Minneapolis Sedation Dentist Emergency Dentist and Cosmetic Dentist

Dental crowns, dental caps, tooth caps or crowns are tooth shaped coverings placed on teeth to rebuild or strengthen them.  Crowns cover all of the tooth structure at and above the gum line.  Crowns can also be used to change or enhance the cosmetic appearance of a tooth.  Dental crowns are frequently made for teeth that are cracked, broken, severely worn down, have large cavities that have destroyed a large amount of tooth structure, or have had root canals.  Crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or replace an existing filling that is in jeopardy of becoming loose or dislocated. Crowns can also be used for cosmetic purposes, such as when a discolored or stained tooth needs to be restored to its natural appearance.

No More Goo

Traditionally, a tooth is prepared for a crown and then a gooey, putty-like material is applied to the tooth to take an impression or mold.  Many patients find this uncomfortable, and many gag from having this goop in their mouth.  Shamblott Family Dentistry offers digital impressions using the Itero Scanner.  The special camera takes multiple pictures of your tooth and emails the photos to the lab, where your crown is custom fabricated.  The result is a beautiful crown that fits really well and looks great.  Shamblott Family Dentistry is one of the first offices in Minnesota to offer this cutting-edge technology.

Types of Crowns

There are several different types of crowns available: all ceramic, all metal and porcelain fused to metal. 

1. All ceramic crowns are the most esthetically pleasing crowns.  They have a very natural, life-like appearance and translucency, so they are especially suited for anterior or front teeth.   Ceramic crowns do not have the same strength as porcelain fused to metal or all metal crowns, so they are not commonly placed on back teeth.

2. Metal crowns are generally made from a gold alloy and are gold in color.   Gold crowns are very strong so they will withstand strong biting forces.  Due to their strength and color, gold crowns are best suited for posterior or back teeth.  Gold crowns are the longest lasting crowns.

3. Porcelain fused to metal crowns, or a PFM, are a combination of ceramic and metal crowns.  A metal shell that covers the tooth is fabricated first, and then the porcelain or ceramic layer is fused on top of the metal.  The color of the porcelain layer is based on the color of the adjacent teeth so the new crown will blend in.   Porcelain fused to metal crowns, or PFM, can be used on front or back teeth.  Under extreme biting forces, the porcelain can chip or crack.  On patients with very strong bites, or who clench and grind their teeth, a gold crown on the back teeth is a longer lasting option than a porcelain fused to metal crown.

 

How a Crown Works

Dental crowns strengthen teeth by covering all of the tooth structure above the gum line and binding it together to prevent it from fracturing and breaking.   In contrast, silver fillings or amalgam fillings have a weakening effect on teeth, especially with larger fillings.  Amalgam fillings are held in place by the remaining tooth structure, so they do not strengthen a tooth or prevent fracturing or damage to the tooth.  Any filling that is greater than one-third the width of the tooth can compromise the strength of the tooth and may require a crown.

Cracked Teeth

If a compromised or weakened tooth is not protected with a crown, it may crack.  Once a tooth starts cracking, the crack will increase in size with exposure to strong biting forces.  Teeth can crack in several different ways.

1. The tooth can crack but there is no mobility (it doesn’t move) and no pieces have broken off.  This type of crack is usually painless, but as the crack spreads it can become painful and even impact the nerve, requiring a root canal. The treatment for this type of crack is a crown.

 

2. The tooth can crack with no mobility and no piece has broken off but the tooth is painful.  Pressure from biting can separate or spread the crack towards the nerve, causing pain.  Patients may experience pain upon biting that quickly disappears. Sometimes it takes biting in just the right spot to feel the crack. This is treated with a crown and sometimes a
   root canal is also necessary.

3. Teeth can crack so that part of the tooth is loose or breaks off completely.  This type of crack can be extremely painful.  Treatment for this type of crack ranges from smoothing a sharp edge to having a root canal and crown.

 

4. Sometimes teeth crack in a way that the tooth can not be saved.  If the crack extends onto the root, frequently the tooth must be extracted.

Getting a Crown

When a tooth needs a crown, the first step is to take an x-ray of the tooth to check the roots of the tooth and the surrounding bone. Then the tooth is numbed using local anesthetic.  All old fillings and any decay are removed.  If there is a lot of damaged tooth structure, a build up may be necessary to support the crown.  The tooth is then shaped for the new crown and a digital impression of the tooth and the surrounding teeth is made.  The digital impression is emailed to the dental laboratory to custom fabricate your new crown.  A temporary crown made of acrylic is custom fabricated for you and cemented with temporary cement.  Temporary crowns are designed to last for 2-3 weeks.  The purpose of the temporary crown is to protect your tooth and hold the adjacent teeth in position.  If your temporary crown comes off, call the office immediately to get it re-cemented or your permanent crown may not fit. 

Local anesthetic or Novocain is not usually needed at your second crown visit.  The temporary crown is removed and your permanent crown is put in and adjusted.  The new crown is polished and cemented.  It is common to have some temporary sensitivity to hot and cold following a crown cementation.  If this does not improve within a week, call the office for an appointment:  your crown may need further adjustments.

Maintaining your Crown

A crown protects against decay except at the gum line.  Brushing at least twice a day and flossing once a day are crucial to preventing decay at the edge of a crown. With proper care, a good quality crown could eight years or longer. It is very important to floss in the area of the crown to avoid excess plaque and debris around the crown.

Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Also, eating brittle foods, ice or hard candy could break your crown or make your crown fall out.  Chewing on ice or hard candy should always be avoided, but especially if you have a crown and clenching or bruxism should be treated with a NTI or a nightguard.

You do not have to live with a cracked tooth or dental pain. Call Shamblott Family Dentistry today at 952-935-5599 for a free new patient exam and x-rays.