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Crowns

What is a crown? When do you need one? What types of crowns are available?

Dental crowns, also known as “caps”, preserve the functionality of damaged teeth.

When Do I Need a Crown?

A dental crown may be used to protect a cracked tooth, restore functionality of a tooth with excessive decay or replace a pre-existing crown. The purpose of a dental crown is to encase a vulnerable tooth with a custom-designed material for extra durability. Dentists today have a variety of conservative treatment options through which to restore teeth. If possible, these options should be explored and discussed before selecting the full coverage crown.

Consultation and Treatment Planning

If tooth decay or damage is so extensive that veneers, direct composite bonding or other conservative treatments aren’t viable treatment options — or if you have undergone root canal therapy — your dentist will consult with you about dental crowns. Whether used to restore a damaged tooth or to create a lifelike tooth replacement for an implant, crowns can be fabricated in dental laboratories or in your dentist’s office, depending on the crown material.

Part of your dental crown consultation may involve taking impressions of your existing tooth (or teeth) as a basis for creating the shape and size of your crown restoration(s). If dental crowns will be used as part of a smile makeover, these impressions are used to make models for designing the new length, shape and alignment of your teeth, so that you can preview your new smile before committing to treatment.

Your dentist also will describe the tooth preparation process, as well as your options with regard to local anesthesia (to numb your teeth and surrounding areas) and sedation dentistry, if necessary. If your dental crown treatment involves placement of a temporary crown, your dentist will advise you of how long you will need to have the temporary in place and what hygiene steps to take to ensure functionality.

Clinical Procedure for Dental Crowns

During the dental crown procedure, your dentist prepares the tooth and makes a molded impression of the teeth to send to a dental laboratory. A fitted, temporary crown is created during this visit to temporarily protect the tooth while the final restoration is being made in the dental laboratory. The final crown will be identical in shape, size, and fit, to the final crown. Any adjustments and refinements you wish to have can be made on the temporary crown to ensure the final crown is exactly right. Once completed, the tooth crown is cemented or adhesively bonded.

Pros & Cons of the CAD/CAM Technology

Some dental offices have embraced chair side CAD/CAM technology, which is a computer-aided design and manufacturing technology which can display a 3-D picture of your teeth with and without a crown. This machine eliminates the temporary crown step, which is not desirable. By allowing the machine to determine the size, shape, fit, and look of your crown, you lose the opportunity to see and feel a temporary version of your final crown.

CAD/CAM technology is a wonderful step forward in technology, and it does save time, but we believe it adds a tier of guesswork for the patient. We prefer the traditional route of allowing patients to test drive their crowns in the form of a temporary, so that adjustments can be made on the final crown before it is applied.

Your Options for Crown Materials

The three predominant choices of restorative materials for the full coverage crowns are:

  • Porcelain-fused-to-metal
  • Gold
  • All-ceramic (all-porcelain)

The material selected is determined by the clinical demands at hand; aesthetic demands, strength requirements, material durability and restorative space available.

Porcelain-Fused-to-Metal Crowns

Porcelain-fused-to-metal crowns provide for a strong, durable and aesthetic treatment option. One of the key factors for the aesthetic and functional success of this type of crown is ensuring the preparation of the underlying tooth structure provides adequate space for the appropriate thickness of the material selected. Additionally, the artistic skill of the laboratory technologist creating the crown will determine its aesthetic appeal.

One consideration in the porcelain-fused-to-metal crown is that these crowns may tend to show the underlying metal or gold margin at the gum line as gums recede over time. Some patients opt for this type of crown, but replace the crown at a later date in order to maintain a higher aesthetic benefit. Porcelain-fused-to-metal crowns with an all porcelain collar can eliminate this vulnerability.

Gold Crowns

Although not as popular a treatment choice for aesthetic reasons, gold crowns are still recommended in some instances. For example, patients with strong bites and those with teeth grinding or jaw clenching habits might be better served with a gold crown. The traditional restorative material can provide stronger support to the remaining healthy tooth structure. Gold crowns offer a level of durability that is appropriate for teeth located in the back of the mouth (such as the molars), where they will not be highly visible. Gold crowns tend to offer greater longevity and require less preparation than porcelain and porcelain-fused-to-metal crowns. When chewing, gold tends to be less abrasive to the opposing tooth than porcelain. This helps prevent teeth for suffering excessive wear.

All-Ceramic Porcelain Crowns

The predominant material choice for all-ceramic crowns today is either zirconia, or aluminous materials. They provide a metal-free aesthetic option with a number of benefits.

By eliminating the need for the supportive metal core, an aesthetic all-ceramic crown can be created with a reduced thickness of material. This makes them a more favorable treatment choice in areas with limited space. Additionally, the elimination of the metal core allows for light transmission through the porcelain for better optical, life-like properties and a higher level of aesthetics.

All-ceramic materials continue to evolve in strength and durability, but caution should still be exercised for areas of the mouth requiring heavy function. Continuing research is exploring the significant vulnerabilities of the porcelain systems in such areas.

Dental Crowns Recovery and Aftercare

After your permanent crown has been placed, your dentist will provide you with information about caring for your new restoration. In general, maintain proper oral hygiene habits by brushing twice daily and flossing with dental floss or inter-dental cleaners (specially designed brushes and sticks) once a day. These practices will help to remove plaque from the area where the crown meets the gum, and help prevent dental decay and gum disease.

Avoid chewing hard foods, ice or other hard objects, since this could damage your crown. It also is important to avoid biting your fingernails and grinding your teeth, which could significantly shorten the life-span of your dental crown. If you habitually clench or grind your teeth, your dentist may recommend wearing a night-time mouth guard to help protect your crowns while sleeping.

Costs

The cost of a dental crown depends on several factors, including the technical demands of the treatment, the training and expertise of the dentist, the training and expertise of the dental technologist, and the location of the dentist. Dental Crowns may range in price from $1,000 to $1,200 and last between 10 and 15 years or longer, though results vary depending upon your unique considerations.

Regardless of treatment coverage by your dental insurance policy, or if you don’t have insurance, you always have the option to finance your Dental Crowns through CareCredit directly at our office. Alternatively, if you do not require financing, a 10% courtesy can be applied for a full up-front payment.

Prolonging the Life of a Crown

The longevity of the full coverage crown is determined by the precision of its fit to the underlying tooth. The fit of a crown can vary tremendously and requires attention to detail by the providing dentist. An ill-fitted dental crown can house bacteria that may build into more serious tooth decay in years to come.

It is also important that the tooth be in a healthy state to ensure its longevity. In all cases, your dentist will evaluate the gums and supporting bone structure to ensure these supporting tissues are in a healthy state. This protects the tooth and minimizes the potential for eventual gum recession that exposes the crown margin.