Dental Crowns Questions

  • When is a dental crown needed?
A: There are a variety of situations that require a tooth to be restored with a dental crown. The following are the most common:

-Large filling: When a tooth has a cavity or fracture that involves half the width of the tooth or more, it needs to be covered with a crown.

-Root canal: Root canal treatment leaves the tooth hollowed out and predisposes the remaining tooth to cracking.

-Cracked tooth syndrome: This is a condition whereby a patient has fractures inside a tooth that cause pain when it is chewed a certain way. A crown will hold the tooth together and redistribute the stress evenly throughout the tooth, eliminating the pain in most instances.

-Broken cusps: Cusps frequently break off of teeth due to trauma or large existing fillings.

-Excessive wear of teeth: If a person has a habit of grinding their teeth, the teeth will become shorter over time. The teeth can also wear away due to acid erosion caused by gastrointestinal acid reflux (GERD), bulimia, or an acidic diet.

-Undesirable appearance of teeth: Teeth that have an unacceptable appearance due to color, shape, or spaces between teeth can be made to look very natural and beautiful with crowns.

-Other Reasons: Crowns are placed on dental implants to restore spaces left from missing teeth. Another way of filling these spaces is with dental bridges, which are made from crowns on the teeth next to the spaces attached to fake teeth in the middle. If teeth are loose, crowns can be placed on multiple teeth and splinted together to provide more stability.

  • What types of dental crowns are available?
A: Crowns can be made out of a gold alloy, some other metal alloy, stainless steel, all-porcelain/all-ceramic, composite resin, zirconia, or porcelain on the outside fused to metal or zirconia on the inside. There are advantages and disadvantages to all of the types of dental crowns. Stainless steel crowns are preformed crowns used to cover baby teeth for children. Gold dental crowns have traditionally been the most durable and require less of the tooth to be removed or shaved down. The primary advantage of porcelain crowns is their aesthetics, while newer types of ceramic crowns have become increasingly more durable.
  • What is the procedure for getting a dental crown?
A: The dental crown procedure first involves numbing the tooth with local anesthesia. If the tooth has been fractured or had a root canal treatment, it will first need to have a buildup, which is a filling that restores enough of the tooth for the crown to hold onto. Then the tooth is shaved down to make room for the crown, and an impression is made of the prepared tooth with a putty like substance or a digital scanner. Dr. Clyde will then determine the shade of the patient's teeth using a shade guide or take pictures of the teeth to help the lab technician make crowns that will match the rest of the patient's teeth. A temporary crown is made from a resin or acrylic material using a molding or stent of the original tooth. This temporary crown is cemented with temporary cement so that it can come off easily once the permanent crown is ready.

Usually a few weeks after a temporary crown, the patient returns for a second visit. During this visit, the tooth may or may not need to be numbed again and the temporary crown is removed. The permanent crown is placed on the tooth and inspected for acceptable fit, bite, and smooth margins. After any necessary adjustments have been performed, the crown is cemented with a permanent cement or dental glue.
  • Is there pain associated with with getting a dental crown?
A: The tooth being restored is numbed so that it isn't painful during the crown preparation. This requires a shot in the gums of lidocaine or another local anesthetic. After the procedure is over and the anesthesia has worn off, the patient may feel some sensitivity with the temporary crown or some soreness in the gums around the tooth. The pain is very minimal though and shouldn't last long.
  • How long do dental crowns last?
A: Dental crowns should last on average from 10 to 20 years. Crowns are still subject to fracture and cavities, so it is important to take extra care in brushing and flossing around crowned teeth to prevent them from needing replacement too often. When all-ceramic crowns or veneers are present, it is often advisable to wear a mouth guard to protect the porcelain from fracturing and prolong the life of the crowns.

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