Crowns
A crown is needed to restore a tooth which has....
· Been broken down by decay
· Been broken down by trauma
· Had a root canal
· Developed a crack which is symptomatic and/or may fracture
These are sometimes referred to as "caps". Fillings are a cost effective way to replace lost tooth structure, but they are limited in their effectiveness once a significant amount of the tooth is lost. Filling material is designed to fill teeth, not necessarily to rebuild an entire tooth. The decision to crown is based on how much tooth structure is gone, where the tooth is in the mouth, the long term prognosis of the tooth, the periodontal condition of the tooth, and many other factors. This is a decision to be made by you after conferring with the doctor.
Crowns are made of metal, porcelain, or a combination of both. The combination crown, called porcelain fused to metal, is the most common. The underside of the crown is metal for strength and accuracy of fit and the outside is of tooth colored porcelain for durability and esthetics.
Making The Crown
Even a crown needs a minimum amount of tooth bulk to work right. Often the tooth is so broken down that a procedure known as a crown buildup is needed. This process uses a filling material to buildup what is left of your tooth so that there is enough to crown properly.
Having a crown made is usually a two appointment process..
Appointment 1-Tooth is numbed and prepared for crown. A crown buildup is done if needed. A very accurate impression of the prepared tooth is made. A plastic temporary is made and cemented.( NOTE: Please call to have your temporary recemented within 48 hours should it come loose. It keeps the tooth from drifting until the crown is made. Otherwise the final crown will not fit). A porcelain shade is selected.
Appointment 2- Final crown is tried in and adjusted to fit properly. If the crown fits well it is cemented to the tooth with a durable, fluoride contain cement.
The most important thing to realize is that the critical aspect to a crown is the accuracy of the fit to the tooth. The better the fit the longer the crown will last you. At each step of the process quality control evaluations will be made. This sometimes results in the repeating of a step or two. This can become a bit frustrating, but try to remember that this is done to get you the highest quality end product.
It is unpredictable how long a crown will last, but it will last longer with proper care and maintainance.
Caring For Your Crown
You still need to care for your crowned tooth. It is still susceptible to decay where the crown meets the tooth at the gum line. The margin where the crown meets the tooth can often harbor harmful bacteria if you do not keep your crown clean. This bacteria can lead to decay and periodontal disease. Treat it like any other tooth in your mouth with proper brushing at the gum line and daily flossing.
You also need to maintain the recall period you have been given. The crown is examined at your check up for any problems. The earlier any problem is found the easier and less expensive it is to treat.