Dental Crown Procedure
What is a Dental Crown Restoration?
The terms ‘crown’ or ‘cap’ are used to define a dental restoration or tooth restoration that covers the entire tooth surface. At Crescent Dental the placement of dental crowns is a common and routine dental procedure.
When are Dental Crowns Used?
Here are a few reasons your dentist may diagnosis a crown as a necessary restoration:
1) A tooth has previously had, or is in need of, a root canal or endodontic procedure. After a tooth has had a root canal it is crucial that the remaining tooth structure is supported with a crown. Additionally, the crown will seal bacteria away from the root canal filling inside the tooth.
2) Broken tooth – A tooth may have a crack or fracture that leads to symptoms. A cracked or fractured tooth is not always initially symptomatic or painful but allowed to propagate it will eventually become so. Alternatively the tooth may have a broken element missing, swallowed or otherwise. However, more often than not, broken teeth are related to some type of trauma and/or teeth that have had large fillings previously placed.
3) Crowning a tooth not only helps ensure the longevity of the tooth, but with today’s porcelain crown technology can also revitalize and improve the appearance of teeth.
What’s the purpose and function of a Crown?
When we have fractures in our bones we place a cast on the limb that is broken. In doing so, the immobilization allows for the bones to form a callus and mend. However such healing capabilities as we find in our bones are not found in certain other tissues in the body – in particular nuerological, optical, and tooth tissue all have very limited healing capabilities. So the enamel that covers the outer surface of our teeth does not have regenerative capabilities and once fractured it will not heal. Therefore to prevent the fracture from propagating deeper into the tooth and damaging the nerve or causing the loss of the tooth, we often choose to cast the tooth with a crown. Like the cast on a broken arm, the crown restoration immobilises the fracture, preventing it from getting deeper as the tooth is continuously used for chewing and cycled between cold foods and hot foods. However, since the enamel will not heal, the cast needs to be a left on the tooth forever.
How is a crown or cap placed on a tooth?
Crowning a tooth is usually a simple and straight-forward process that our dentists perform routinely. After a thorough examination and consultation with your dentist, preliminary molds will be taken of your existing teeth. This gives your dentist information to help decide on the placement and fit of the crown. Next, the material that the crown is to be made from will be chosen. This decision will be based on several factors:
- What are your desires and expectations as a patient?
- Where is the tooth that needs the crown located in the mouth?
- Have you had other crowns placed and what type of crowns are they?
- Do you clench or grind your teeth?
- What is the pathology that the placement of the crown is addressing?
- Do you have any metal allergies?
- What is the existing health of the surrounding teeth and gum tissues?
- What is your budget?
At Crescent Dental we offer a number of different types of crowns, including:
1) Porcelain Fused to Metal
2) Porcelain Fused to White Gold
3) Full Porcelain (Procera / Lava)
Prior to beginning the preparation of the tooth, your dentist will administer local anesthetic to ensure comfort during the tooth shaping. Your medical history, past experiences with local anesthetics, and anxiety levels will help your dentist choose the best anesthetic to use. Dental Sedation can be offered to patients who are very anxious about undergoing treatment. Once your comfort is assured, the tooth will be shaped to very exact specifications. This process is done under controlled conditions to protect your tooth and gum tissue from injury. Once the tooth is shaped, another mold is made of the tooth and a colour is chosen to match your other teeth. On occasion, the dentist will consult with our laboratory technician to match a difficult tooth color – this is called a custom shade. The mold will then be delivered to the laboratory for fabrication of the appropriate type of crown. As for your prepared tooth, a custom temporary crown will be placed.
The temporary crown will serve several important functions.
1. Protect the tooth during chewing
2. Stabilize the tooth to keep it from shifting
3. Maintain the appearance of your dentition
The temporary crown will be glued in place with temporary cement. It will remain in place until the second appointment, approximately 1-2 weeks following the first visit. During the second appointment, the dentist will gently remove the temporary crown, thoroughly clean the tooth, adjust and cement the new permanent crown with very strong luting cement. In most cases there is no requirement for anaesthetic during this last step.