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Crowns Are For More than Kings and Queens

When Are Crowns For Your Teeth Necessary and What Are Your Options?
When you’ve got a bad tooth and your dentist suggests that you need a crown, the options that you are presented with can often be mind-boggling. In this week’s blog, we’ve tried to give you an overview of what types of oral health problems call for using a crown and the types of materials you have to choose from when the crown is made.
So what exactly is a crown? For many years, it was what royalty wore (and still do in some countries like England). But in the dental world, a crown is a covering that goes over a tooth and is known as a type of dental restoration.  Crowns can be fabricated with various types of materials, from metals to porcelain.
A crown is needed in the following situations:

  • Damage to a tooth is so severe that it cannot be fixed by placing an amalgam or composite restoration (a filling).
  • The appearance of the tooth is less than desirable and the placement of a crown can improve the shape, color and in some cases the alignment of the tooth.
  • To protect a weak tooth due to decay.
  • To protect a weak tooth that has been cracked.
  • To hold a dental bridge into place.
  • To cover a dental implant.

There are several steps involved when placing a permanent crown.  The doctors at Personal Care Dentistry will evaluate the patient’s needs and decide what is best for the patient.  If a crown is necessary the doctor will proceed by prepping the tooth that needs the crown.  This step entails removing any decay and preparing the tooth for its permanent crown.  This may include fabricating a build-up if there is not enough healthy tooth surface left to hold and stabilize the new crown.
An impression is taken and a temporary crown is fabricated after the tooth is prepped.  The temporary crown is seated while the permanent crown is being made in the lab.  Once the crown is finished, typically 1 to 2 weeks, the patient will return to get the permanent crown cemented into place.
So what are the different types of materials used in crowns?
Stainless steel crowns are prefabricated crowns that are used on permanent teeth primarily as a temporary measure. The crown protects the tooth or filling while a permanent crown is made from another material. They are often used with children’s primary teeth. The crown covers the entire tooth and protects it from further decay. When the primary tooth comes out to make room for the permanent tooth, the crown comes out naturally with it.
Metals used in crowns include gold alloy, palladium, 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, metal crowns rarely chip or break. The metallic color is the main drawback. Metal crowns are a good choice for out-of-sight molars.
 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 occurs 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. 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 porcelain-fused-to-metal crowns.
All-ceramic or all-porcelain dental crowns provide better natural color match than any other crown type and may be more suitable for people with metal allergies. However, they are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.
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 a lab.
SOURCE: WebMD and American Dental Association

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