration. Depending on the materials used to craft the implant and the restoration, implant-supported crowns last for many years and often function like a natural tooth.
Dental patients have many choices when it comes to dental crowns types; they can consist of ceramic, resin, porcelain, porcelain-fused-to-metal, all-metal materials, and more. The crown that is right for you will depend on your budget, medical needs, and cosmetic desires.
- Metal crowns: Metal crowns are a less than ideal choice for visible teeth, as their gold color makes them more noticeable than other crown materials. Despite their aesthetic disadvantages, metal crowns are durable, require less removal of the natural tooth structure than other types of crowns, and withstand the daily wear caused by chewing and grinding. They are often placed in the back teeth or in patients that are looking for a less expensive dental crown material.
- Porcelain-fused-to-metal: Porcelain-fused-to-metal crowns are stronger than all-ceramic and porcelain crowns. These crowns offer better cosmetic results than metal crowns, but do not look as natural as tooth-colored crowns. A metal line is visible along the gum line and the presence of metal gives the crowns more of an opaque, rather than a translucent, quality.
- All-porcelain: All-porcelain crowns are widely considered to be the most aesthetically pleasing. The material makes it easy for dentists to fabricate a crown that matches the color of surrounding teeth. However, porcelain crowns do have their drawbacks. Their thickness requires dentists to remove more of the patient's natural tooth and it can be difficult for dentists to achieve a good fit along the gum line.
- All-ceramic: Ceramic crowns are made of a translucent, tooth-colored material that is designed to blend in with surrounding teeth. Ceramic crowns are an excellent option for patients that want a natural look or are allergic to metals. The disadvantage of ceramic crowns is that they are not as durable as metal crowns, especially on the back teeth, which must withstand more force from biting and chewing.
- All-resin: Crowns made of all-resin composite material are the most affordable variety of tooth-colored crowns, but they are prone to fractures and wear.
- Stainless steel: This type of crown is typically used as a temporary crown while a permanent restoration is made, or used to repair a child's tooth. These crowns are pre-made, so they can be placed in one appointment. Like metal crowns, these do not have a very cosmetic appearance, but they are very durable.
- Solid zirconia: Dental crowns made from zirconium mimic the appearance and texture of a natural tooth, but do not chip or fracture as easily as porcelain or ceramic crowns. Many digital fabrication machines can create these crowns in one day. They are often called "biocompatible" because they integrate well with the gums and other teeth, functioning like a natural tooth.
Your dentist will discuss which crown material may be appropriate for your needs and preferences at your initial consultation.
Preparing the Teeth
At your first treatment appointment, your dentist will need to treat any ongoing conditions with the tooth. This may include removing decayed areas of the tooth, performing root canal therapy, or both. Once the damaged portions of your tooth have been treated and removed, your dentist will further shape the chewing surface and sides of your tooth so that it can accommodate the dental crown. If your dentist didn't file down your tooth slightly, the crown would not fit in well with your other teeth and not cap your tooth snugly. If you have extreme decay or a cracked tooth, your dentist may also place a dental filling or bonding agent to hold it together and build it up such that he or she can stably place a crown over it. The shaping process is typically done under local anesthesia, although you may also request sedation if needed.
Next, your dentist will take an impression of your tooth. This is a mold that he or she will use with digital equipment or send to a lab to custom-make your crown to fit your exact tooth. There are two ways to take a dental impression. The most conventional and common is with PVS, a type of clay-like putty. If your dentist uses PVS, he or she will take an impression of your teeth by having you bite into clay for a few minutes. However, your dentist may also be able to take an impression using a digital intraoral scanner, a small wand device that uses wavelengths to create a 3D model of your mouth. In either case, this impression will guide your crown creation.
Thn, your dentist will place a temporary crown, typically made of composite or stainless steel, so that your tooth is protected and more aesthetically pleasing while you wait for your permanent crown to be manufactured. The temporary crown can also give you a general sense of how your permanent restoration may look and feel, so you should report any comments or concerns about your crown to your dentist. Your dentist will cap your tooth with your crown using a special adhesive that is relatively weak so that it can be easily removed. This means you need to be particularly cautious about your dental habits while wearing the temporary crown.
