A dental crown is a tooth-shaped “cap” that is cemented onto existing teeth or implants. Crowns can be used to strengthen and protect a damaged or cracked tooth, and/or after a tooth has had root canal treatmentdone, and/or improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function.
When do you need a dental crown?
To protect a weak, cracked or damaged tooth from further breakage
To restore a severely worn or cracked tooth
To reinforce a tooth with a large filling
To reinforce a tooth that has had root canal treatment
To cover poorly shaped or severely discolored teeth
To hold a dental bridge in place
To cover a dental implant
Crown protecting tooth underneath
Crown on dental implant
What are dental crowns made of?
The most popular type of dental crown in the market today is Zirconia. Other materials include gold and metal alloys, other types of porcelain (lithium disilicate) or resin-ceramic hybrids. Porcelain can also be combined with zirconia or metal bases.
Very lifelike and aesthetic.
More expensive than metal crowns.
Greater material thickness required (more tooth trimming).
Can chip or break.
Lifelike and aesthetic. Can be combined with ceramic for better aesthetics.
Stronger than all-ceramic crowns.
Strong enough to be used in thin section or on back teeth.
More expensive than all-ceramic crowns.
Not completely unbreakable.
Porcelain-fused to-metal crown
Less expensive than pure ceramic or zirconia crowns.
Opacity may be useful for covering a discoloured tooth.
Internal metal surface is compatible with titanium implant surface.
Dark grey discolouration can occur at the gum line due to metal show through.
Looks opaque so may not blend in with natural teeth
Easily adjusted to match neighbouring teeth.
Useful as temporaries.
Translucent: dark underlying tooth structure may show through.
Very long lasting.
Softer metals like gold alloy do not cause aggressive tooth wear, perfect for patients who suffer from severe night time grinding.
Stainless steel crowns are used for baby teeth that need reinforcement.
Gold alloys are expensive,.
DentalCrowns at Elite Dental
Before any dental treatment can proceed, it is extremely important to first consult us to assess if your tooth would indeed benefit from a dental crown.
Step 1: Preparing your Tooth
First, your tooth and the surrounding tissues will be numbed with a local anaesthetic. Decay and any defective old fillings will then be removed from your tooth. The cavity is cleaned and refined. A base filling is placed to seal the tooth from bacteria and to regularize the tooth shape.
The tooth is then trimmed so the new crown can fit over it and there is sufficient space for the chosen crown material. A mould or digital scan of the tooth is then made and transferred to the dental laboratory. A temporary crown will be made to protect your tooth in the meantime.
Step 2: Fitting of the crown
Once the final crown is ready, the temporary crown will be removed. The crown is then cemented onto your tooth and excess cement will then be removed. We will then check your bite to make sure it is balanced before we give the new crown a final polish.
We work with a talented team of ceramic artists who will make sure the colour, shape and surface texture of the new crown is exactly as what we have designed and prescribed , to create a crown that is extremely natural looking.
Do dental crowns ruin your teeth?
In order to fit the crown in between your teeth without altering your bite, the tooth to be crowned needs to be trimmed. This trimming is performed on all surfaces of the tooth, with more trimming done on the biting surface so that the new crown will be strong enough to bite on without cracking.
This is especially critical for crowns made of porcelain (including zirconia).
Crowns made of metal (such as gold alloys) can be made thinner without compromising strength. Your dentist may advise a metal crown for a tooth with a short crown height (the part of the tooth visible above the gum) to maximise available tooth structure.
Teeth with large fillings or cracks that compromise structural integrity are usually crowned to prevent severe fractures that require extraction. A crown is a good way to prevent this from happening.
How much does a dental crown cost?
Crown fees vary depending on the dental clinic, the case difficulty, the material used and the lab used.
Case difficulty determines how much time and skill will be required to perform the crown treatment. Patients with limited mouth opening, severely broken down teeth, multiple crowns and highly aesthetic crowns are cases that are considered difficult.
Crowns made of metals like gold cost more than non-precious metal or non-metallic crowns because of the alloy used. Gold is very long lasting, very strong and does not wear out the opposing teeth so it is still used in dental crowns today.
A good dental lab is an important part of making quality crowns. Dental technicians vary by skill and training. Good labs that do highly aesthetic crowns that fit well do not come cheap. The dental technician has to work closely with your dentist to deliver a high quality crown according to the requirements of the case.
How long do dental crowns last?
A well-made and well-fitting crown can last for many years if it is maintained well by the patient.
Crowns can become damaged if decay develops under the margin or if the surface gets damaged by repeated wear and tear. Wear of the crown may be accelerated in patients who grind/clench their teeth (bruxism). To prevent this from prematurely damaging the crown, patients who are at risk of breaking their crowns will be fitted with a custom-made night guard to wear during sleep.
Your dentist will be able to monitor the crowns placed by examining them at your active maintenance appointments (every 4-6 months) and periodic dental x rays (bitewings).
Why is my crown hurting?
A painful tooth (crowned or not) may be caused by pulpitis (inflammation of the nerve inside the pulp of the tooth) or a heavy bite.
Teeth that require crowns have often been through multiple rounds of dental treatment or have significant cracks in them. Some teeth may also have sustained traumatic injuries that have caused fracture of the tooth. These increase the risk of pulp irritation.
If the tooth has been heavily prepared (trimmed) for a crown, that reduces the thickness of the dentine layer that protects the pulp from bacteria. The amount of trimming required depends on the type of crown material that has been planned and the bite pattern planned. Severely worn teeth may be completely destroyed if prepared in the conventional way for the crown to fit into the current bite pattern.
Old crowns may have margins that do not fit well or may be undermined by decay. Open or leaky margins may cause sensitivity or dislodgement of the crown. Poorly-fitting crowns should be replaced to prevent loss of the tooth underneath.
For severe toothache, the treatment of choice would be a root canal treatment. This may be done by making a hole in the crown (which is patched up later).
After a new crown has been fitted, the bite may be heavier on the crown than on the unprepared tooth previously. This overloading of the tooth may cause transient tenderness on biting or even cold sensitivity. These symptoms can be easily managed by leveling the bite to ensure that other teeth share the load of chewing.
How is a tooth crown fitted?
Your crown has been custom-made to fit a particular tooth.
First, the temporary crown has to be removed under local anaesthetic. Even a root canal-treated tooth should be numbed so that the surrounding gum tissue can be manipulated during the cementation process painlessly.
Once the temporary crown has been removed, the temporary cement and plaque is cleaned from the tooth surface. The crown is tried in to check for fit, colour and then the bite is checked. Your dentist may also take an x-ray of the crown to check the fit before cementation.
Once the fit and colour have been verified, the tooth is cleaned of saliva once again and kept dry. The fitting surface of the crown is also cleaned and may be chemically-prepared for the cement.
The cementation must take place in a dry environment to ensure that the cement sets properly. Sometimes, a rubber dam is used to ensure a dry field, especially for cementing certain types of porcelain crowns.
Once the crown has been attached to the tooth, excess cement is removed carefully. The bite is checked and refined once again. Another x-ray may be taken to check for cement remnants under the gumline.
What is the difference between a crown and an inlay?
An inlay is a lab-made filling. An inlay can be made of resin composite (a type of toughened plastic), porcelain or metals like gold. By definition, an inlay does not cover the cusps (the protruding parts of the tooth).
A crown is a cap that covers all the biting surfaces of the tooth. The crown margins may extend very close to the gumline (a full crown) or may stop quite high up the side of the tooth (an onlay).
An inlay does not reinforce weakened cusps, so is not suitable for teeth with large fillings/cavities or teeth that have been root canal treated.