Procedure for dental crowns: Getting a dental crown on your tooth
The dental crown procedure is one of the most common procedures practiced by dentists. There are several reasons that a patient may choose to get a dental crown, ranging from aesthetic reasons to medical ones. That’s why we compiled with helpful guide to help you know what to expect from a dental crown procedure.
What Exactly is a Dental Crown?
Put simply, a dental crown is a small custom-made cap that fits over a tooth. Crowns may be made from porcelain, metal, resident, or other materials, depending on the reason for the application.
Dental crowns are used to restore the tooth to its original size, strength, shape, and integrity. Crowns are ideal for improving your appearance and restoring the functionality of your teeth.
What Can Dental Crowns Do?
Crowns can work to:
- Mask misshapen or discolored teeth.
- Secure a dental bridge in place.
- Support and cover a filling when there isn’t sufficient tooth left.
- Protect a tooth weakened from tooth decay from incurring further damage.
- Hold parts of a cracked tooth together.
- Restore the integrity and function to a severely worn down tooth or one that is already broken.
Dental crown procedure
At least two dental visits are typically needed to prepare a tooth for a dental crown to be placed. The purpose of the first dental visit is to examine and prepare the tooth that is to be crowned and create an impression of the tooth so that the crown can be constructed. A temporary crown to protect the tooth is also usually placed during this visit.
In the second visit, which occurs once a dental laboratory has constructed the crown, the temporary crown can be removed and the permanent custom-made crown fixed in place.
First Visit: Investigation, Tooth Reshaping, Impression and Temporary Crown
During the first dental visit, an X-ray is usually taken of the tooth and jawbone to investigate for signs of decay and other factors that could increase the risk of infection or injury to the pulp of the tooth. For some patients, root canal treatment may be required prior to the placement of a crown on a tooth.
The tooth will need to be shaped to allow room for the crown to be placed; the extent of reshaping will depend on the type of crown being used. Metal-based crowns tend to be thinner and, therefore, require the removal of less structure of the tooth than porcelain crowns. The top and sides of the tooth are filed down to shape the tooth as needed for the crown. Any tooth decay should also be treated during this step.
For some patients with severe decay or damage to the tooth, there may be insufficient tooth structure remaining to place the tooth. In this case, a filling material may be needed to build up the structure of the tooth so that the crown can later be put in place.
Once the tooth has been adequately shaped, the next step is to create an impression of the shaped tooth so that the crown can be made to fit the tooth as closely as possible. An impression also often needs to be created for the tooth on the opposing jaw that will connect with the crown when the patient bites. This is to ensure that the crown fits well to the other side of the mouth, in addition to the area where it will sit.
Impressions are usually made using a paste or putty that holds the shape of the tooth. It is spread over the area to be copied and then pulled away, keeping the shape of the relevant teeth on its surface.
At this point, it is important to record details about the tooth that will affect the production of the crown, such as the natural fit and color. Ideally, the color of the crown should match that of the tooth and surrounding teeth so that it is not noticed when it is placed inside the mouth.
Finally, a temporary crown is usually placed over the tooth to protect it until the crown has been constructed and is ready to be fixed in place. This will be removed at the next dental visit to make room for the permanent crown.
Second Visit: Permanent Crown Placement
In the meantime, the impressions of the teeth are sent to a dental technician or laboratory to form the crown in the correct shape. This process typically takes up to three weeks, which is why more than one dental visit is needed to place a permanent crown correctly.
Once the dental technician or laboratory has created the crown, it is time for the crown to be placed over the tooth. If a temporary crown has been placed, this should first be removed.
It is important to check that the crown has been made correctly, ensuring that both the fit and the color of the crown match that of the natural and surrounding teeth before it is cemented in.
A local anesthetic is usually administered to numb the area during the procedure to fit the crown. Dental cement is utilized to fix the crown in place over the tooth. It may be necessary to make small adjustments to the shape of the crown, particularly if there are problems with the patient’s bite when the crown meets the opposite tooth.
Same-Day Crowns Placement Procedure
In some cases, crowns may be constructed in the dental practice so that the crown can be made and placed on the same day, without the need to send the impressions to a dental laboratory.
Rather than making an impression of the tooth, a scanning device called a wand is used to take pictures of the teeth. These images are uploaded into computer software that creates a 3D model of the tooth. This digital model can then be used to create a ceramic crown the same day. This method is known as computer-aided design and manufacture of dental crowns (CAD/CAM) and can be completed in approximately 15 minutes so that the crown can quickly be put in place.
