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Crowns

What is a crown?

A crown is a cap that is placed over a tooth and held in place by dental adhesive or cement.

Crowns are used for several reasons:

What are crowns made from?

Crowns can be made from a variety of materials.  They can be made from plastic, ceramic or metal alloys.  A combination of metal and ceramic is also possible to maximise strength and simulate the appearance of natural teeth.

How are crowns made?

Firstly, a thorough clinical examination is conducted with radiographs, by the dentist.  The suitability for crowns is assessed and any preparatory work is carried out.  Your dentist will also be able to advise on material choices, treatment sequence and any other concerns you may have.

At the second appointment, the teeth to be crowned are prepared. This involves reduction of the tooth size (usually under local anaesthesia) followed by an impression or mould of the prepared tooth.  This trimming of the tooth is required to create space for the crown to be fitted.  The mould taken is then sent to a laboratory where skilled technicians will fabricate the crown. In the meantime, a temporary crown is made and fitted onto the trimmed tooth.

At the third appointment, the temporary crown is removed and the tooth surfaces cleaned.  The completed crown is tried on the tooth for fit, harmony with the bite, and appearance.  Finally, the crown is cemented onto the prepared tooth with dental cement.

How long do crowns last and how do I care for them?

Crowns are made of inert materials that do not deteriorate over time. However, the underlying tooth is still prone to decay and gum disease.

Ceramic on the surface may chip or fracture. Avoid chewing excessively-hard substances like ice or bones. Daily brushing and flossing are essential for maintaining good oral health as well as keeping the crown trouble-free. The most vulnerable portion of the crown is the margin or the junction between tooth and crown.

Regular check-ups will enable your dentist to detect any problems with your crown and recommend necessary treatment.


Frequently Asked Questions

What is a crown?

Crowns are an ideal way to rebuild teeth which have been broken, or have been weakened by decay or a very large filling. The crown fits right over the remaining part of the tooth, making it strong and giving it the shape and contour of a natural tooth. Crowns are sometimes also known as ‘caps’. An ‘Anterior Crown’ is a crown fitted to the front eight teeth.

Why would I need a crown?

There are a number of reasons. For instance:  the tooth may have been weakened by having a very large filling  you may have discoloured fillings and would like to improve the appearance of the tooth  you may have had a root filling which will need a crown to protect it  you may have had an accident and damaged the tooth  it may help hold a bridge or denture firmly in place.

What are crowns made of?

Crowns are made of a variety of materials and new materials are being introduced all the time. Here are some of the options available at present:

Porcelain bonded to precious metal: this is what most crowns are made from. A precious metal base is made and layers of porcelain are then applied over it. Porcelain: these crowns are not as strong as bonded crowns but they can look very natural and are most often used for front teeth. Porcelain and composite: porcelain and composite resin materials can sometimes look the most natural. However, these crowns are not as strong as bonded metal crowns. Glass: these crowns look very natural and are used on both front and back teeth. Precious metal (gold and palladium): these crowns are very strong and hardwearing, but are not usually used at the front of the mouth, where they are highly visible.

How is a tooth prepared for a crown?

The dentist will prepare the tooth to the ideal shape for the crown. This will mean removing most of the outer surface, and leaving a strong inner ‘core’. The amount of the tooth removed will be the same as the thickness of the crown to be fitted. Once the tooth is shaped, the dentist will take an impression of the prepared tooth, one of the opposite jaw and possibly another to mark the way you bite together. The impressions will be given to the technician, along with any other info.

Who makes the crown?

The impressions and information about the shade of your teeth will be given to a dental technician who will be skilled in making crowns. They will make models of your mouth and make the crown on these to be sure that the crown fits perfectly.

Will the crown be noticeable?

No. The crown will be made to match your other teeth exactly. The shade of the neighbouring teeth will be recorded, to make sure that the colour looks natural and matches the surrounding teeth. A temporary crown, usually made in plastic, will be fitted at the end of the first appointment to last until the permanent one is ready. These temporary crowns may be more noticeable, but they are only in place for about two weeks.

How long does the treatment take?

You will need to have at least two visits: the first for the preparation, impression, shade taking and fitting the temporary crown, and the second to fit the permanent crown.

Does it hurt to have a tooth prepared for a crown?

No. A local anaesthetic is used and the preparation should feel no different from a filling. If the tooth does not have a nerve, and a post crown is being prepared, then local anaesthetic may not be needed.

Are post crowns different?

Post crowns may be used when the tooth has been root filled. The weakened crown of the tooth is drilled off at the level of the gum. The dentist makes a double-ended ‘post’ to fit into the root canal. This can be either prefabricated stainless steel or custom made of gold. One end of the post is cemented into the root canal, and the other end holds the crown firmly in place.

Are there any alternatives to post crowns for root-filled teeth?

If a root-filled tooth is not completely broken down, it may be possible to build it up again using filling material. This ‘core’ is then prepared in the same way as a natural tooth and the impressions are taken.

How long will a crown last?

The life of a crown will depend on how well it is looked after. The crown itself cannot decay, but decay can start where the edge of the crown joins the tooth. It is very important to keep this area as clean as your other teeth, or decay could endanger the crown. Properly cared for crowns will last for many years – your dentist will be able to tell you how long.

How are crowns fixed to teeth?

Once the fit and appearance of the crown has been checked – and approved by you – it will be cemented in place with special dental cement. The cement also forms a seal to help hold it firmly in place.

Will the crown feel different?

Because the shape of the crown will be slightly different from the shape of your tooth before it was crowned, you may be aware of it to begin with. Within a few days it should feel fine, and you will not notice it. The crown may need some adjustment if it feels higher than the surrounding teeth. If it is at all uncomfortable ask your dentist to check and adjust it.

Is there an alternative to a crown?

A veneer may be an alternative to having an anterior crown. Your dentist will advise you.

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