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A dental crown is a tooth-shaped "cap" that is placed over a tooth – covering
the tooth to restore its shape, size and strength.
The crowns, when cemented into place, fully encase the entire visible portion
of a tooth that lies at and above the gum line.
Why is a Dental Crown Needed?
A dental crown may be needed when at least one of the following
What Types of Crown Materials are Available?
To protect a weak tooth (for instance, from decay) from breaking or to hold
together parts of a cracked tooth.
To restore an already broken tooth or a tooth that has been severely worn down.
To cover and support a tooth with a large filling when there isn't a lot of
To hold a dental bridge in place
To cover misshaped or severely discolored teeth
To cover a dental implant
Permanent crowns can be either all metal, porcelain-fused-to-metal,
all resin, or all ceramic.
What Steps are Involved in Preparing a Tooth for a Crown?
Metals used in crowns include gold alloy, other alloys (for example, palladium)
or a base-metal alloy (for example, nickel or chromium). Compared with other
crown types, less tooth structure needs to be removed with metal crowns, and
tooth wear to opposing teeth is kept to a minimum. Metal crowns withstand
biting and chewing forces well and probably last the longest in terms of wear
down. Also, they don't chip or break. The metallic color is the main
drawback. Metal crowns are a good choice for out-of-sight molars or for
patients who are heavy "grinders".
Porcelain-fused-to-metal dental crowns can be color matched to your adjacent
teeth (unlike the metallic crowns). However, more wearing to the opposing teeth
may occur with this crown type compared with metal or resin crowns. The crown's
porcelain portion can also chip or break off. Next to all-ceramic crowns,
porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes
the metal underlying the crown's porcelain can show through as a dark line,
especially at the gum line and even more so if your gums recede. These crowns
can be a good choice for front or back teeth.
All-resin dental crowns are less expensive than other crown types. However,
they wear down over time and are more prone to fractures than
All-ceramic or all-porcelain dental crowns provide the best natural color match
than any other crown type and may be more suitable for people with metal
Temporary versus permanent. Temporary crowns can be made in your dentist's
office whereas permanent crowns are made in a dental laboratory. Temporary
crowns are made of acrylic or stainless steel and can be used as a temporary
restoration until a permanent crown is constructed by the dental laboratory.
Preparing a tooth for a crown usually requires two visits - the first step
involves examining and preparing the tooth, the second visit involves placement
of the permanent crown.
How Should I Care for My Temporary Dental Crown?
Examining and preparing the tooth. At the first visit, your dentist may take a
few x-rays to check the roots of the tooth receiving the crown and surrounding
bone. If the tooth has extensive decay or if there is a risk of infection or
injury to the tooth's pulp, a root canal treatment may first be performed.
Before the process of making your crown is begun, your dentist will anesthetize
your tooth and the gum tissue around the tooth. Next, the tooth receiving the
crown is filed down along the chewing surface and sides to make room for the
crown. The amount removed depends on the type of crown used (for instance,
all-metal crowns are thinner, requiring less tooth structure removal than
all-porcelain or porcelain-fused-to-metal ones). If, on the other hand, a large
area of the tooth is missing (due to decay or damage), your dentist will use
filling material to "build up" the tooth enough to support the crown.
After reshaping the tooth, your dentist will take an impression of the tooth to
receive the crown. The impression is sent to a dental laboratory where the
crown will be manufactured. If your crown is made of porcelain, your
dentist will also select the shade that most closely matches the color of the
neighboring teeth. During this first office visit your dentist will make a
temporary crown to cover and protect the prepared tooth while the crown is
being made. Temporary crowns usually are made of acrylic and are held in place
using a temporary cement.
Receiving the permanent dental crown. At your second visit, your dentist will
remove your temporary crown and check the fit and color of the permanent crown.
If everything is acceptable, the new crown is permanently cemented in place.
Because temporary dental crowns are just that – a temporary fix until a
permanent crown is ready, most dentists suggest that a few precautions be taken
with your temporary crown. These include:
What Problems Could Develop With a Dental Crown?
Avoid sticky, chewy foods (for example, chewing gum, caramel), which have the
potential of grabbing and pulling off the crown.
Minimize use of the side of your mouth with the temporary crown. Shift the bulk
of your chewing to the other side of your mouth.
Avoid chewing hard foods (such as raw vegetables), which could dislodge or
break the crown.
Slide flossing material out-rather than lifting out-when cleaning your teeth.
Lifting the floss out, as you normally would, might pull off the temporary
What are "Onlays" and "3/4 Crowns?"
Discomfort or sensitivity. Your newly crowned tooth may be sensitive
immediately after the procedure as the anesthesia begins to wear off. If the
tooth that has been crowned still has a nerve in it, you may experience some
hot and cold sensitivity. Your dentist may recommend that you brush your teeth
with a toothpaste designed for sensitive teeth. Pain or sensitivity that occurs
when you bite down usually means that the crown is too high on the tooth. If
this is the case, call your dentist. He or she can easily fix this problem.
Chipped crown. Crowns made of all porcelain can sometimes chip. If the chip is
small, a composite resin can be used to repair the chip with the crown
remaining in your mouth. If the chipping is extensive, the crown may need to be
Loose crown. Sometimes the cement washes out from under the crown. Not only
does this allow the crown to become loose, it allows bacteria to leak in and
cause decay to the tooth that remains. If your crown feels loose, contact your
Crown that falls off. Sometimes crowns fall off. Usually this is due to an
improper fit or a lack of cement. If this happens, clean the crown and the
front of your tooth. You can replace the crown temporarily using dental
adhesive or temporary tooth cement that is sold in stores for this purpose.
Contact your dentist's office immediately. He or she will give you specific
instructions on how to care for your tooth and crown for the day or so until
you can be seen for an evaluation. Your dentist may be able to re-cement your
crown in place; if not, a new crown will need to be made.
Allergic reaction. Because the metals used to make crowns are usually a mixture
of metals, an allergic reaction to the metals or porcelain used in crowns is
Dark line on crowned tooth next to the gum line. A dark line next to the gum
line of your crowned tooth is normal, particularly if you have a
porcelain-fused-to-metal crown. This dark line is simply the metal of the crown
These are variations on the technique of dental crowns. The difference between
these crowns and the crowns discussed previously is their coverage of the
underlying tooth - the "traditional" crown covers the entire tooth; onlays and
3/4 crowns cover the underlying tooth to a lesser extent.
How Long Do Dental Crowns Last?
On average, dental crowns last between 5 and 15 years. The life span of a crown
depends on the amount of "wear and tear" the crown is exposed to, how well you
follow good oral hygiene practices, and your personal mouth-related habits (you
should avoid such habits as grinding or clenching your teeth, chewing ice,
biting your fingernails and using your teeth to open packaging).
Does a Crowned Tooth Require any Special Care?
While a crowned tooth does not require any special care, remember that simply
because a tooth is crowned does not mean the underlying tooth is protected from
decay or gum disease. Therefore, continue to follow good oral hygiene
practices, including brushing your teeth at least twice a day and flossing once
a day-especially around the crown area where the gum meets the tooth.