If you have one or more teeth affected by decay, chipping, cracks, or other damage, dental crowns (also referred to as dental caps) can be a great solution. Crowns provide support for your teeth, but also help to make your smile look complete and natural again. Because everyone's natural teeth are unique, care must be taken to ensure that crowns not only match existing teeth in terms of appearance, but also help create a correct bite. Read on to learn more about this restorative dentistry treatment.
While dental crowns can provide a significant cosmetic improvement to a patient's smile, they can also provide strength and protection for damaged teeth. Dental crowns may be recommended when:
- The teeth do not look healthy and attractive
- The teeth are yellow or discolored
- The teeth are misshapen or proportionally too small
- The teeth are cracked or chipped
- The teeth need additional support and strength
- The patient is unable to comfortably chew food
- The bite is not aligned properly
- A dental filling or inlay/onlay will not provide enough support to the tooth
A suitable candidate for dental crowns must also have healthy gums, because they will work in tandem with the remaining healthy portion of the tooth to provide support for the crown.
Creating custom crowns involves preparing the tooth, taking a mold of the tooth, and placing a temporary restoration until the more permanent crown is ready. In some cases, a dental bridge is attached to dental crowns to fill in the space left by missing teeth. For other patients, dental crowns are used to cover dental implants. The dental crown procedure generally involves two visits to the dentist over the course of two to three weeks.
Stage 1: The First Treatment Appointment
The first treatment appointment generally takes longer than the second treatment appointment. Generally, the first treatment appointment takes about one hour.
- Tooth preparation: Placing a dental crown begins with the dentist removing decayed areas of the tooth, as well as some healthy portions of its structure to accommodate the dental crown.
- Mold: Next, an impression is made using putty. This impression will guide technicians at a dental lab in creating the crown.
- Fabrication of the crown: Your dental crown will be custom-fabricated to fit your tooth and look proportionally correct among surrounding teeth. If the crown's color is intended to match the patient's existing teeth, that color will be determined at this time.
- Placement of a temporary crown: A temporary crown made of either stainless steel or acrylic is placed to protect the tooth, giving the patient the most natural look and feel possible until the permanent crown is ready to be placed.
Some dental offices now employ CAD/CAM and CEREC® technologies to digitally plan, design, and fabricate your porcelain dental crown in a single appointment. The accuracy with which these tools create ceramic restorations help improve your overall result.
Stage 2: Between Appointments
Patients should be aware that they will need to take special care of the temporary restoration to ensure that it stays in place and protects the tooth. Patients should watch what they 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.
The Second Treatment Appointment
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 first the temporary restoration is removed and the new dental crown is securely bonded in place by a strong adhesive. The dentist will then buff and polish the crown until the patient's bite is correct.
Maintenance of Crowns
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 10 years or more. Be sure to brush your teeth twice a day, floss daily, and visit the dentist twice a year. 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.
Additionally, if you can 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, this procedure can give you years of positive results.
Dental patients have many choices when it comes to dental crowns types; they can consist of ceramic, resin, porcelain, porcelain-fused-to-metal, or all-metal materials. The crown that is right for you will depend on your budget and cosmetic desires.
- Metal crowns: Metal crowns are a less than ideal choice for visible teeth, as their gold color make them more noticeable than other crown materials. Despite their aesthetic disadvantage, 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 on 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, and those that 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 withstand more force from biting and chewing.
- All-resin: Crowns made of all-resin are the most affordable variety or ceramic crowns, but they are prone to fractures and wear.
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 dramatically. Although most insurance carriers cover 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.
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-$2,00 per tooth
The cost of treatment can be significantly reduced with dental insurance.
Because dental crowns are used to restore a damaged tooth, dental insurance will offer partial or full coverage for the cost of treatment. In cases in which patients do not have full coverage, they may have to pay more out-of-pocket for all porcelain and ceramic crowns versus porcelain-fused-to-metal and metal crowns.
Dental crowns offer a number of benefits, including:
- Improved appearance: The most obvious advantage is the complete, natural look it can restore to a smile (the extent of this effect depends greatly upon the materials used to make the crown)
- Improved chewing ability: Though 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.
- Improved bite: Missing or misshapen teeth can disrupt this balance, leading to temporomandibular disorder, or TMD, a condition causing 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.
The risk of complications can be greatly reduced by undergoing treatment with a qualified 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.
- Increased sensitivity: Alteration of the tooth can result in increased sensitivity to heat and cold. Patients can use special toothpaste to reduce these effects.
- TMJ disorder: While dental crowns can correct TMJ disorder, they can also cause it if a dentist does not finish the crown properly, allowing the jaws to rest in a balanced manner. Following placement of a crown, the dentist will generally make several small modifications until the patient's bite is correct. Recipients should be cognizant of any discomfort such as headaches or shoulder pain in the months following a dental crown procedure.
- Allergies: Crowns are available in a variety of materials, from porcelain to metal alloys to combinations of both. Patients should always undergo tests to make sure they are not allergic to the materials that will make up their crown.
- Tooth decay: If a tooth is not properly sealed before the crown is placed, further decay take place. It is important to remember that crowns are not intended to last a lifetime.
- Removal of portions of the tooth: If an existing tooth is going to serve as a foundation, portions of the tooth must be removed so it can accommodate the crown.
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