Crown

A crown or "cap" is a full coverage restoration that helps restore function and aesthetics to a tooth or teeth.

When is a crown needed?

A crown is usually indicated but not limited to the following situations:

• Large filling or cavities: When teeth have large, deep, wide fillings and or cavities, the surrounding tooth structure around the filling/cavity is thin and weak, making the tooth susceptible to breakage. As a preventative measure, a crown is placed on the tooth to prevent further complications.
• Cracked teeth: Depending on the severity of cracks in a tooth, a crown is indicated prior to breakage of the tooth, or appearance of symptoms such as hot and cold sensitivity; chewing sensitivity and a dull ache. These symptoms will get worse over time and if a crack reaches the nerve of a tooth prior to the tooth breaking then the tooth will need a root canal or an extraction.
• Broken teeth: After teeth break, a crown is used to restore the missing tooth structure if possible, regaining function. Sometimes teeth break and are not restorable, needing extraction.
• Root canal treated teeth: After decay removal and root canal completion, the void left in the tooth is usually large and the remaining tooth structure is weakened. A crown is therefore the ideal treatment to restore the tooth back to normal.

What is a crown made from?

There are different types of crowns:

• Full gold crowns
• Porcelain fused to metal crowns: This is where the substructure of the crown is metal. Different types of metals can be used in this case. At our practice we choose to use gold (high noble metal) which offers the best biocompatibility, strength and aesthetics for this type of crown. The metal does not show through the porcelain.
• All ceramic crowns: These crowns are made strictly from porcelain, there is no metal present. A crown like this is used more toward the front of the mouth, in aesthetic areas. They are very natural looking and are difficult to discriminate from your natural dentition.

Procedure

Completion of a crown usually requires two appointments. On the first appointment, the tooth or teeth of concern are anesthetized. The old filling and all decay is removed, a filling (build up) is placed in the tooth. The tooth is reduced in size and shaped in a special way for the crown. A medicated retraction chord is gently packed between the gum and the tooth. This helps us get an accurate impression of the tooth which is the next step. To complete the appointment, a custom made, tooth colored, temporary acrylic crown is made and cemented. You will have the temporary crown for approximately three weeks till your next appointment when your permanent crown arrives from the lab. Note that the permanent crown, if porcelain is shaded to match your teeth.

On the second appointment, anesthesia is given if necessary; the crown is tried in for fit; the bite is adjusted and if all is well, the crown is cemented permanently.

What can I expect from the "crown" treatment?

The most common symptoms are but not limited to:

• Hot or cold sensitivity on the involved tooth. For example, if you drink something hot or cold, the tooth is sensitive for a few seconds (0-30 secs.). This is normal inflammation of the tooth nerve due to the procedure. If you have any lingering pain after hot or cold stimulation, you need to contact us ASAP. For example, after drinking something hot or cold and the pain lingers for minutes. This happens because the nerve of the tooth may be in the process of deteriorating and may need a root canal. This is not a common occurrence but does happen at times, depending on the clinical situation.
• Any chewing sensitivity can be eliminated by adjusting your temporary or permanent crown. This needs to be addressed at the earliest convenience to minimize tooth inflammation and symptomology.

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