Temporary Crown Care
You should be aware that you will need to take special care of the temporary restoration to ensure that it stays in place and protects the tooth. You should watch what you eat and take other precautions while wearing their temporary dental crown, including:
- Avoid eating sticky and chewy foods such as gum, taffy, and caramel. These foods could cause the temporary crown to shift out of place or fall off completely.
- Avoid eating hard, crunchy, or difficult to chew foods such as hard candy, raw vegetables, or beef jerky. These foods could cause the crown to move out of place or break.
- Use the teeth on the other side of your mouth when chewing foods.
- Take care when flossing so you don't accidentally remove the temporary crown. When flossing your teeth, floss downward, then slide the floss out the side of the tooth. Pulling the floss in an upward motion could pull the crown off of the tooth. In the majority of cases, patients only have to wear their temporary dental crowns for a few days to up to about one week.
Your dentist will provide more specific instructions about caring for your temporary crown at your appointment.
Fabricating the Crown
Using your impression, your dentist or dental lab will create a unique restoration that fits your tooth.
Dental Lab Restorations
If your dentist uses a dental lab to create your crown, he or she will send your impression to the company, where dental lab technicians will use it to manually or digitally fabricate your restoration. Depending on the types of materials and equipment used, this process may take between a few days and several weeks. If your crowns are part of a larger dental bridge, this process may take longer since the restoration is more complex.
Some dental offices now employ CAD/CAM (computer-aided design and manufacturing) technologies such as CEREC® to digitally plan, design, and fabricate your porcelain dental crown in a single appointment. The accuracy with which these tools create ceramic restorations helps improve your overall result, and many patients appreciate that they spend less time at the dentist's office.
Placing the Crown
If your dental crown was sent to a laboratory, it should be ready for placement with one or two weeks. During the second visit to the dentist, the dentist will remove your temporary restoration and bond the new, permanent crown in place with a strong adhesive, slipping it over your remaining tooth or dental implant until its edges sit securely against your gum line. Your dentist will then buff and polish the crown until its texture is smooth and your bite is correct. Once this is complete, your dentist will have you use a mirror to affirm that the size, shape, and color of your crown is agreeable to you.
If your tooth is not particularly sensitive, you may not need any anesthesia for this procedure. Most dentists use local anesthesia, and you may request sedation if you suffer from dental phobia, a low pain threshold, or other dental complications that may make the crown placement process more difficult for you.
Restorations created in-office may be placed the same day as crown preparation, so they might not require a temporary crown at all.
Combining Crowns with Other Treatments
Since they are typically used as a restorative treatment, dental crown placement is often combined with other procedures that repair a tooth.
Tooth bonding consists of filling in dental damage with a tooth-colored composite material. Bonding is often used as a cosmetic alternative to porcelain veneers, since the resin can cover discoloration, lengthen teeth, close gaps, and improve their shape. However, in conjunction with dental crowns, bonding is typically used to fill in chips, seal cracks in broken teeth, or protect an exposed tooth root so that the tooth is stable enough to hold a crown in place.
If decay is the cause of your tooth damage, your dentist may need to place a small filling so that your tooth's structure can adequately support the crown, as with dental bonding. However, many dental crowns are placed as alternatives to fillings, so they do not require this treatment.
In some cases, the damage to your tooth from decay, trauma, or infection may be so great that your dentist needs to extract the tooth, or your tooth may already be missing. In this case, your dentist may recommend placing a dental implant. This ceramic or titanium replacement tooth root will fuse to your jawbone and attach to the restoration at the gum line. To replace a single tooth, dentists often use implant-supported crowns, and these may also serve as abutment teeth for implant-supported bridges, which can fill in the space left by one or more missing teeth.
