Comprehensive Guide to Dental Crowns: Everything You Need to Know

Dental health is an essential aspect of our overall well-being, and when it comes to preserving and restoring damaged teeth, dental crowns play a crucial role. A dental crown is a common dental procedure that aims to protect and strengthen a damaged or weakened tooth. In this comprehensive guide, we will explore what dental crowns are, why they are needed, the different types of crowns available, and their significance in maintaining oral health.

What is a Dental Crown?

A dental crown, also known as a dental cap, is a custom-made covering that is placed over a damaged or decayed tooth to restore its shape, size, strength, and appearance. These crowns are cemented into place, encapsulating the entire visible portion of the tooth above the gum line. Dental crowns are a versatile solution used in various situations to address a range of dental issues.

Why is a Dental Crown Needed?

Dental crowns are needed for several reasons, and they serve multiple purposes in maintaining oral health:

1. Protection: Crowns protect weak teeth from further damage, particularly when a tooth has a large filling or extensive decay. They act as a shield, preventing fractures or breakage.
2. Restoration: Damaged or broken teeth can be effectively restored with crowns, restoring their original shape and functionality. This allows for better chewing and biting.
3. Cosmetic Enhancement: Crowns can improve the appearance of teeth by covering stains, discolorations, or misshapen teeth. They can be matched to the natural color of your teeth, ensuring a seamless blend.
4. Support for Dental Bridges: Dental crowns are used as anchor points for dental bridges, which replace missing teeth. Crowns on adjacent teeth provide support for the bridge, allowing for a natural-looking and functional replacement.
5. Protection after Root Canal Treatment: Teeth that have undergone root canal therapy are often weakened and need crowns to provide added strength and protection.

What is Involved in a Dental Crown Procedure?

A dental crown procedure typically involves the following steps:

1. Consultation: The process begins with a consultation with one of our dentists, where we'll assess your oral health and determine if a crown is needed.
2. Preparation: If a crown is deemed necessary, we'll prepare the tooth by removing any decay or damaged portions. In the case of extensive damage, a post and core procedure may be performed, explained more in depth below.
3. Impression: An impression of the prepared tooth is taken to create a custom-fitted crown. This can be done traditionally with molds or digitally using 3D scanning technology.
4. Temporary Crown: If a traditional crown is being made, a temporary crown is placed to protect the tooth while the permanent crown is being fabricated. Same-day crowns do not require temporary crowns and is our preferred method, as they are extremely precise.
5. Crown Fabrication: In the case of traditional crowns, the impression is sent to a dental laboratory where the crown is custom-made. For same-day crowns, this step is skipped as the crown is milled on-site.
6. Fitting and Bonding: Once the permanent crown is ready, it is fitted onto the prepared tooth. Our dentists ensure that it fits snugly and comfortably before bonding it in place using dental cement.
7. Final Adjustments: Our dentists make any necessary adjustments to the crown to ensure it aligns correctly with your bite and feels natural.
8. Polishing: The crown is polished to match the shine of your natural teeth, ensuring a seamless blend.
9. Post-Procedure Care: We'll provide instructions on caring for your new crown, including oral hygiene and any precautions to take.

Types of Crowns and Their Differences

There are several types of dental crowns available, each with its unique characteristics, advantages, and considerations. The choice of crown material depends on factors like the location of the tooth, aesthetic preferences, and budget. Here are the most common types of dental crowns:

1. Ceramic Crowns: Ceramic crowns are known for their natural appearance, making them an excellent choice for front teeth. They are made of porcelain material that can be color-matched to your existing teeth, ensuring a seamless blend. Ceramic crowns are highly biocompatible and do not cause allergic reactions, making them suitable for most patients.

Types of Ceramic Crowns:

a. Empress All-Ceramic Crowns:

Empress crowns are a type of all-ceramic dental crown known for their aesthetic appeal and natural-looking appearance. They are fabricated from a

high-quality, leucite-reinforced porcelain material known as Empress, which was developed by the Ivoclar Vivadent company. Empress crowns have

gained popularity in cosmetic and restorative dentistry due to their ability to closely mimic the translucency, color, and texture of natural teeth.

b. E.max All-Ceramic Crowns:

An e.max all-ceramic crown is a state-of-the-art dental restoration that combines cutting-edge technology with the beauty of ceramic materials to

create a durable and aesthetically pleasing solution for damaged or decayed teeth. The "e.max" in its name stands for lithium disilicate, which is the

primary material used in these crowns. Lithium disilicate is a type of glass-ceramic that is renowned for its exceptional strength, durability, and lifelike

appearance. This makes e.max crowns one of the top choices in modern dentistry for both cosmetic and restorative purposes. They are metal-free,

making them an excellent choice for individuals concerned about metal allergies.

c. Zirconia Crowns:

A zirconia ceramic crown is a type of dental crown made from a high-strength, biocompatible ceramic material known as zirconia. These crowns have

gained popularity in modern dentistry due to their excellent combination of strength, durability, and aesthetics. Zirconia is a type of crystalline oxide

ceramic that is known for its exceptional properties, making it a reliable choice for dental restorations.

