Dental Crowns
What is a dental crown?
Steps of a Dental Crown Appointment
1. Preparation Visit: In most cases, getting a crown involves two visits. During the first visit, we will numb the tooth and surrounding area. The dentist then carefully trims and shapes the tooth to make room for the crown (removing decayed or weakened parts in the process). We will remove enough tooth structure so that once the crown is placed it will sit flush with your other teeth. If the tooth has very extensive decay or a fracture, we might need to build it up with a filling material (core build-up) first to support the crown.
2. Impression or Scan: After shaping the tooth, we take an impression (mold) of the prepared tooth and the teeth around it. This could be done with a putty-like material or a digital scanner. We also record the color shade of your surrounding teeth so the crown can be color-matched. The impression/scan is sent to a dental lab that will fabricate your permanent crown (which usually takes 1–2 weeks).
3. Temporary Crown: Before you leave the first visit, we will place a temporary crown made of acrylic or resin on your tooth to protect it. The temporary will be cemented with a weak adhesive for easy removal later. It will be shaped to allow you to eat and look okay for the short term. (It won’t match perfectly and isn’t as strong, so some care is needed – see below.)
4. Crown Delivery Visit: Once your permanent crown is ready, you’ll return for a second appointment. We’ll remove the temporary crown and clean off the tooth. We will test fit your new crown, checking the margins (fit against the gum) and your bite. If everything looks and fits right, we will cement or bond the crown in place with a strong dental cement. We’ll then clean up any excess cement and verify your bite again. This visit usually doesn’t require numbing (unless adjustments to the tooth are needed).
(Note: In some cases, we offer same-day crowns with CAD/CAM technology. In that scenario, steps 2–4 happen in one day: we scan your tooth, mill the crown in-office, and cement it, eliminating the need for a temporary crown. If this applies to you, we will let you know.)
Key Benefits of a Crown
– Strengthens a Damaged Tooth: A crown reinforces and protects a tooth that is cracked, heavily filled, or weak. It covers the entire tooth, holding it together and distributing chewing forces evenly. This greatly reduces the chance of the tooth fracturing apart.
– Restores Function: With a properly fitted crown, you can bite and chew on that tooth normally again. Crowns are made of strong materials designed to handle the forces of chewing for many years. This means improved eating comfort and efficiency, even on teeth that were previously painful or non-functional.
– Improves Appearance: Crowns can be made to look very natural. They can correct discoloration, odd shapes, or alignment issues. For front teeth, a porcelain crown can dramatically improve your smile by providing a perfectly shaped and colored tooth surface. Even for back teeth, we match the crown to your tooth color, so your dental work isn’t obvious.
– Protects After a Root Canal: Teeth that have had root canal treatment often become brittle. Crowning such a tooth seals it and prevents fractures. It’s generally the standard of care to put a crown on a posterior (back) root-canaled tooth to ensure its longevity.
– Long-Term Durability: Crowns are one of the longest-lasting dental restorations. With good oral hygiene and care, crowns often last 10-15 years or more. Many patients keep crowns much longer without issues. Crowns resist wear and are not prone to cavities themselves (though you must keep the area around the gumline clean, cavities can develop here).
Risks or Side Effects of Having a Crown Placed
– Tooth Sensitivity or Discomfort: After the tooth is prepared for a crown, it may be sensitive, especially to cold or heat, due to the removal of outer enamel. The temporary crown and the final crown both insulate the tooth, but you might notice mild sensitivity for a few days. If you had a root canal, the tooth has no nerve so sensitivity is usually not an issue. Any sensitivity typically resolves after the permanent crown is in place and your tooth settles down. Using a sensitive toothpaste can help in the interim.
– Temporary Crown Issues: The temporary crown is not as sturdy as the final one. It could come off or crack if you chew something sticky or hard. If your temporary pops off, keep it safe and call us – we can re- cement it easily. Also, the tooth under the temporary may be sensitive, and the gum around might be a little irritated. Be gentle when flossing around a temporary (slide floss out rather than lifting up through the contact) to avoid dislodging it.
– Possible Need for Root Canal: In the process of removing decay and preparing the tooth, or even after crown placement, it’s possible the tooth’s nerve can become irritated or inflamed. In a small percentage of cases, a tooth that wasn’t initially slated for a root canal may end up needing one after a crown due to lingering sensitivity or pain (this could be weeks or months later). This happens if the nerve was already compromised or becomes traumatized – it’s not common, but it is a known risk. If this occurs, the crown would be opened or removed to perform the root canal, and then the crown (or a new one) re-cemented.