Root Canal Therapy
Due to decay or injury, the tooth's pulp, its innermost blood vessels and nerves, can become irritated, swollen, or even infected. In this case, dentists often perform root canal therapy, removing the pulp altogether, disinfecting the tooth, and replacing the pulp with a synthetic material called gutta-percha. Your dentist will often place a filling over the chewing surface of the tooth to cover the hole made by the file, the device he or she uses to access the root. In addition, most dentists combine root canal therapy with a dental crown to cover the vulnerable tooth and protect it from further issues.
Dental bridges are larger restorations to replace missing teeth. They are held in place by two abutment teeth, which are on either side of the gap and act as anchors for the prosthesis. Typically, two crowns make up the part of the bridge that covers the abutment teeth. These can be traditional or implant-supported.
Full Mouth Reconstruction
Patients who have multiple dental issues may opt for a full mouth reconstruction, a customized regimen of restorative dentistry procedures. As part of your dentist's design, he or she may include one or more dental crowns, since they repair missing teeth, can hold prosthetics like bridges, and provide a cosmetic appearance.
TMJ and Bruxism Treatment
Sometimes, patients require dental crowns because they suffer from bruxism, or teeth grinding. This usually means that they clench their teeth together unconsciously during sleep, gradually wearing away the top layers of enamel on the chewing surfaces. This behavior can also cause problems with the temporomandibular joint, which acts as a hinge between the temples and the jaw so that you can properly open and close your mouth. Treatment for TMJ disorder is often multi-pronged, and may include changes in diet (eating softer foods and avoiding gum or taffy), mouth guards, physical therapy, relaxation techniques, and dental crowns to replace the most damaged teeth.
Crowns and Cosmetic Dentistry
If you want to whiten your teeth, your dentist may recommend that you do so before placing a crown, since whitening agents do not work on crown materials and could cause the color of your teeth to appear uneven. You may also choose to have a dental crown placed during the orthodontic process. In addition to improving your overall oral health, crowns can instantly straighten a tooth, lessening the amount of work required. Since they can provide a straight, white appearance, some patients choose to place dental crowns over their teeth for strictly cosmetic purposes.
The results of dental crowns are typically very good, but your unique success with this treatment will depend on the severity of your tooth's condition, your dentist's expertise, and the material you choose for your crown. Most dental crowns are durable and last many years with proper care. On an immediate basis, you can usually expect your dental crown to:
- repair the damage incurred to your tooth
- improve your ability to drink and chew
- protect the tooth from further complications or injury
- enhance the appearance of your teeth, if you choose a tooth-colored material
You should discuss your desired results in detail with your dentist during your initial consultation.
Dental crowns are not intended to last forever, but if you are willing to dedicate time every day to cleaning your teeth, the crown could last ten years or more. Here are some basic tips to help you maintain the appearance and functionality of your dental crown:
- Be sure to brush your teeth twice a day with non-abrasive toothpaste and floss daily. You may also need to change your flossing technique in order to avoid dislodging your dental crown. When flossing near the crown, you should pull the floss from front to back between teeth, rather than pulling the floss straight up or down. This way, floss will not become caught underneath the crown, pulling it from its foundation. If you have an implant-supported crown, ensure that you also floss the connector attaching the crown to the implant.
- See your dentist at least twice a year. Your dentist will monitor your crown, clean your teeth, and may also take X-rays so that he or she can assess the health of the remaining tooth underneath the crown.
- Refrain from eating sticky foods such as caramel and make a conscious effort to minimize the use of the side of your mouth that contains dental crowns.
- Avoid hard foods that require excessive force to eat as much as possible. Try to avoid munching on ice or cracking apart hard candies.
- If you suffer from bruxism, wear your mouth guard every night to avoid damaging your crown, as well as your natural teeth.
- Some people use their teeth to tear apart plastic packages. Do not use the area of your mouth containing the crown to do so (and in general, many dentists recommend not putting this sort of pressure on any of your teeth). Also, try not to bite your nails, as this could also jeopardize your crown.
- Using mouthwash can help preserve your oral health, but do not use alcohol-based mouthwashes, as these could interfere with the bonding cement holding your crown in place. Also, avoid heavy alcohol drinking, which could have the same effect.
