When Is a Dental Crown Needed?
A dental crown may be needed in the following situations:
To restore an already broken tooth or a tooth that has been severely worn down
To cover and support a tooth with a large filling when there isn’t a lot of tooth left
To hold a dental bridge in place
To cover misshapened or severely discolored teeth
To cover a dental implant
To make a cosmetic modification
For children, a crown may be used on primary (baby) teeth in order to:
Protect the teeth of a child at high risk for tooth decay, especially when a child has difficulty keeping up with daily oral hygiene.
Decrease the frequency of sedation and general anesthesia for children unable because of age, behavior, or medical history to fully cooperate with the requirements of proper dental care.
In such cases, a pediatric dentist is likely to recommend a stainless steel crown.
What Types of Crowns Are Available?
What Steps Are Involved in Preparing a Tooth for a Crown?
Preparing a tooth for a crown usually requires two visits to the dentist — the first step involves examining and preparing the tooth, the second visit involves placement of the permanent crown.
First Visit: Examining and preparing the tooth.
At the first visit in preparation for a crown, your dentist may take a few X-rays to check the roots of the tooth receiving the crown and surrounding bone. If the tooth has extensive decay or if there is a risk of infection or injury to the tooth’s pulp, a root canal treatment may first be performed.
Before the process of making a crown begins, we will anesthetize (numb) the tooth and the gum tissue around the tooth. Next, the tooth receiving the crown is filed down along the chewing surface and sides to make room for the crown. The amount removed depends on the type of crown used (for instance, all-metal crowns are thinner and require less tooth structure removal than all-porcelain or porcelain-fused-to-metal ones). If, on the other hand, a large area of the tooth is missing (due to decay or damage), we will use filling material to “build up” the tooth to support the crown.
After reshaping the tooth, we will use a paste or putty to make an impression of the tooth to receive the crown. Impressions of the teeth above and below the tooth to receive the dental crown will also be made to make sure that the crown will not affect your bite.
The impressions are sent to a dental lab where the crown will be manufactured. The crown is usually returned to our office in two to three weeks. If the crown is made of porcelain, we will also select the shade that most closely matches the color of the neighboring teeth. During this first office visit we will make a temporary crown to cover and protect the prepared tooth while the crown is being made. Temporary crowns usually are made of acrylic and are held in place using a temporary cement.
Second Visit: Receiving the permanent dental crown.
At the second visit, we will remove the temporary crown and check the fit and color of the permanent crown. If everything is acceptable, a local anesthetic will be used to numb the tooth and the new crown is permanently cemented in place.
How Should I Care for My Temporary Dental Crown?
Because temporary dental crowns are just that — a temporary fix until a permanent crown is ready — we suggest that a few precautions. These include:
– Avoid sticky, chewy foods (for example, chewing gum, caramel), which have the potential of grabbing and pulling off the crown.
– Minimize use of the side of your mouth with the temporary crown. Shift the bulk of your chewing to the other side of the mouth.
– Avoid chewing hard foods (such as raw vegetables), which could dislodge or break the crown.
– Slide flossing material out-rather than lifting out-when cleaning your teeth. Lifting the floss out, as you normally would, might pull off the temporary crown.
What Problems Could Develop With a Dental Crown?
Discomfort or sensitivity. Your newly crowned tooth may be sensitive immediately after the procedure as the anesthesia begins to wear off. If the tooth that has been crowned still has a nerve in it, you may experience some heat and cold sensitivity. we may recommend that you brush teeth with toothpaste designed for sensitive teeth. Pain or sensitivity that occurs when you bite down usually means that the crown is too high on the tooth. If this is the case, call our office. He or she can easily fix the problem.
Chipped crown. Crowns made of all porcelain can sometimes chip. If the chip is small, a composite resin can be used to repair the chip with the crown remaining in your mouth. If the chipping is extensive, the crown may need to be replaced.
Loose crown. Sometimes the cement washes out from under the crown. Not only does this allow the crown to become loose, it allows bacteria to leak in and cause decay to the tooth that remains. If a crown feels loose, contact your dentist’s office.
Crown falls off. Sometimes crowns fall off. Usually this is due to an improper fit, a lack of cement, or a very small amount of tooth structure remaining that the crown can hold on to. If this happens, clean the crown and the front of the tooth. You can replace the crown temporarily using dental adhesive or temporary tooth cement that is sold in stores for this purpose. Contact our office immediately. we will give you specific instructions on how to care for the tooth and crown for the day or so until you can be seen for an evaluation. We may be able to re-cement the crown in place; if not, a new crown will need to be made.
Allergic reaction. Because the metals used to make crowns are usually a mixture of metals, an allergic reaction to the metals or porcelain used in crowns can occur, but this is extremely rare.
Dark line on crowned tooth next to the gum line. A dark line next to the gum line of your crowned tooth is normal, particularly if you have a porcelain-fused-to-metal crown. This dark line is simply the metal of the crown showing through.