– Crown Detachment or Damage: Although rare with proper care, a crown can uncement or even crack. Biting on extremely hard objects (ice, hard candy, popcorn kernels) or grinding your teeth can jeopardize a crown. If a crown ever feels loose or comes off, contact us immediately – usually it can be re-cemented if the tooth is still sound. If the crown cracks (which is more likely with porcelain if a heavy force occurs), it would need to be replaced.
– Gum Irritation or Allergic Reaction: Right after crown placement, your gum around that tooth might be slightly sore from the procedure or from the temporary. This is temporary and can be managed with saltwater rinses. True allergic reactions to crown materials are very rare; the crowns we use are high-quality and typically inert. If you have any known metal allergies, let us know (e.g., some porcelain-fused-to-metal crowns contain nickel). We have metal-free options in such cases.
– Esthetics or Bite Adjustments: We take care to match the color and shape, but once the crown is in, minor adjustments might be needed. Perhaps your bite feels a tad high or the shape feels different. It may take a few days to get used to a new crown. If your bite feels off or you have pain when biting, we can adjust the crown’s surface. In terms of esthetics, we will have you approve the look before cementing. Occasionally, slight color or contour tweaks are desired; if so, those should be addressed prior to final cementation, as changes after cementation are limited.
Alternatives to a Crown
– Large Filling or Onlay: In some cases, if enough healthy tooth remains, we could place a large filling or a partial crown (onlay) instead of a full crown. However, large fillings on heavily damaged teeth often do not hold up long-term and could fracture. An onlay (covering one or more cusps but not the entire tooth) is a more conservative option if suitable, preserving more natural tooth than a full crown. We will advise if an onlay is possible for your case.
– Extraction (and Replacement): If the tooth is extremely compromised, one alternative is to extract it. Of course, then you would have a missing tooth that should be replaced with an implant, bridge, or denture for function and appearance. Extraction avoids the cost of a crown but leads to the need for a different procedure (and losing a natural tooth is usually a last resort). We typically recommend saving the tooth with a crown if it’s viable, since natural teeth, when restorable, often function longer than replacements.
– No Treatment / Temporary Fix: If a crown has been recommended, it’s usually because the tooth is at risk (cracked, decayed, etc.). Delaying a proper restoration may result in the tooth breaking or pain developing, which could then force an emergency extraction or more extensive work. A crown is generally the definitive solution for long-term protection in these situations. We’re offering the crown to prevent future problems and save the tooth.
Post-Procedure Care Instructions: (After Crown Prep and After Crown Placement)
– Care for Temporary Crown: If you have a temporary crown, treat it gently. Avoid very sticky foods (caramel, taffy, chewing gum) on that side, as they could pull the temporary off. Also avoid extremely hard or crunchy foods on it. If flossing, slide the floss out rather than lifting up, to prevent snagging the temporary. Keep the area clean with brushing and rinsing; you can use a saltwater rinse to soothe the gum. If the temporary comes off or cracks, please contact us – we’ll arrange to reattach or remake it promptly.
– After Permanent Crown Cementation: You can generally eat and use the tooth normally once the permanent crown is placed (the cement sets quickly). However, it’s wise to avoid chewing very hard substances for the first 24 hours to let the cement fully cure. You might feel minor sensitivity or mild soreness in the gum for a day or two. Maintain normal brushing and flossing; in fact, keeping the crown margins clean is crucial for its longevity. When flossing around the new crown, use the same technique – it’s a real tooth underneath, so it needs flossing to prevent decay at the edges. If it’s a bridge (multiple crowns connected), we’ll show you how to thread floss under it.
– Bite and Fit: Pay attention to how your new crown feels when you bite. It should feel like a natural tooth. If your bite feels uneven or the crowned tooth hits first, give us a call to adjust it. A high spot can cause sensitivity or soreness. It’s a quick fix if needed.
– Oral Habits: Crowns are strong, but you should still avoid chewing on ice, pens, or non-food objects, and avoid using your teeth (crowned or not) to open packages or bottles. If you grind your teeth at night (bruxism), please use a night guard. Grinding can wear down or fracture a crown over time just as it would natural teeth. We can make a custom night guard if you need one.
– When to Contact Us: If you experience persistent pain, or if the crown feels loose or comes off, contact our office. Save the crown if it fell off – it can often be re-cemented if the tooth is still in good shape. Don’t be shy about calling; it’s important to address any issues early to prevent further damage.