Crowns

A dental crown, sometimes referred to as a cap, is exactly what it sounds like: a cap that goes over a tooth. It's used to completely cover a tooth that has sustained damage or decay, and it looks like a regular tooth. A crown can be installed for purely cosmetic reasons, or it can serve several different useful functions. Crowns are made from a variety of materials, ranging from metals to ceramics. They can be colored to match your other teeth, and they help to restore the function of a tooth that is otherwise dead or damaged.

The Need for Crowns

A dentist might recommend installing a crown for any of several reasons, including, but not limited to, these:

• to cap a tooth after a root canal,
• to connect a dental bridge,
• to attach to a dental implant,
• to cover a discolored tooth for cosmetic reasons or
• to cover a cracked or damaged tooth to support and strengthen it.

Benefits

A dental crown is beneficial because it

• preserves what's left of a damaged or decayed tooth,
• strengthens and supports the tooth,
• can be fashioned to look like a regular tooth and
• prevents further decay of a tooth.

Types of Crowns

Crowns can be made of several different types of materials. Each has different advantages and disadvantages. The materials from which a crown is made can also affect the cost.

Metal

These can be the most costly type of crowns because gold alloy is one of the substances commonly used. Other metals can be used as well. The advantages to metal crowns are that they are extremely durable, less of the tooth needs to be removed to install them, and they rarely crack. A disadvantage is the metal color. On account of this, they are recommended for molars, which are out of sight.

Porcelain-Fused-to-Metal

Porcelain covers the metal on these crowns, so they can be tooth-colored. They're useful for front or back teeth. Porcelain is more likely to crack, and these crowns tend to wear against the other teeth with which they come in contact during chewing. The metal can sometimes become visible on them, near the gumline.

Resin

These crowns are made entirely of resin and are therefore a much more affordable option. The disadvantage is that they wear out easily and have to be replaced.

Porcelain or Ceramic

These are the best option for a crown that's the same color as the rest of your teeth. They're considered the best choice for capping front teeth, and people with metal allergies can still have them installed. The disadvantage is that they tend to crack easily if you bite down incorrectly on them. They also wear down opposing teeth because the materials are harder than tooth enamel.

Permanent crowns are assembled in a laboratory and are custom-designed to fit over your tooth. If a crown is needed until your permanent crown arrives, the dentist can craft and place a temporary one. This is usually done when getting a root canal, for example.

How a Crown Is Installed

The dentist will examine the tooth, usually through X-rays, to make sure the support structure is there to receive a crown. She'll also look for root strength and decay. A root canal may be necessary first to correct an infection or any damage to the root pulp of the tooth.

The dentist will offer a numbing agent, usually a shot, to prevent any pain during the procedure. The tooth in question will be filed down so the crown can be installed on it. Metal crowns require less material to be removed, while other types of crowns will require more filing. If a section of the tooth is missing, the dentist will fill it in with materials that harden and create enough surface space for the crown.

The dentist will then make a mold of the tooth with a putty-like material. The mold will be sent to a laboratory so a crown can be made to the exact dimensions needed. It can take up to 3 weeks for a crown to be fashioned. The dentist will make a temporary crown out of acrylic and fasten it in place with a temporary adhesive. This will cover and protect the tooth until the new crown is installed.

The next time you go to the dentist, she'll remove the temporary crown. Once she examines the permanent crown to make sure it fits and that the color matches your other teeth correctly, she'll install it using a permanent adhesive.

Costs

A crown can range in price from $500 to $3,000 per tooth. The materials from which the crown is made, the dentist's experience, your geographic location and other factors can affect the price. Your insurance plan will most likely cover the cost if it's a medically necessary procedure. If it's being done for cosmetic reasons, it will probably not be covered.

Read more about the cost of dental crowns.

Alternatives

There are arguments both for and against alternatives to crowns. Some say alternatives such as inlays and onlays are just as effective, while others argue that the crown is the strongest and best option to preserve a tooth. Talk with your dentist to decide which option you think is best for you.

Inlays or onlays can replace a missing or damaged tooth structure, without completely covering the tooth. The materials can be bonded to the original tooth with lasers and are sometimes able to restore the tooth to its original strength. A 3/4 crown is another option to cover a tooth partially.

Risks and Complications

The biggest risk with crowns is that some materials can crack or chip under pressure. Sometimes a chip can be filled in with resin, but with bigger cracks, the entire crown may need to be replaced. A crown can become loose if the adhesive underneath it erodes over time. This can lead to tooth decay inside the crown if bacteria gets in. Sometimes a crown will become so loose that it falls off. If you haven't swallowed the crown in your sleep (which does happen), clean it. You can buy a temporary adhesive in stores to cement the crown back in place. Schedule a visit with your dentist immediately to have it professionally reattached.

Recovery

A tooth with a crown might be extra sensitive to hot and cold food and drinks when first installed. It may also be sensitive for the first few days as you adjust to it. Your dentist may prescribe toothpaste for sensitive teeth. If there's pain when you bite down, you should call your dentist for a follow-up appointment. Pain usually means the crown isn't fitted correctly. Correcting this is usually a simple procedure for the dentist.

Post-Treatment Care

Keep up with good oral hygiene to make your crown last longer. Avoid doing anything rough with your teeth, such as grinding them or chewing hard substances like ice or candy. You'll also be told to avoid sticky foods that can adhere to the crown and possibly loosen it as you chew. Depending on how well you take care of it and the materials from which it's made, a crown can last anywhere from 5 to 15 years.

Finding the Right Dentist

Use our handy Dentist Finder to find a reputable dentist in your area.

Sources:

http://www.ada.org/2635.aspx
http://www.medicinenet.com/dental_crowns/article.htm
http://www.webmd.com/oral-health/dental-crowns
http://www.costhelper.com/cost/health/dental-crown.htm