January 5, 2019

Dental Crowns: The Need, the Materials and the Advances

What is a dental crown?
The anatomy of a tooth can be divided into two basic parts — the root and the crown. In a person with healthy gums and bone, the root of the tooth is covered by the gums and bone. The crown is part of the tooth visible in the mouth, above the gum line on the lower teeth and below the gum line on the upper teeth. A cemented restoration that partially or completely covers the outside of the tooth is referred to as a dental crown or cap.

When is a dental crown needed?
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 teeth to cracking.
  • Cracked tooth syndrome: This is a condition whereby a patient has fractures inside a tooth that cause pain when it is chewed  in a certain way.
  • Broken cusps: Cusps frequently break off the  teeth due to trauma or large existing fillings. Since the cusps are part of the tooth that take the most stress during chewing, they need to be completely covered or the tooth or filling will keep fracturing.
  • 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. Dental veneers are a very effective and conservative way of enhancing the look of the front teeth.

Is there pain associated with getting a dental crown?
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.

Are there any special considerations for getting a dental crown during pregnancy?
If it is possible, it is best to wait until after pregnancy for elective dental procedures to minimize the stress on both the mother and baby. Getting crowns is often the result of a sudden fracture or other unavoidable situation though, and treatment may need to be immediate. The materials used for crowns are all safe during pregnancy, so when necessary, it is possible to get a dental crown during pregnancy.

How long do dental crowns last?
Dental crowns should last on average from 7 to 10 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.

What kind of crown is best for the back teeth?
If looks aren’t a factor, then an all metal crown is probably the best choice. The metal crown is cast as one piece at the dental lab so there are no layers to it that can chip or fracture. If looks are a factor then a Porcelain to Metal Crown or a Zirconia Crown may be used. For a Porcelain to Metal Crown, there is a metal understructure which is usually a silver color and the tooth colored porcelain is layered on top of the metal. A Zirconia Crown is tooth colored. Sometimes the Zirconia is used alone and sometimes it is used as a base with additional tooth colored porcelain layered over it.

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