If a person has one or more teeth affected by decay, chips, cracks or other kind of damage, dental crown would be the best solution. Dental crowns are use to fill the gaps between the teeth, provides better oral care and offer cosmetic benefits by restoring a smile if the person is having missing or damaged teeth. A crown also helps in biting and chewing the food properly that can have positive impact on digestive system also. Crowns are custom-made and are crafted carefully to complement the surrounding natural teeth with regard to color, shape, size and texture.
A dental crown is a cover or tooth-shaped “cap” which is a fixed prosthetic object placed over a tooth to cover and restore its shape, size, strength, alignment of the mouth and improve appearance. Unlike removable devices such as dentures that can be taken out and can be clean daily, crowns and bridges are cemented and fixed and can only be removed by a dentist. A patient’s tooth should be prepared and mould must be taken to create a customize crown and a temporary restoration is used to protect while the permanent crown gets ready to be placed in the damaged part. Before setting in the new crown, dentist will first reduce the tooth size to make the crown fit in properly.
Dentist will first check and diagnose the problem that has caused damage to the tooth to see if it needs a crown or assess the condition of the jawbone in case the patient is missing a tooth or wants to have dental implant. Doctor may also take X-rays to check the underlying structure of the roots and bones of the teeth and to make a treatment plan that may include removal of decay, root canal, and dental implant placement or in some cases, tooth extraction. Once the condition is diagnosed, dentist will discuss about the type of crown material keeping in mind the preferences and concerns regarding the appearance, durability and expense.
There are several reasons why doctor may recommend a dental crown such as:
1. If the cavity is too large for filling where isn’t enough tooth remaining
2. Missing tooth that may need a bridge
3. Cover a dental implant
4. Protect a weak, cracked or worn out tooth from fracturing
5. Cover the tooth that has root canal treatment
6. Cover a discolored or badly shaped tooth
7. To hold together parts of a cracked tooth
8. To make a cosmetic modification
There are different types of crowns. Permanent crowns can be made from metal like gold or any other alloy, ceramic, all resin, stainless steel or porcelain fused to metal.
1. Metals – non-corrosive alloys that have a high content of gold or platinum or base metal alloys such as cobalt-chromium and nickel chromium alloys. Metal crowns are very strong that can withstand biting and chewing and rarely get chipped or break. It also requires the least amount of healthy tooth to be removed prior the fitting. The only main drawback is the metallic color of it.
2. All resins – These dental crowns are less expensive than others. But they have less life and wear down over time. Also, these are more prone to fracture than the porcelain fused to metal crowns.
3. Ceramic – These are used for restoring front and back teeth and provide better natural color that blends perfectly with the natural tooth color. All ceramic crowns are more suitable for the people with metal allergies.
4. Stainless steel – these are prefabricated crowns that are used on permanent teeth mostly as temporary solution. The stainless steel crown protects the entire tooth from decaying it further or filling till the time permanent crown is made from another material. These are generally used for children as they don’t require multiple dental visits and are cost effective than the other custom made crowns.
5. Porcelain fused to metal – Is a good choice for front and back teeth as well as long bridges where the metal is required for strength. These are stronger than regular porcelain as it is connected to a metal and is extremely durable.
Generally, dental crowns can last between 5 to 15 years if properly maintained through proper oral health and hygiene practices such as brushing and flossing, regular check-ups with the dentist, avoiding habits such as grinding or clenching the teeth, chewing ice etc.
There are several steps in placing the crown that involves dental visits. Dentist will prepare the tooth by removing its outer portion to fit in the crown and any decay. A mold will be made to provide an exact model for the crown. Dentist will place a temporary crown while a new permanent crown gets prepared. The temporary crown can be a sensitive to hot and cold. When the crown is prepared, dentist will places it the patient’s mouth and make the adjustments. If the patient and dentist are satisfied with the new adjusted crown, it will cement in a place permanently. After the permanent crown is placed, dentist will provide a guideline for taking care of the new restoration.
There can be some risks and complication involved:
1. Nerve Damage – if the tooth’s surface is penetrated or made too thin
2. Discomfort and increased sensitivity – can result in sensitivity to cold and hot if the crowned tooth still have a nerve in it.
3. Tooth decay – further decay can still happen if the tooth is not properly sealed.
4. Chipped crown – porcelain fused to metal crowns sometimes can get chipped. If the chip is small then a small composite resin can be used to repair the chip with the crown remaining in the mouth. If the chipping is big the crown may be replaced.
5. Dental infection – if the crown is too long, short, and narrow or wide, bacteria can form in the gums and if left untreated can damaged the tooth further.
6. Loose or displacement of the crown – an incorrectly fitted crown or exposed to excess pressure from chewing can get dislodged or sometimes the cement washes out from under the crown that may allows the crown to become loose and making room for bacteria to buildup. Contact dentist immediately if this happens.
7. Allergic reaction – allergic reaction can occur because the metals used to make crowns are usually a mixture of metals. In rare cases, reaction can occur due to the porcelain crowns.
8. A dark line over the gums – this is not big problem as this is just a result of the metal bottom of the porcelain fused to metal crown showing through. This can upset some patient by the appearance of the dark line and cosmetically unacceptable.
Some temporary side effects are tooth sensitivity or aching, bleeding gums, reaction to anesthesia, side effects to pain killers.
Cost of crowns varies on several factors such as technical demands of the treatment, expertise, location of the dentist, and the type of crown used.