- Maintain a healthy, balanced diet without too many acidic, sugary, or carbohydrate-heavy foods that could encourage plaque to form. The bacteria in plaque can break down your enamel and cause cavities. Having cavities in the teeth around your crown could put it at risk. If you do eat a cavity-causing treat or drink a carbonated, sugary beverage, rinse your mouth with water and try to clean your teeth as soon as possible.
- Avoid smoking, which negatively impacts your dental and oral health overall.
Ask your dentist for more crown maintenance tips that may be specific to your particular circumstances or lifestyle.
In addition to restoring the tooth, many dental crowns provide a cosmetic appearance. Obviously, stainless steel and metal crowns have a noticeable look within the mouth, but tooth-colored crowns can provide instant aesthetic improvements. In fact, some dentists use crowns as a cosmetic dentistry treatment. The aesthetic benefits of crowns include:
- The natural balance and symmetry they can restore to a smile, especially if the tooth involved is particularly prominent or severely damaged.
- Dental crowns can immediately whiten and straighten the tooth, since the crown covers any imperfections. In addition, porcelain is typically stain-resistant, preventing future discoloration with proper care.
- While it depends on the specific material used, most tooth-colored crowns are relatively durable, minimizing the risk of future chipping or cracking.
- Implant-supported crowns and bridges often provide an improved appearance over traditional restorations for missing teeth because they are less likely to shift and behave more like natural teeth, since they are attached to a synthetic root.
These restorations can prevent you from feeling less embarrassed of or self-conscious about your smile while also improving your dental health.
Oral Health Benefits
Crowns fortify a damaged tooth to prevent further harm and improve your overall dental health. The oral health benefits of dental crowns may include:
- Alleviated discomfort: Along with preparatory treatment, placing a dental crown can relieve uncomfortable symptoms of tooth damage, such as sensitivity, toothache, inflammation, halitosis (foul tasting breath), fever, or even a tooth abscess (a pus-filled pimple).
- Increased chewing ability: Although caps are not meant for chewing tough or overly sticky foods, they can improve a patient's ability to chew.
- Improved support: If a tooth has sustained damage, but has enough healthy structure to act as a foundation, dental crowns can give patients an alternative to pulling the tooth or replacing it with a dental implant. Dentists can remove decayed portions of teeth or reshape damaged teeth so that they may accommodate a cap, which will in turn provide support and restore functionality to the tooth.
- A properly aligned bite: Missing or misshapen teeth can disrupt this balance, leading to temporomandibular joint disorder, or TMJ, a condition that can cause accelerated tooth wear, headaches, and general pain and discomfort. Maintaining a proper, balanced bite is very important to your health, and dental crowns can help your upper and lower teeth to meet properly and comfortably. If a crown is crafted accurately based on your dentist's calculations, your upper and lower teeth should meet correctly, with pressure equally balanced across your jaws.
- Decreased wear on other teeth: Having one weaker tooth transfers some of the pressure from chewing to the surrounding teeth, putting them at greater risk. In addition, unresolved decay or infection could also spread to other teeth, so treating these issues and completing treatment with a dental crown can prevent this from occurring.
- Stronger jawbones: Implant-supported crowns to replace missing teeth often help to prevent degeneration of the jawbone by exercising it through the artificial ceramic or titanium tooth root.
- Easier dental hygiene: While dental crowns require some special dental care to properly maintain, they are simpler to clean than a broken, decayed, or infected tooth. Easier brushing and flossing benefits your overall oral health.
You may experience additional oral health benefits from your dental crown based on your particular diagnosis and circumstances.
The risk of complications can be greatly reduced by undergoing treatment with an experienced, reputable dentist. Though the risk is low, the following complications can occur:
- Nerve damage: The preparation of the tooth can result in nerve damage if the tooth's surface is penetrated or made too thin. In that case, root canal therapy, or the complete removal of the tooth's nerves, must be carried out before the dental crown is placed.
