Dental crown also known as “tooth cap” is a rigid cap placed on the tooth for various purposes like: restoration, protection, esthetics etc. These tooth caps fully encase the tooth, and depending on the situation there are different types that we are going to mention later in this article.
Why are tooth crown needed for:
- Protection and Support fort the residual tooth – Sometimes teeth are compromised because of big carious processes or cracks or received root canal therapy. Removing all decay means removing all the damaged tissue of the tooth and leaving only the healthy part but this reduces his strength. When teeth receive root canal therapy they also have a large filling. To protect these filling materials and to protect the tooth from going through fractures should be placed a cap.
- Restoration – A broken tooth or a decayed one that lost part of the tooth’s tissue loses its function as well. For teeth to do their proper function, they should have contact with the adjacent teeth (except for the wisdom teeth) and should contact their antagonist. Caps restore teeth’s functions to assure the right mastication or speaking.
- Missing teeth – When you lose one tooth because of decay, periodontal disease, or trauma, you can’t leave an empty space especially if it is a frontal tooth. One way to replace the missing tooth is by placing a bridge. These means placing a crown or two on the adjacent teeth and a fake one to fill the place of the lost tooth. Also the empty space can be filled with a dental implant, this way the dentist doesn’t have to damage the adjacent teeth by preparing them for crowns. Since the implant is made of titanium, to cover all the metallic part is used a crown.
- Aesthetic purposes – Sometimes for problems that might occur during the development of the tooth before we are even born or after, they might be discolored, misshaped, etc. Sometimes they might be discolored because of badly done root canal therapy or badly done restoration. To assure a good looking smile one or several caps might be needed.
Types of tooth crowns
Tooth cap can be temporary, used while waiting for the treatment to end or while waiting for the permanent cap, or can be permanent.
Permanent crowns can be made from different materials like metal (gold or other metal alloy),all ceramics or a combination of both, they can also be made all from resinous material.
- Metal crowns can be made of gold, palladium, chromium or other alloys. Except for the gold crown the other are the cheapest in the market. Their use has decreased over the years not because of their dysfunction. They can protect the remaining tooth tissue very well, they are more conservative when removing tooth tissue for the preparation and they are very well tolerated from the gingival tissue but because their esthetics is not very good especially for the frontal teeth. They can be used only to cover out of sight molars.
- All Ceramic crowns nowadays are used very often because they have very good properties and because they can be very close to the color of a natural tooth. So the chances to have a beautiful smile are very high but you also have to pay a higher price. Your dentist will sacrifice more healthy tooth tissue for the preparation and you are also going to pay more money.
- Ceramic fused onto metal crowns are also very common because they are cheaper then all ceramic crowns and they can be very esthetic. Their problem is that the laboratory process they have to go through is more difficult and so there are more chances to have flows that can cause several problems after their permanent cementation.
- Resin caps are used as permanent caps or temporary one. The resin used for the two types of crown is also different. They can restore the tooth lost function, its form and color and can be very aesthetic but they are less resistant to fractures, abrasion or discoloration factors over time.
Dental crown procedure
In case of a decayed tooth, after removing all the carious process the lost tooth tissue is replaced with filling material. If the tooth needs root canal therapy than the preparation for the permanent crown is made after the root canal therapy is finished. In case of fractures the fractured part of the tooth is also replaced by filling materials. After the replacement of the lost tooth tissue starts the preparation. The dentist will remove the tissue depending on the type of the crown both of you have chosen and the type of restoration that should be done. Preparing a cap for a tooth is a process that needs a little time so while it is produced by the lab your dentist will place a temporary cap, made of resin, which he can prepare in a moment and cement it with temporary cement. Temporary caps are used to protect your tooth while undergoing root canal treatment, while the lab prepares the permanent cap and so you can go around having a social life without having to stay home during all the therapy. When all is ready the dentist removes the temporary cap, cleans the tooth for any residual cement and cements the permanent crown.
Dental crown problems
In a perfect world all the work is done well during preparation of the tooth and during the preparation of the crown and shouldn’t be any problems with the dental crown. But as we all now we don’t live in a perfect world and problems often occur. The most frequent are:
- Crowns fall off – these is because of improper fit of the crown with the tooth or because lack of the cement. Most of the time these happens when you can’t go to a dentist right away so while you wait for an appointment you can use some dental adhesive that is sold in the store, but should be really careful after because it could fall off again and there’s a risk to swallow. Finding it will be a difficult process.
- Loosen crown – differently from the first case these time the crown doesn’t fall but you feel it moving. The risk of swallowing it is also present but it increases also the risk for tooth fractures since the cap isn’t always in the proper position and while biting the forces aren’t right. Also the main reason for these problem is improper preparation of the tooth or of the crown.
- Chipped crown – If the piece chipped is small enough it might be replaced from your dentist in a little time with some resin material. If the chip is bigger than it’s needed to remove the cap and replace all the ceramic if it is a metal ceramic one or replace it altogether if it’s another type of crown. These might happen because the prosthetic planning isn’t good and during mastication or speaking the crown touches the antagonist teeth in a wrong way or because all of the sudden you decided to break nuts with your mouth.
- Discomfort and sensitivity – if it happens just after the procedure of the cap placement its not a very bad sign, because it might be caused by the trauma that the tooth received during the preparation. If the discomforts like feeling hot or cold or feeling it higher when biting doesn’t go away then it is a problem because it means that something isn’t right with your crown and you should talk with your dentist about it. This is very important before fracturing your teeth, of getting an irreversible inflammation of the tooth nerve or gingival tissue.
Taking care of one or more teeth crowns
After their placement crowns they are just like your teeth and they need to be taking care of. To extend their life just like for your natural teeth you should clean them. They might be made of metal or ceramics but they should be clean, because you have to protect all the surrounding tissue from bacteria. If you don’t clean your caps properly nothing happens to ceramics or the metal but an inflammation starts on the gingival tissue, starting periodontal disease or a carious process under the crown. Also decay process starts on the tooth next to the cap if dental plaque accumulates.
To prolong the crowns life and also to have a healthy mouth make sure to brush your teeth after each meal or at least three times a day. Floss at least once a day and use mouth wash. Also very important is to have check-up appointments and professional cleaning appointment with your dentist.