Welcome to the second blog post in my 8-week series about the different types of services a typical dentist offers! Last week’s topic was all about dental fillings.
This week’s topic is about DENTAL CROWNS!
Dental crowns are typically prescribed by dentists to act as a full-coverage protection of weak teeth that:
- have been root canal treated,
- show signs or symptoms of a cracked tooth,
- have been severely damaged by large decay, or
- have severe wear due to aggressive grinding or clenching.
Dental crowns have evolved tremendously during the past few decades. Most dentists back in the day used GOLD as the primary material for crowns. Gold was a great choice of material due to its durability, strength, and conservative preparation requirements. However, its limitations were predominantly in its poor visual appeal.
As we became more aesthetic-conscious, porcelain-fused-to-metal (PFM) crowns quickly rose in popularity. PFM crowns achieve their strength and rigidity from their metal substructure, and their natural aesthetics from the porcelain coated on top of the metal. This enables dentists to seamlessly blend the dental crown with your natural teeth because porcelain is able to mimic the natural contour and color of teeth.
Over the last decade, dentistry has moved even further away from metal due to the gray discoloration it can produce by the gum line. Nowadays, full-ceramic crowns like Feldspathic, Emax, and Zirconia are the most common materials used because of their superior aesthetic results. Though they lack metal substructure, they are extremely rigid and durable due to significant advances in ceramic dentistry. These advances have brought even more attraction to cosmetic dentistry.
Though they are all ceramic, each material has different properties. Therefore, they differ in strength and aesthetics. Your dentist will determine which is the ideal ceramic material for you depending on your grinding habits, the nature of your bite, and the location of the tooth.
Below are a few key points that differentiate each ceramic material.
Feldspathic: Feldspathic porcelain is ideal for front teeth and is typically used for veneers because it is the most visually appealing. It has great translucent qualities that mimic the natural tooth color most. However, it does not handle strong occlusal/bite forces. Thus, it is not ideal for posterior (back) teeth because it is not as strong as other porcelain.
Emax: Also known as lithium disilicate glass, Emax is the most commonly used ceramic for veneers and anterior restorations due to its excellent translucent qualities and strength. It is great for both front and back teeth. Emax crowns can also be bonded to your natural teeth. Thus, it is the ceramic of choice for short teeth that lack the height needed for adequate retention of the crown.
Zirconia: It is the strongest ceramic, but it is also the least aesthetic of the ceramic crowns. It is more opaque in color and lacks the translucency of a natural tooth because it is monochromatic in structure. It is made out of white, powdered metal oxide which gives it its incredible strength. Zirconia ceramic is the ideal material for dental bridges and for individuals who suffer from severe wear due to grinding and clenching. To compensate for its poor aesthetics, the dental lab can add a layer of porcelain on top of the zirconia layer, giving it a more natural appearance.
This is a typical step-by-step instruction of how a tooth is prepared for a dental crown:
- Your dentist will diagnose a crown if necessary, to protect your tooth.
- When you achieve profound anesthesia, your dentist will use a high-speed drill to remove any decay and/or damaged enamel around the tooth. A “build-up” composite filling may be necessary to fill the areas if decay is extensive.
- The dentist will continue to prepare the tooth so that at least 1 mm of tooth structure is removed from all around the tooth. This is necessary because this is where the porcelain crown will sit on top of the tooth to provide coverage.
- Once the dentist is finished with the preparation, a mold or an impression, is made. This mold is used by the dental lab to fabricate your crown. Any disturbance in the mold will result in an imperfect crown, so it is crucial that the impression is perfect.
- Your dentist or the dental assistant will fabricate a temporary crown chairside so that you can function normally as we wait for your crown to be made.
Seat Crown Appointment:
- Two to three weeks later, you will come for another appointment to seat your permanent crown.
- Your temporary crown is removed, and the permanent crown is seated. Your dentist will inspect the margins, making sure everything is properly sealed. A properly sealed tooth will have no space or voids between the tooth and the crown. Any voids or space will result in recurrent decay and/or sensitivity. Your dentist may use an x-ray to verify a proper seal.
- Your bite will then be adjusted so that when you bite, the crown is not too high. A crown that is too high will cause pain and sensitivity, so it is crucial that it is adjusted properly.
- After proper seating and bite is confirmed, your dentist will use a permanent cement to cement your crown.
- Excess cement is cleaned. Your bite is re-checked for good measure.
Frequently Asked Questions:
Is it normal to feel sensitivity after a crown?
Yes!
Some people may feel sensitive for a few days after a crown preparation. This is because your tooth has just been worked on and may take some time to heal. If it gets worse, this may mean that the temporary or permanent crown may be too high and will need a bite adjustment.
Can I eat normally on that side?
Yes and no…
To be on the cautious side, I always caution my patients to eat softer foods where the temporary crown is. Sticky foods like gum and taffy should be avoided because they can stick on the temporary crown and remove it. Same with hard foods, they can crack it. However, once the permanent crown is cemented, you can eat and function as normal.
Are dental crowns expensive?
Dental crowns are NOT cheap!
Luckily, your dental insurance will almost always cover a portion of it (usually 50%). If your dentist has prescribed you a dental crown, don’t delay treatment! Delaying treatment can result in a much more complex restoration that is more expensive down the line (you may end up needing an extraction and implant, which will cost about $4,000). Ask your dental office if they offer any payment plans. It’s better to get started sooner rather than later!
How many appointments does it take to complete a dental crown?
Two!
One appointment for the preparation. The second appointment is to seat the permanent crown. The first appointment typically takes 45 minutes to an hour. The seat appointment usually takes 30 minutes.
Questions about dental crowns? Visit BMEDental.com or book your appointment online!