Things you need to know about Dental crowns

A dental crown is a cap that covers the tooth and restores any damaged tooth. The tooth’s shape, size, strength and appearance improve with the placement of the crown.

When do you require crowns?

• Broken tooth: The crown provides proper shape to the broken tooth and protects from any further breakage.
• Root canal treated tooth: The root canal treatment tooth has lower strength than a vital tooth. Therefore, in order to provide strength, such tooth must be provided with crowns. This will not only add on to the strength of the tooth but also enable its use ineffective chewing of food.
• Bridge fabrication: Dental bridge is a prosthesis for replacing missing teeth. A bridge is fabricated by taking support from the adjacent teeth on either side of the missing tooth. The crowns are prepared for two/more adjacent teeth based on the number of teeth to be replaced. These crowns act as the support for the bridge which will replace the missing tooth.
• Discoloured tooth: The discoloured tooth can be covered with a crown matching the patient’s natural teeth. This improves the appearance of the tooth.
• Dental implant: Dental implants are the most advanced way to replace one/more missing teeth. The implant replaces the root and the crown mimics the natural tooth structure.

Procedure:

In the first appointment, the tooth that is to receive the crown is trimmed on all the surfaces. Space, thus created, is meant for the crown. The amount of natural tooth structure that would be trimmed is based on the type of crown. Metal crowns require extensive trimming of the original tooth compared to the ceramic ones.

Post-trimming, the impression of the trimmed tooth is recorded using putty impression material/ with a digital scanner. The cast developed from this impression is used to fabricate customized crowns after matching the shade.

The crown is fixed with cement in the second visit. This is permanent and cannot be easily removed.

Types of crowns:

Metal ceramic crowns: The metal-ceramic crowns have a metal base and a ceramic coating above them to provide natural tooth-like appearance. These crowns are sturdy because of the metal base and also aesthetically good. However, the original tooth has to be trimmed relatively to a large extent in order to make a place for both metal and ceramic. Also, the metal is usually visible near the gum. They could be used for posterior teeth where strength plays an important role than the aesthetics.

E-Max crowns: These crowns are made with lithium disilicate. It is a glass-ceramic which is ideal for anterior teeth and veneers, due to its natural-looking tooth colouring and excellent light-optical properties. These crowns are durable as they do not fracture easily and also require minimal preparation of the original tooth.

Zirconia crowns: This is also a type of all-ceramic crown made from powdered zirconium. Therefore, the aesthetic factor is its prime advantage. Also, the strength of these crowns is better than the metal-ceramic crowns. They do not chip off, unlike porcelain fused metal (PFM) crowns. Zirconia crowns are available in two forms: solid and highly translucent. The solid variety has higher strength and is more opaque(also called as Bruxir crowns) Hence, it can be used for posterior teeth. The translucent variety is less opaque and has high aesthetic value. Hence, it can be used for the anterior teeth.

How long does a crown last?

Crowns can last anywhere between five to fifteen years based on the patient’s oral hygiene maintenance post crown fixation. Although the crown can protect the underlying tooth structure from decay to an extent, poor oral hygiene can cause gum diseases resulting in failure of the crown.

How to care for crowns?

• Maintain good oral hygiene by brushing twice and flossing.
• Do not bite on hard substances like sugarcane, bone, etc.
• Do not try to open bottle caps with teeth.
• In case the crown dislodges, get an appointment with your dentist to check if the same crown could be fixed.

What Problems Could Develop With a Dental Crown?

• Dark line near the gum on the tooth with the crown.A dark line may be visible next to the gum line of your crowned tooth if you have a porcelain-fused-to-metal crown. This is the metal beneath the porcelain which is shown through. This can be avoided with an all-porcelain or ceramic one.

• Discomfort or sensitivity. A newly crowned tooth may be sensitive once the anaesthesia wears off. If the crown is placed on a vital tooth, one may experience some heat and cold sensitivity. A desensitizing toothpaste will be prescribed to relieve the sensitivity. Although for the initial days after fixing the crown, one might feel mild discomfort due to change in the height of the crowned tooth. However, if the tooth is too high, there might be a pain while chewing. In such cases, fix an appointment with your dentist to get it corrected.
• Chipped crown: A porcelain part of a PFM crown or all-porcelain crown may chip when the crowned tooth is used to bite on something hard. This can be corrected with composite resin if only a minute part of the crown is chipped. However, if a larger portion of the porcelain is broken, the crown would require replacement.
• Loose crown: The cement from beneath the crown may get washed off over a long period of time. This results in the loose crown and also the tooth underneath may be prone to decay as the bacteria may enter the tooth below.
• Crown falls off: The crown may fall off due to the cement washing off or due to decay of the underlying tooth. In such cases, the crown may have to be re-fixed or redone based on the condition of the supporting tooth.
• Allergic reactions: Very rarely, the metal used in the crown may cause a reaction in some patients. In such cases, please contact your dentist as soon as possible as the crown would have to be remade with a different material.
• So What Should I Consider When Getting a Dental Crown?
• A well-made dental crown may last for 5-15 years, based on the oral hygiene maintenance of the patient post crown fixation. So, it is important to get it done from a skilled dentist.
• There are a variety of crowns one can choose from. Weigh the pros and cons of different crowns, assess the crowns based on your requirement and decide. Speak to Dr Amruta Dash, the clinical director at ivory smiles dental clinic to know more. The team can help you understand the advantage and disadvantage of the various options and help you make a decision.
• If you are concerned about esthetics, we would suggest a metal-free crown-like E-max or zirconia.

If you want to get more information about dental crown types and cost, feel free to call Ivory Smiles Dental Clinic at 9008647868/080-42229797.