2. Metal Crowns: Metal crowns, often made of alloys containing gold, palladium, or nickel, are exceptionally durable and long-lasting. They are less likely to chip or break compared to other materials. However, their metallic appearance makes them less desirable for visible teeth.

3. Porcelain-fused-to-Metal (PFM) Crowns: PFM crowns combine the strength of metal with the aesthetics of porcelain. The metal base provides durability, while the porcelain overlay ensures a natural appearance. PFM crowns are commonly used for molars and premolars.

4. Resin Crowns: Resin crowns are typically less expensive than other options, but they are not as durable. They are more prone to wear and may need replacement sooner than other materials. They are mainly used as temporary crowns.

Same Day Crowns with CEREC® 3-D CAD/CAM

Traditionally, getting a dental crown involved multiple visits to the dentist over several weeks. However, advancements in dental technology have introduced same-day crowns using CAD/CAM (Computer-Aided Design/Computer-Aided Manufacturing) systems like CEREC (Chairside Economical Restoration of Esthetic Ceramics). Here's how the process works:

1. Digital Impressions: Instead of traditional molds, a digital impression is taken of the tooth using a 3D scanner. This provides precise measurements and eliminates the need for messy impression materials.
2. Designing the Crown: Using CAD software, we can design the crown digitally, customizing it to fit the patient's tooth perfectly. The software ensures optimal aesthetics and functionality.
3. Milling: Once the design is complete, the CEREC machine mills the crown from a block of ceramic material. This process typically takes less than an hour.
4. Placement: The newly milled crown is bonded to the tooth immediately, eliminating the need for a temporary crown and a second appointment.

Same-day crowns offer convenience, reduced waiting time, and excellent results, making them a popular choice among patients and dentists alike.

Dental Laboratory Made Crowns

Dental laboratory-made crowns are the traditional choice and are fabricated by skilled dental technicians in a dental lab. Here are some key aspects of these crowns:

• Customization: Dental lab-made crowns are highly customized to match the patient's specific needs. They can achieve precise color matching and aesthetic results.
• Materials: These crowns can be made from a variety of materials, including porcelain, metal, or porcelain-fused-to-metal, depending on the patient's requirements.
• Production Time: The production of these crowns typically takes a few weeks, so patients may need to wear temporary crowns during this period.
• Quality Control: Dental laboratories have strict quality control measures in place to ensure the crown's fit, durability, and aesthetics.

Post and Core Procedure

In some cases, a tooth may be extensively damaged or have a large filling, making it unsuitable for a crown placement directly. This is where a "post and core" procedure comes into play. Here's how it works:

1. Removal of Damaged Portion: We remove the damaged or decayed portion of the tooth, leaving behind a small, stable foundation.
2. Placement of Post: A post, typically made of metal or fiber, is inserted into the root canal space. This post provides additional support and stability.
3. Core Build-Up: A core build-up material, often a resin or composite, is used to create a foundation for the crown. It fills the space between the post and the tooth's surface.
4. Crown Placement: After the post and core are in place, a crown is custom-made and fitted over the prepared tooth, restoring its strength and function.

Post and core procedures are crucial for salvaging teeth that would otherwise be too weak to support a crown.

Temporary Crowns

Temporary crowns serve as placeholders between the preparation of a tooth for a crown and the placement of the permanent crown. They serve several essential functions:

1. Protection: Temporary crowns protect the prepared tooth from damage, sensitivity, and infection while waiting for the permanent crown.
2. Esthetics: They help maintain the appearance and function of the tooth, preventing any noticeable gaps or discomfort.
3. Testing Fit: Temporary crowns allow patients and dentists to evaluate the fit, comfort, and aesthetics before the permanent crown is placed.

Temporary crowns are typically made from resin or acrylic material and are designed to be a temporary solution until the permanent crown is ready.

