Dental Crowns
A dental crown is a tooth-shaped "cap" that is placed over a tooth - covering the tooth to restore its shape and size, strength, and/or to improve its appearance. Dental crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.
Why is a Dental Crown used?
A dental crown may be used to protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth, to restore an already broken tooth or a tooth that has been severely worn down or to cover and support a tooth with a large filling when there isn't a lot of tooth left. It may also be used to hold a dental bridge in place, to cover misshapen or severely discoloured teeth, and to cover a dental implant.
Dental Crowns Procedure
If you need a crown, you may also need endodontic or root canal treatment on the tooth. Such treatment may be recommended if you have a lot of decay in the tooth or a risk of infection or injury to the tooth's pulp. Not everyone who needs a crown will also need a root canal.
Before placing a crown, your dentist may need to build up a foundation to support it. A foundation is needed if large areas of the tooth are decayed, damaged or missing. If you are receiving the crown after root canal treatment, your dentist may insert a post-and-core foundation.
To place a dental crown, your dentist will file down the tooth to make room for the crown. If you are receiving an all-metal crown, less of the tooth needs to be removed because these crowns can be made thinner than PFM or ceramic ones.
After filing down the tooth, your dentist will use a piece of thread or cord to push down the gum around the tooth. Then the dentist will make an impression (copy) of the tooth with a rubber-like material. The impression material sets in about five minutes. Then it is removed. Your dentist will also take an impression of the teeth above or below the tooth that will receive the dental crown. The purpose is to make sure the crown will fit into your normal bite.
The impressions are sent to the lab, where the dental crown is made. During that time, you will have a temporary crown placed. These crowns are usually made of plastic. They are made in advance by the laboratory or made by the dentist during your preparation visit. Then the dentist fits the temporary crown to your tooth.
These short-term crowns are not meant to last for a long time. In some cases, however, a temporary crown can stay in place for a year or longer. If it needs to last longer, a lab-made plastic crown is best. It is stronger and will last longer than a temporary plastic crown that is made by the dentist.
Temporary cement is used to keep the crown in place. It is special cement that is designed to be weak. This allows your dentist to easily remove the temporary dental crown at each visit as your permanent crown is fitted.
At a second visit, your dentist will remove the temporary crown and test the permanent one. Sometimes crowns need additional polishing or glazing or some other adjustment before they are placed. Once the dental crown is ready, it's cemented to your tooth.
Dental Crown Procedure Risks
You shouldn't feel any discomfort or sensitivity after a dental crown is placed. However, if your tooth has not had a root canal it will still contain the nerve. You may therefore have some temporary sensitivity to heat and cold. If you notice pain or sensitivity when you bite down, contact your dentist. Usually this means that the dental crown is too high. This can be adjusted easily.
You may notice a thin, dark line next to the gum line on your crowned tooth if you look very closely in the mirror, particularly if you have a PFM crown. This dark line is the metal of the dental crown showing through and is normal.
A crowned tooth is protected from decay, except for the gum line. Your dentist may prescribe a high-fluoride gel for you to use every night to protect against decay. A dental crown does not protect against gum disease. You should continue practicing good oral hygiene.
Dental crowns, especially all-porcelain ones, can chip. This can sometimes be repaired in the mouth. Your dentist will etch the porcelain with acid and bond a composite resin to it to fix the chip. Porcelain repairs often don't last long. If there's a lot of chipping, you may need a replacement dental crown.
It's also possible that the cement could wash out from under the dental crown, but it does not fall out. Under these conditions, bacteria can leak in and cause decay. If your crown seems loose when you chew, or if you have an unusual odour around the tooth, discuss this with your dentist. Your dentist will check your crowns at your regular visits.
Dental crowns sometimes fall out. This can be caused by a lack of cement or an improper fit. If this happens, place the crown in a secure, zip-top plastic bag. Then return to your dentist to have it cemented back in place. If you are in no discomfort and your appearance is not affected, don't try to put the crown back in place yourself.
If you do need to put it back in your mouth, clean it well on the inside. Use a toothpick to loosen and remove any cement or debris that is stuck to the crown. A wet cotton swab can finish the cleaning. You can replace the dental crown temporarily using denture adhesive or temporary cement. This is sold in many pharmacies. Contact your dental office immediately and try to schedule a visit for the next day.
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