Ask The Dentist is a series of columns written by Dr. Mady to answer your questions about dentistry and oral health!
Dear Dr. Mady: My dentist is recommending that I get crowns placed on a couple of my teeth. What exactly are crowns and what is the reason that some people need them? - Sylvio in Puce
Dear Sylvio: A crown is a tooth shaped covering or “cap” that is placed over a tooth to restore it to it’s original size and shape, to strengthen it and to improve it’s appearance. When completed and cemented in place, a crown completely covers the entire visible portion of your tooth that is above the gum line.
There are many reasons why crowns are needed on teeth and why your dentist may recommend them. Sometimes crowns are used to strengthen a weak or cracked tooth. This tooth may even be broken or moderately worn. Crowns are also extremely beneficial when a tooth has a very large filling in it, not a lot of natural tooth structure remaining and when it is structurally compromised.
You may have a need for a crown if your teeth are misshaped or severely discolored, or if you have a dental implant. The most common need for a crown is when a tooth has had a root canal (endodontic treatment), especially on posterior or back teeth. Endodontically treated teeth become brittle over time due to the loss of nerve and blood supply and are very susceptible to fracture. When a crown is placed, it can actually strengthen the tooth and is an excellent preventative measure.
Preparing your tooth or teeth for a crown usually requires two dental visits. At the first appointment, your crown prep will be completed using a local anesthetic, a final impression or mould will be taken and a temporary crown will be placed. The second appointment is when you will get your permanent crown(s) delivered or placed.
While waiting for your permanent crown to be fabricated, you have to be cautious with the temporary crown. Avoid sticky foods that can pull the crown off and try not to floss aggressively around the temporary. These are usually fabricated from acrylic and are not meant to be on “too tight”. If the temporary crown does come off, you must notify your dentist immediately because the prepped tooth can move or hyper-erupt, which causes risk of the permanent crown not fitting.
Permanent crowns can be made of metal, all porcelain ceramic, or a combination of porcelain fused to metal. The metal crowns are usually made from gold but the porcelain crowns can be color matched to the adjacent teeth. Metal crowns require removal of less tooth structure as opposed to the other types. Porcelain can wear the opposing teeth more than metal, and fracture easier, but most patients shy away from metal due to the “look” of it.
All-ceramic crowns are the most common choice for anterior or front tooth restorations because they provide the best natural color match of all crown types. They are also more suitable for individuals with metal allergies.
The newly crowned tooth may be sensitive immediately after the anesthetic wears out. This may occur after the prep and even after the permanent cementation. If the tooth in question still contains a live nerve, you may experience some hot and cold sensitivity. This usually subsides quickly but if it does not or if it worsens, let your dentist know.
Crowned teeth do not require any special care, but many believe that a crowned tooth can not get a cavity. This is completely false and if good oral hygiene is not practiced, the tooth structure that supports the crown can decay and often without you knowing it. Therefore, after your crowns are placed, continue brushing at least twice a day, flossing once a day and keep your regular check-up and cleaning appointments with your dentist.
If you need any other information or have any dental questions, please contact our office!