Dental crowns are coverings, or “caps”, which are positioned over a tooth which is structurally compromised or aesthetically unappealing and cover the entire tooth down to the gum line. Teeth which are weak due to decay often need crowns in order to prevent further damage, as do teeth which are already broken or severely worn down. Crowns are also required in cases of extremely large fillings which need to be held in place when an insufficient portion of the original tooth remains. Severely misshapen or discolored teeth are sometimes covered with crowns, and crowns are used to hold together dental bridges
or cover dental implants
Several materials are available for patients to choose from, all with varying price ranges, disabilities, and aesthetics. Metals such as gold alloys and other alloys allow for more preservation of the original tooth and keep collateral damage to neighboring teeth to a minimum, and are more durable than most other materials. However, metals are usually reserved for molar crowns because of the often undesirable metallic color. Porcelain-fused-to-metal crowns are a popular alternative because they can be color matched to neighboring teeth and are among the cheaper options. However, more damage accrues over time to opposing teeth and porcelain is more prone to chipping under stress such as chewing. Another drawback to these crowns is the potential of a dark line’s developing over time at the gum line as the metal interior begins to show as gums recede. All-resin crowns are the least expensive, but are also the fastest to wear down and fracture. All-ceramic and all-porcelain crowns offer the most natural looking color and are hypo-allergenic but they are not as resilient as porcelain-fused-to-metal crowns and pose a greater risk to neighboring teeth than metal or resin crowns. As such, these are often used for front teeth due to their supreme aesthetics.
The process for making a crown usually involves two visits – one for measuring and preparing the tooth for the permanent crown by reshaping it to ensure a proper fit and securing a temporary crown, usually made of acrylic, and the second for placing the permanent crown which was prepared in a dental laboratory. While the temporary crown is in place patients must avoid sticky foods such as chewing gum, minimize chewing on that side of the mouth, and not consume too many hard foods which may dislodge the crown. Problems which can develop include sensitivity which can usually be solved by using toothpaste formulated for sensitive teeth, a chipped, loose, or dislodged crown all of which can be fixed by a dentist, or an allergic reaction in rare cases which calls for immediate replacement. A dark line at the gum is not a cause for concern – merely the metal showing through and should not require dental attention. With proper maintenance, a crown can last five to fifteen years depending on the original material as well as avoidance of habits such as grinding teeth, chewing ice, biting fingernails, and biting hard objects.
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