- Increased sensitivity: Alteration of the tooth can result in increased sensitivity to heat and cold. Patients can use special toothpaste to reduce these effects. However, if tooth sensitivity results from an exposed root left uncovered by a crown that is too short, your dentist will need to modify the crown to protect your tooth.
- TMJ disorder: While dental crowns can correct TMJ disorder, they can also cause it if a dentist does not finish the crown properly, preventing the jaws from resting in a balanced manner. Following placement of a crown, the dentist will generally make several small modifications until the patient's bite is correct. You should take special note of any discomfort such as headaches or shoulder pain in the months following a dental crown procedure, as this may be a sign of an improperly aligned bite. Talk to your dentist if you experience any of these symptoms.
- Tooth decay: If a tooth is not properly sealed before the crown is placed, further decay can develop. It is important to remember that crowns are not intended to last a lifetime, so your dentist should continually monitor the tooth beneath the crown for decay or any other issues.
- A dark line over the gums: While this is a purely cosmetic issue, some patients are upset by the appearance of a dark line or grayish hue over their gums. This is not an indicator of any oral health issues. It is the result of the metal bottom of a porcelain-fused-to-metal or fully metal crown showing through.
- Dental or periodontal infection: If the crown is too long, short, narrow, or wide, pockets can form in your gums where bacteria can collect. If untreated, this bacterial infection could jeopardize your tooth.
- Future replacement or repair: While crowns can last up to 15 years with proper dental hygiene and maintenance, they are not made to last forever. You should be aware that you might at some point have to replace your crown. You can be prepared for this eventuality and improve the health of your crown by having your dentist carefully monitor it.
- Crown displacement: An incorrectly fitted crown or one exposed to excess pressure from chewing can become dislodged or even come off of the tooth. This could be uncomfortable and costly as it would expose the weaker tooth underneath the crown. If this happens to your crown, contact your dentist immediately for an emergency appointment.
- Damage to opposing teeth: If your crown is not sufficiently smooth, it can erode the chewing surface of the opposing tooth, wearing down the enamel. This could cause tooth sensitivity or other issues with the opposing tooth, as well as making eating uncomfortable. If your crown feels abrasive, ask your dentist to further polish it.
Your dentist will further cover the risks of your procedure at your initial consultation.
Temporary Side Effects
Preparing for and placing a dental crown can relieve many uncomfortable symptoms, but this procedure may have temporary side effects. These can include:
- Tooth sensitivity or aching: If an existing tooth is going to serve as a foundation, portions of the tooth must be removed so it can accommodate the crown. This can cause slight tenderness for the next several days, although it may be managed with a prescription for painkillers.
- Bleeding gums near the site of the crown: A properly fitted dental grown should rest on the gum line. However, sometimes placing the crown on the gums can cause temporary irritation, inflammation or bleeding, especially if it digs in too low. If bleeding persists, contact your dentist, as your crown may need to be adjusted.
- Adverse reaction to anesthesia: Most dentists use local anesthesia to place a dental crown. While very rare, some patients have an allergic reaction to local anesthesia, which could cause itchiness, rashes, hives, difficulty breathing, or, in severe cases, anaphylactic shock, which can be life-threatening if not immediately addressed. To reduce this risk, discuss your medical history and allergies with your dentist before your procedure.
- Side effects of painkillers: If you take a painkiller to diminish discomfort after crown preparation or placement, you may experience temporary side effects from this medication. These can include rash, nausea, heartburn, dizziness, fatigue, headache, drowsiness, and confusion.
If any of these temporary side effects continues for more than a few days, contact your dentist.
Dental crown preparation and placement are typically safe procedures. However, you and your dentist should carefully consider the materials used to create your crown before placing it. Crowns are available in a variety of materials, from porcelain to metal alloys to combinations of both.