Partial Crowns: Onlays

In addition to full dental crowns, there is another option known as a partial crown or an onlay. Onlays are used when a tooth has a large filling but is not extensively damaged enough to require a full crown. Here's what you need to know about onlays:

• Conservative Restoration: Onlays are a more conservative option compared to full crowns because they preserve more of the natural tooth structure.
• Custom Fit: Like full crowns, onlays are custom-fitted to the tooth for optimal fit and function.
• Materials: Onlays can be made from various materials, including ceramic and porcelain, providing both strength and aesthetics.
• Versatility: Onlays are versatile and can be used to restore the chewing surfaces of molars and premolars.

How Long Do Dental Crowns Last?

The lifespan of a dental crown can vary depending on several factors, including the type of crown, your oral hygiene practices, daily habits, and the skill of the dentist. On average, dental crowns can last anywhere from 5 to 15 years or even longer. Here are some key factors that influence the longevity of dental crowns:

1. Type of Crown Material: The type of material used for the crown plays a significant role in its durability. Different materials have different lifespans:
2. Metal Crowns: Metal crowns, typically made of gold or other metal alloys, are known for their longevity and can last 15 years or more. They are highly durable and resistant to wear.
3. Ceramic Crowns: Ceramic crowns, including all-ceramic and porcelain-fused-to-metal crowns, are aesthetically pleasing but may not be as durable as metal crowns. They can last 10-15 years with proper care.
4. Oral Hygiene: Good oral hygiene practices are crucial for the longevity of dental crowns. Proper brushing, flossing, and regular dental check-ups help prevent the development of cavities and gum disease, which can affect the tooth underneath the crown and its longevity.
5. Diet and Habits: Certain habits and dietary choices can impact the lifespan of dental crowns. Avoid chewing on hard objects like ice, pens, or hard candies, as this can lead to crown damage or fracture. Similarly, be cautious with very sticky or chewy foods, as they can pull on the crown and cause it to dislodge.
6. Teeth Grinding (Bruxism): If you grind your teeth at night (bruxism), it can put excessive pressure on the crown and potentially lead to its premature wear or damage. A nightguard prescribed by one of our dentists can help protect your crown if you have this habit.
7. Dental Care and Maintenance: Regular dental check-ups are essential to monitor the condition of the crown and the underlying tooth. Your dentist can detect any issues early and address them before they worsen.
8. Proper Crown Fit: Ensuring that the crown is properly fitted and cemented by an experienced dentist is crucial. An ill-fitting crown can lead to problems and may not last as long.
9. Underlying Tooth Health: The health of the tooth underneath the crown is essential. If the tooth develops decay or experiences other issues, it can affect the integrity of the crown. Regular dental check-ups can help detect and address any problems with the tooth.
10. Location of the Crown: Crowns on back teeth (molars and premolars) typically endure more force during chewing, so they may have a shorter lifespan compared to crowns on front teeth.
11. Age: Crowns may need to be replaced as they age, even if they are still in good condition. This is because the fit may become less secure over time, and normal wear and tear can occur.
12. Dentist's Expertise: The skill and expertise of your dentist in preparing, fitting, and bonding the crown can significantly impact its longevity. Choosing an experienced dentist, such as Dr. White or Dr. Myers, is crucial.

In summary, the lifespan of dental crowns varies depending on multiple factors. While they can last anywhere from 5 to 15 years or more, proper care, maintenance, and regular dental check-ups are essential for maximizing their longevity. If you notice any signs of damage or discomfort with your dental crown, it's important to consult one of our dentists promptly to address any issues and ensure the continued health of your tooth and crown.

Conclusion

Dental crowns are invaluable tools in the field of dentistry, offering a wide range of benefits, from restoring damaged teeth to enhancing aesthetics. The different types of crowns available, such as ceramic, metal, and resin, cater to various patient needs and preferences. With advancements like same-day crowns and CAD/CAM technology, the dental crown procedure has become more convenient and efficient.

Whether you need a crown to protect a weakened tooth, improve your smile, or restore dental function, consulting with us is the first step. One of our dentists can evaluate your oral health, discuss your options, and recommend the best type of crown for your specific situation. With proper care and maintenance, dental crowns can provide lasting solutions that contribute to your overall dental health and well-being.

Request an Appointment with Dr. Myers or Dr. White!

Ready to take the first step in restoring your smile? One of our experienced dentists would love to help you assess how a crown can be tailored to meet your distinct oral needs. Contact Dr. Jesse Myers & Dr. Alan J. White's office at 540-886-1979 in Staunton, VA, and our dedicated team will assist you promptly. Alternatively, you can fill out our online appointment request form at the bottom of this page at your convenience.