Dental crown types
Crowns are available in a selection of materials, each of which has different benefits and risks. Your dentist will discuss with you which will be the best crown for your tooth. Dental crowns are often called caps.
Porcelain Crowns and Zirconia Porcelain Crowns
Porcelain crowns are the most cosmetic type of crown. The crown is made entirely of porcelain which is a glassy strong, rigid material. Porcelain can be made to be slightly translucent, so that it reflects light similarly to a natural tooth. Porcelain crowns are available in the full range of colours which teeth naturally occur in. The master technicians we use to custom build your crown will mix a range of these colours to create texture for a natural looking smile. Porcelain crowns are very hard, but that also means they are more brittle. Porcelain crowns are more likely to fracture under high loads than other crowns and due their surface hardness, they can cause wear for other teeth opposite them. Zirconia based porcelain crowns are a higher strength version of porcelain, which reduces the risk of fracture, but at the expense of the translucency. Translucent porcelain can be build up over the zirconia, though, so a great aesthetic result can still be achieved. These types of dental crown are the best for cosmetic dentistry and high visibility areas.
Gold crowns are rarer these days, due to increased aesthetic demands and the improvements made in better looking, more aesthetic materials. However, gold crowns are still the gold standard for strength and longevity. Gold crowns are very unlikely to fracture and cause minimal wear against the opposing tooth. Gold does not look natural, so is usually only used in areas that are not very visible, or in areas with a high fracture risk. Some people do like the appearance of a gold tooth, but that is becoming less common as whiter teeth become the fashion. Gold crowns are not made of pure gold, which would be too weak, but it is a combination of a number of metals, called an alloy.it is the best for teeth grinding and non visible areas
Porcelain Fused to Metal Crowns
Porcelain fused to metal crowns offer a compromise between porcelain crowns and gold crowns. They have a metal core on the inside for strength. Porcelain is built up over this to match the colour of the adjacent teeth. Due to the colour of the metal, an opaque white porcelain is used to block it out, with the matching colour then built up over this. The opacity means that the crown is not as glassy as a natural tooth, but can still have a high aesthetic result, depending on the natural colour properties of your teeth. Porcelain fused to metal crowns are made with a variety of metals and usually contain nickel. If you have a nickel sensitivity (such as sensitive to costume jewellery), you should let your dentist know, so that a nickel free alternative can be arranged. Best for Good compromise between stength and aesthetics.
Do I really need to have a crown? Does root canal treatment mean I need a crown?
A crown will usually be recommended if your tooth has suffered significant damage. When the size of the filling increases, it logically means that the amount of healthy tooth remaining is less. The loss tooth that is there, the weaker it will be. This can cause your tooth to crack or split, sometimes meaning you can end up losing the tooth. Placing a crown minimises this risk. Unfortunately after your tooth has been damaged in any way, your tooth is always going to be weaker than it was.
Root canal treatment, by its nature is damaging to your tooth. Usually a back tooth will need a full coverage restoration, such as a crown, after treatment. A tooth that would benefit from a crown does not necessarily need a root canal treatment, however. Usually, the reason for getting a dental crown is due to significant damage to the tooth, and it should be borne in mind that this same damage can be traumatic to the pulp, necessitating root canal treatment in the future. When a crown is on a tooth, if it needs root canal treatment, the crown will often need to be drilled through, and then replaced. For this reason, sometimes an elective root canal treatment is considered prior to placement of a crown.
How long does a crown procedure take?
The milling machine creates your new crown in about 20 minutes. Then, dentist places the crown. This eliminates the need to create a temporary crown and schedule a second appointment for the permanent crown.
Are dental crowns painful?
Getting a crown is not a painful experience; thanks to the use of anesthetic and sedation, most patients feel only mild discomfort. The benefits of getting a crown far outweigh this temporary discomfort.
How do you care for your dental crown?
Although your crown can’t decay, the edge of the tooth on which it sits can. You will need to brush your teeth with fluoride toothpaste and floss your teeth, as is usually recommended.
Alternatives to dental crowns
There are alternatives to dental crowns. If you want to improve discolouration, then veneers - which are thin layers fixed onto the front surface of a tooth — might be an option. If your tooth is chipped, your dentist may also try to rebuild your tooth structure using filling material.
How much does a crown cost?
A dental crown costs may vary and depends on many factors such type of crown and geography location of dental office. For very front teeth, a premium option may be offered if the dentist thinks there will be benefit. This of course would be optional. Remember, there may also be preparatory work needed to get the tooth ready for a crown, depending on its current condition. dentists can always issue a quote before treatment so you should have no unexpected expenses. As with any quote, it can vary if something unexpected needs to be done, but they will always let you know.