Crowns - what you need to know

What is a crown?

A crown or "cap" is a dental restoration that covers the entire surface of the tooth restoring the tooth back to its normal size/shape.  Crowns are used to strengthen or improve the appearance of a tooth.  Some examples of when a crown is beneficial are:  a fractured tooth,  cracked tooth,  root canal treated tooth,  tooth with extensive filling material that is at risk for fracture,  discolored or non-aesthetic tooth.

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How is a crown fabricated?

Generally a 2 appointment procedure, at the first appointment, the tooth is prepared by removing the outer portion of the tooth to accommodate the thickness of the material that will be used for the crown.  Impressions are taken of this area as well as of the opposing teeth that is sent to a commercial dental laboratory.  A temporary crown is fabricated for this tooth that is cemented.  At the second appointment, the crown is tried in, adjusted if necessary, and cemented.  In some cases a third appointment is necessary if shading, contour, or fit need improvement.

What are the materials that are available for crowns and which is the best?

There are many dental materials available now for crowns and the materials are continually improving.  The location of the tooth and the needs of the patient will generally dictate the material.  Some examples are:  all porcelain, zirconium, porcelain fused to metal, and gold; each of them has advantages.  Crowns that have the best aesthetics have no metal as a substructure allowing them to have good translucency similar to enamel.  The strongest crowns have no porcelain - since porcelain, like your china, always has the possibility of chipping or fracturing.    Gold crowns require the least amount of reduction of the tooth and will never fracture. 

How much is a crown?

The fee for a crown is based on a number of factors - material/lab/facility, etc.  The primary factor in determining the fee is by the time, care, skill and judgment of the dentist. 

How do I take care of my crown?

The margin of the crown is the junction of the crown to the tooth - this area is susceptible to having decay recur so it is very important to keep plaque off of it daily with brushing/flossing, but also to stay on a regular professional dental hygiene schedule to ensure the areas are kept clean.  To avoid fracturing the crown, the patient should avoid any hard foods, ice, or hard objects.

How long will my crown last?

This is extremely variable depending on numerous factors.  Factors that influence the longevity of the crown are:  the material of the crown, which tooth is being restored, did the tooth have a prior crown or root canal, the oral hygiene of the patient, the bite of the patient, the condition of the tooth prior to having the crown.  The most important factor is how the tooth was prepared and the fit of the crown.