If you need a replacement tooth, it can cause considerable anxiety which may mean that you put off getting essential treatment. This, in turn, may lead to the need for more complicated procedures in the future. This guide will talk you through everything you need to know about dental crowns and the procedures used to fit them.
The crown of a tooth is the visible enamel-covered area that sits above the surface of the gumline. When the integrity of your natural crown is compromised as a result of decay or trauma, your dentist may recommend having a dental crown to protect and repair your tooth.
Dental crowns are caps that are placed onto the remaining portion of your tooth. They are used when other repairs such as fillings are not suitable. Once the dental crown is in place it will restore the appearance, strength, function, and shape of the tooth.
Typically, dental crowns are made from materials that are designed to match the colour and appearance of your natural teeth, blending seamlessly with the rest of your mouth.
The Uses of Dental Crowns
There are several ways that dental crowns can be used. These include:
- To protect a tooth that has become weak through trauma or decay and prevent further damage
- To restore a tooth that is severely worn
- To cover a large filling where much of the tooth has been lost
- As a cover for a dental implant
- To support a dental bridge
- To cover discoloured and misshapen teeth
- To cover a tooth following root canal treatment
- For cosmetic reasons
Provided you care for your crown and follow the advice of your dentist, a dental crown may last for many years. The exact length of time your crown will last will largely depend on the type of material of which it’s made.
The Types of Dental Crown
There are several types of crowns available. When deciding which option suits you best, you may want to consider cost, durability, and appearance. If you’re anxious about having a crown, the complexity of the procedure may also be an important factor to you.
Prefabricated crowns made from stainless steel are a popular choice for temporary use. This type of crown will usually be used while a permanent crown is being made using an alternative material.
Stainless steel crowns are often used in children that have decayed or damaged primary (baby) teeth. The crown will protect the tooth. As the primary tooth starts to come out to make way for the permanent tooth, the stainless steel crown will naturally fall out too.
This cost-effective option is often used for children as their placement doesn’t require several visits to the dentist.
There are a variety of metals used in crowns. Metals used are typically alloys with a high platinum or gold content or base-metal alloys such as nickel-chromium or cobalt-chromium alloy. These materials are ideal for use in crowns as they withstand the pressure from chewing and last for a long time.
While they don’t have a tendency to chip, the colour of the metal along with the high price of materials such as gold are drawbacks. Due to the colour, this type of crown are largely reserved for use on back teeth.
For crowns that match the colour of your adjacent teeth, having a porcelain-fused-to-metal crown is a popular option. The drawback to these crowns is that there is a tendency for opposing teeth to become more worn than with other popular materials. In addition to this, porcelain can chip.
While these crowns look like normal teeth, it is possible that the metal beneath the porcelain can sometimes be seen, particularly around the gum line and especially if you have receding gums.
Porcelain-fused-to-metal crowns can be used for either front or back teeth.
One of the most cost-effective options is to have a resin crown. Over time, this type of crown will wear down. They are also more likely to get damaged in comparison to porcelain-fused-to-metal crowns.
For the most natural appearance, all-ceramic and all-porcelain crowns provide the best colour match and are the best option for people that have allergies to metal. This option can be used for both front and back teeth.
Temporary Vs. Permanent Crowns
Prior to the placement of a tailor-made permanent crown, your dentist may provide you with a temporary crown. These are often made at the dental practice, whereas impressions of your teeth will need to be sent off to a dental laboratory to be made.
Temporary crowns are usually made of stainless steel or acrylic.
What to Expect From the Dental Crown Procedure
If you experience dental phobia, understanding any procedure you need will help you learn what to expect. This will allow you to prepare for your appointments.
Prior to your appointment, discuss your dental anxiety with the practice. Many practices offer sedation for nervous patients, and dentists will also be able to explore ways to help you feel more at ease throughout the treatment. Booking a longer appointment will allow the dentist to take the procedure at your pace.
The procedure for placing dental crowns usually involves two visits to the dentist. On your first appointment, the dentist will examine and prepare your teeth. On the second visit, the permanent crown will be put in place.
The First Appointment
During this visit, the dentist will assess the root structure of the tooth receiving the crown as well as the quality of the jawbone beneath it. To do this, X-rays will be taken.
Where a tooth has considerable decay and its pulp is at risk of infection, a root canal treatment may be required before placing the crown.
Before a crown can be placed, the remainder of the tooth will need to be prepared. To do this, it will be necessary to reshape it. This will be done under local anaesthetic, numbing the area that the dentist will be working.
The amount of enamel that the dentist will remove will depend on the type of crown that will be used. If there is insufficient enamel, the dentist will build up the tooth so that the crown can be fully supported.