An allergic reaction to crown materials can create contact dermatitis, localized skin and gum irritation, or sinusitis, an inflammation of the sinuses and nasal passages. Porcelain, ceramic, and zirconia crowns tend to be very biocompatible, meaning that they do not cause allergic reactions. However, some patients are allergic to composite or metallic crowns. You should undergo tests to make sure you are not allergic to the materials that will make up your crown. Fortunately, if you are allergic, there are many options for crowns, so you should be able to find one that meets your needs.
Frequently Asked Questions
Dental crown placement is a routine treatment, but many patients have questions about this procedure. Below, we've answered some of the most common questions patients have when they believe they may need a crown.
How long should my dental crown last?
With adequate dental hygiene and regular dentist visits, your dental crown should last between ten and 15 years. This may vary depending on the materials used in your crown, the type of dental damage the crown repairs, and your dentist's particular expertise.
Does getting a dental crown hurt?
Most patients require only local anesthesia to remain comfortable during the crown preparation, shaping, and placement processes. Toothache and sensitivity after these procedures are also usually mild, but can be mitigated with a prescription for painkillers. Severe pain from a dental crown is an indication of more serious complications that should be addressed by your dentist.
Why is it called a crown?
A dental crown is called a crown simply because it fits over the top of your remaining tooth or dental implant. These restorations are also sometimes called dental caps.
How thick are dental crowns?
The dimensions of dental crowns depend largely on the materials used. In general, the thickness can range from 0.5 to two millimeters on the sides and at least 1.5 millimeters on the chewing surface. Metal crowns are often thinner than porcelain crowns. Dental crowns may also need to be thicker or thinner to accommodate particular tooth damage or complications from treatment.
Will I be able to tell the crown apart from my teeth?
If you choose a metal crown, it will be easy to tell the crown apart from your teeth. However, tooth-colored crowns can often be made to look indistinguishable from your existing teeth, especially from a distance. The dental crown may feel slightly different than your natural tooth in your mouth, especially if it is not adequately polished or properly fitted. If your crown bothers you, speak to your dentist about how to improve its shape and texture.
Can I whiten my dental crown?
No. Dental crown materials do not respond to whitening treatments, meaning that the crown will be a different color among the lightened natural enamel. If you want to whiten your teeth, most dentists recommend that you do so before you receive a dental crown, or that you replace the crown with a lighter material as part of your smile makeover process.
What are my alternatives to a dental crown?
In most cases, dentists recommend dental crowns to restore teeth when other options are insufficient. If you have a missing tooth, you may also be able to replace it with a dental bridge, which typically includes two dental crowns. Fillings, inlays, or onlays may repair decayed teeth if the area of damage is small enough. Cracked or chipped teeth can sometimes be restored with dental bonding instead of a crown, although these treatments can also be combined. If you are using dental crowns as a purely cosmetic treatment, you may be able to achieve a similar whitening, straightening effect with porcelain veneers or a combination of orthodontia and teeth whitening.
Can I get orthodontia if I have a crown?
Many adults are now pursuing straightening treatments later in life when they already have restorations like crowns. Fortunately, you can correct crookedness even if you have dental crowns. While possible to use, traditional braces may not attach correctly to crown materials like metal or porcelain, so many dentists and orthodontists recommend using clear plastic aligners that simply slip over the teeth if you have dental crowns. If you are considering replacing your dental crown at the time of orthodontia, most orthodontists recommend waiting until your treatment is complete. In rare cases, orthodontic treatment can disrupt the placement of your crowns.
Can children get dental crowns?
Unfortunately, it is possible for a primary (baby) tooth to be so damaged that it requires a crown. Many dentists prefer not to pull a severely infected or decayed baby tooth, because this tooth will hold the space needed for the permanent tooth when it comes in and prematurely missing a baby tooth could put increased pressure on the jawbone and gums.
Typically, dentists use pre-formed titanium crowns to protect baby teeth, but some parents request tooth-colored crowns for a more cosmetic appearance. Pediatric crowns can be covered with resin, plastic, or a bonded veneer for a more natural look. Some dentists may also make zirconia crowns for children, although these are typically more expensive and therefore reserved for only the anterior (front) teeth that are most visible.
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