Dental crowns

Dental Crowns: What You Need to Know

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Crowns are one of the more common restorations available to keep our teeth’s appearance and functionality.

If you’ve been told that you need to get one done and still have some questions in your mind, our specialist prosthodontist Dr. Omar Aldaoudi offers you a list of answers to the most frequently asked questions about crowns.

  • 01What is a crown? Does it make the tooth stronger?

    A crown is an artificial replacement that restores missing tooth structure by surrounding the remaining coronal tooth structure, or is placed on a dental implant. The tooth-crown unit restores the aesthetic and function like any natural tooth. Dental crowns are permanently cemented existing teeth or implants and can only be removed by a dentist.

  • 02

    When does a tooth need a crown?

    • Following a Root Canal Therapy (RCT), it is highly recommended to protect the teeth, especially the molars and premolars, with a crown. Crowns will protect the teeth that have become highly susceptible to breaking, fracturing or splitting through the roots.
    • Crowns can be used to close spaces between teeth, fix chipped, worn, discolored and poorly shaped teeth.
    • When there is excessive loss of tooth structure (like large decays and fractures) that involves multiple surfaces, the crown could be the restoration of choice.
    • In some cases, the placement of a crown on a cracked tooth provides maximum protection and prevent tooth loss.
    • For teeth that are restored with very large filling and in cases where the amount of the remaining tooth structure is small, it is recommended to place crowns to prevent fractures and/or cracks.
    • In case of severe loss of enamel, crowns are successfully used to restore the functions and esthetics of the patients.
    • Crowns are used to attach a bridge. A dental bridge is composed a pontic (false tooth) and two anchoring dental crowns or abutments.
    • A crown covers a dental implant; an ‘implant crown’ is placed to replace the missing tooth.
  • 03

    What are crowns made of?

    There are three types of materials commonly used:

    • All-ceramic: due to the true revolution in dental industry. The “metal free” crowns are suitable for most cases. They combine excellent biocompatibility, high strength and high esthetics to ensure long-term success.
    • Porcelain-fused-to-metal: the crown is made from both metal (precious or non-precious) and porcelain. PFM crown are still very commonly used for the back teeth but do not meet today’s esthetic standards for the front teeth.
    • Gold: the use of gold crowns has significantly declined due to the importance of esthetic and the progress made in dental materials. However, in some cases they are still the best available option.

  • 04

    How long does the treatment take? How many visits will it take to complete the whole procedure?

    Treatment planning is very important for all dental procedures, in some case when a 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.

    Crowns generally require two sessions:

    • First session for when the dentist prepares the teeth, takes impressions and places a temporary crown.
    • Second session for when the actual crown is fitted and cemented.

    Porcelain crowns do require some laboratory time to be created, it takes generally 5-7 working days.

  • 05

    Does it hurt to have a tooth prepared for a crown? Is there particular preparation a patient has to do before his crown is made or fitted?

    The treatment is pain free. After porcelain crowns are cemented, some patients may occasionally experience sensitivity to hot and cold temperatures. It’s best to consult with your dentist for more information about your individual case.

  • 06

    Will the crown be noticeable? Will the crown feel different?

    Crowns look very natural, they replicate the original tooth and improve the aesthetic when needed.

  • 07

    How are crowns fixed to teeth?

    Crowns are fixed with cements. The cementation technique is specific for each type crowns based on the material used.

  • 08

    How long will the crown last? How should I take care of my crown?

    While crowns and bridges can last a lifetime, they do sometimes come loose or fall out.

    It is very important to practice good oral hygiene to ensure the longevity of your crowns. Keep your gums and teeth healthy, visit your dentist and hygienist regularly for checkups and professional cleanings.

    Patients with grinding and clenching will need to use their night guards to protect the porcelain from unnecessary and excessive pressure and use.

References:

  • American Dental Association
  • "Dental Crowns: Uses, Types, and How the Procedure Is Done". Webmd.com. 2010-11-16.
  • The anterior all-ceramic crown: a rationale for the choice of ceramic and cement. British Dental Journal 205, 251 - 255 (2008)
  • American Academy of Cosmetic Dentistry
  • American Association of Endodontists