Once the tooth has been reshaped, the dentist will make impressions either using putty or digitally using a device such as an intraoral scanner. These impressions will be used by the laboratory to create the final crown. This assessment is important as it will ensure that your new crown doesn’t affect your bite.
The turnaround time for the production of a crown is usually just two or three weeks. When having a porcelain crown, the dentist will colour match the material to your neighbouring teeth.
Once the tooth is prepared and impressions have been taken, the dentist will usually fit a temporary crown made out of acrylic.
The Second Appointment
A few weeks later, your dentist will ask you to return so that the permanent crown can be fitted. Prior to cementing this into position, the dentist will check that the exact colour and fit has been achieved.
Once the dentist is satisfied with this, they will permanently cement the new crown under local anaesthetic.
This procedure is painless and routine. You should experience no more discomfort than you would do if you were having a filling.
Caring for Your Dental Crown
While wearing your temporary crown, you will need to take care to ensure it doesn’t fall out. Avoid eating chewy or sticky foods such as chewing gum or toffee that could dislodge the crown. Hard foods like raw vegetables should be also be avoided.
Wherever possible, try to limit the amount you chew with the side of your mouth where the temporary crown is.
Once your permanent crown has been placed, there will be much less chance of the cement failing, however, ongoing care is important.
To maximise the lifespan of your crown and to prevent damage and decay to the tooth it covers, you should follow good oral health practices. This includes:
- Brushing your teeth twice a day for two minutes at a time
- Using dental floss daily
- Rinsing your mouth with mouthwash daily
You should also avoid any activities that could chip or break your crown such as:
- Opening packaging using your teeth
- Biting your nails
- Clenching and grinding your teeth
- Chewing ice
Risks and Complications
Crowns are useful for dealing with several issues, however, there are several minor risks and complications. These include:
- Sensitive teeth – Crowned teeth can become sensitive to heat and cold. If your tooth is sensitive when pressure is applied to it, it may need adjusting.
- Chipped crown – Depending on the material your crown is made out of, it may chip or crack if proper care is not taken. A dentist may be able to repair minor damage.
- Allergic reaction – While uncommon, some people may experience allergic reactions to certain metals used in dental crowns.
- Gum disease – At the point where your crown touches your gums it can cause irritation. This can lead to gingivitis.
- Loose crown – If there is insufficient cement holding your crown to the underlying tooth, it may move about or fall out. A dentist will be able to reattach your crown.
Dental Crown FAQs
What are the alternatives to dental crowns?
Dental crowns are an effective way of repairing and protecting damaged teeth, capping off dental implants or holding bridges in position.
Alternative options may include:
Should I feel worried about the procedure?
Having worries about any dental procedure is fairly normal, however, having a crown fitted is very straightforward and any discomfort will be minimal.
If you have a phobia relating to any part of the procedure, talk to your dentist about these. A dental phobia certified dentist will talk you through the procedure, listen to your concerns, and may offer sedation dentistry to minimise any discomfort.
How long do dental crowns last?
The exact length of time that a dental crown will last will depend on the material it’s made of. Typically, a crown may last for between 5 and 15 years.
What questions should I ask my dentist?
If you have phobias surrounding any dental procedure, you’ll no doubt have lots of questions you’ll want to ask. Dentists are usually very happy to answer questions, so do ask anything you need to know.
Questions surrounding how to care for your dental crowns are always helpful. Taking proper care of your crown will help minimise the need for further treatment on that tooth.
Will the crown feel different to your natural teeth?
At first, your crown will feel different to your normal teeth, however, after a couple of days, you’ll barely notice it.
If the positioning of your crown doesn’t feel right, speak to your dentist and they will be able to adjust it.
Does having dental crowns hurt?
No. Dental crowns are fitted under local anaesthetic. This means that the tooth and the surrounding area will be numbed so that you don’t feel a thing!
What should I do if I have a dental phobia?
It’s normal to feel some level of anxiety over needing a dental procedure, however, if this is preventing you from getting the treatment you need, it could have an impact on your oral health.
Book an appointment with a Dental Phobia Certified dentist as they will be experienced at helping nervous patients and may offer sedation dentistry.
You may also want to:
- Book your appointment for the quietest time of the day (e.g. the first appointment of the day)
- Take a friend, partner, or family member with you for support
- Consider wearing noise-cancelling headphones during the procedure
- Book a longer appointment so that the dentist can carry out the procedure at your pace
Talking through the things you’re phobic of with your dentist will help them adjust their treatment. An understanding dentist can often help phobic patients overcome their dental fears.