Wednesday, April 25, 2007

FAQs on Dental Crowns

What is a dental crown and why is it needed?
A dental crown is a tooth-shaped "cap" that is placed over a tooth, covering the tooth to restore its shape and size, strength, and/or to improve its appearance. The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.

A dental crown may be needed:
· To protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth
· To restore a broken or worn-down tooth
· To cover and support a tooth with a large filling when there isn't a lot of tooth left
· To give esthetics to a misshaped or discolored teeth
· To hold a dental bridge in place
· To cover a dental implant

What types of materials are available for crowns?
Permanent crowns can be made from all metal, porcelain-fused-to-metal, all resin, or all ceramic.

· 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. Tooth wear to the opposing teeth is kept to a minimum. Metal crowns withstand biting and chewing forces well. They last the longest in terms of wear down and they rarely chip or break. The main drawback is the metallic color. 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. 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 porcelain-fused-to-metal crowns.
· 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 allergies. However, they are not as strong as porcelain-fused-to-metal crowns and they wear down the opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.

Details of the procedure

What steps are involved in crowning a tooth?
Crowning a tooth usually requires two visits – in the first visit the dentist examines and prepares the tooth, and in the second visit he places the permanent crown.

Step 1: Examining and preparing the tooth
Your dentist may take a few x-rays to check the roots of the tooth receiving the crown and the 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.

Your dentist will first anesthetize your tooth and the gum tissue around the tooth. Next, he will file down the tooth receiving the crown 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). On the other hand, if 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 make an impression of the tooth to receive the crown. Impressions of the teeth above and below the tooth to receive the dental crown will also be made to make sure that the crown will not affect your bite.

The impressions are sent to a dental laboratory where the crown will be manufactured. The crown is usually returned to your dentist's office in 2 to 3 weeks. 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.

Step 2: 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, a local anesthetic will be used to numb the tooth and the new crown is permanently cemented in place.

What should I watch out for after I have received a dental crown?
· Discomfort or sensitivity: You will likely experience some sensitivity immediately after the procedure as the anesthesia begins to wear off. If the crowned tooth has a nerve in it, you may experience some heat and cold sensitivity. You may be recommended to brush your teeth with toothpaste designed for sensitive teeth. If you have pain or sensitivity when you bite down it may usually mean that the crown is too high on the tooth. This problem can be easily fixed by your dentist.
· Chipped crown: All-porcelain crowns can sometimes chip. A small chip can be repaired using a composite resin with the crown remaining in your mouth. For extensive chipping the crown may need to be replaced.
· Loose crown: In some cases the cement under the crown washes out causing loosening of the crown, which results in bacterial activity in the area and causes decay to the remaining tooth. You must contact your dentist if your crown feels loose.
· Crown falls off: Crowns may sometimes fall off due to an improper fit or a lack of cement. You should contact your dentist immediately in such a case. Your dentist may be able to re-cement your crown in place or replace it with a new crown.
· Allergic reaction: In very rare cases, you can have an allergic reaction to the metals or porcelain used in making crowns.
· Dark line on crowned tooth next to the gum line: Sometimes the metal of your crown may show through in the form of a dark line next to the gum line of your crowned tooth. It is normal, particularly if you have a porcelain-fused-to-metal crown.

Does a crowned tooth require any special care?
The tooth underlying the crowned tooth needs to be protected from decay or gum disease. You should 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.

How long do dental crowns last?
Dental crowns last between 5 and 15 years on an average. 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).

Cost and availability

How much do crowns cost?
Costs vary depending on the type of crown selected (for example, porcelain crowns are typically more expensive than gold crowns, which are typically more expensive than porcelain-fused-to-metal crowns).
Click here for details.

Which countries/hospitals is it available in?
Click here to check the availability of dental implants with our partner hospitals.

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Note: All information presented here has been obtained from publicly available medical resources and is here for reference purposes only. Healthbase does not claim to be a medical professional and does not provide any advice on any issues relating to medical treatment.