What are crowns?

Crowns are dental restorations otherwise known as "caps" which are coverings that fit over teeth. Crowns may be necessary because of broken down old fillings, fractured, chipped or sensitive teeth. Crowns are also used to improve the appearance of natural teeth that are malformed, malpositioned or discolored.

Crowns are made of natural looking porcelain and are made to improve your overall smile or to blend in with your own teeth. Sometimes an underlying metal shell is used under the porcelain if additional strength is needed.

Some of the indications for a crown are:

• A previously filled tooth where there now exists more filling than tooth. The existing tooth structure becomes weakened and can no longer support the filling.
• Extensive damage by decay.
• Discolorations and compromised esthetics.
• Fractures
• Root canal - After root canal, teeth tend to become brittle and are more apt to fracture. These teeth need to be protected by a crown.
• Bridges - When missing teeth are replaced with a bridge, the adjacent teeth require crowns in order to support the replacement teeth.

Crowns strengthen and protect the remaining tooth structure and can improve the appearance of your teeth. Crowns can be made from different materials which include the full porcelain crown, the porcelain fused-to-metal crown and the all-metal crown. You and your dentist will decide which type is appropriate, depending upon the strength requirements and esthetic concerns of the tooth involved.

Fitting a crown requires at least two appointments. During your first visit, the tooth is prepared for the crown, an impression or mold is made of the tooth, and a temporary crown is placed over the prepared tooth. At the subsequent visit, the temporary crown is removed and the final crown is fitted and adjusted and cemented into place.

First Appointment

The first visit begins by giving you a local anesthetic. Depending upon the type of local anesthetic used, you can expect to be numb for one to four hours. If your anesthesia should last longer, do not be concerned. Not everyone reacts to medication in the same manner. One word of caution : While you are numb, please be careful not to bite your lip or tongue. A soft diet or no meal at all while you are numb is probably a good idea. If your child has been the patient, please watch them carefully to be sure they do not play with their tongue or lip while it is numb. Once you are numb, your dentist will prepare your tooth in a very specific way in order to maximize the retention and esthetics of your new porcelain to metal crown. After the tooth is fully prepared, we proceeded with the impression stage. We used a thin piece of retraction cord which is placed around your tooth in order to get the impression material under the gum where the crown ends. Please rest assured that this small piece of cord was removed prior to the end of today's visit.

Should you experience any discomfort you can take a mild analgesic (Tylenol™, Advil™, Anacin™, etc.) as long as there is no medical contraindication based upon your medical history. Typically, you can take anything you would normally take for a headache. If the discomfort persists, please call your dentist.

Once the impression stage is completed , your dentist or his assistant will place a temporary (transitional ) crown (or bridge if multiple teeth were involved) on your tooth. These plastic (acrylic) restorations are placed on teeth to protect them and the gum tissues between dental visits. The temporary cementing medium used is designed to allow the easy removal of the temporary at your next scheduled visit.

There are a couple of additional facts you should know about regarding the care of your temporary crown:

• Home care is extremely important while your temporary crown is in place. The health of your gum tissue and the success of your final treatment restoration depends upon it. PLEASE do not be afraid to clean your teeth between visits. With a minimal amount of home care, you should be able to maintain the continued health of your teeth and gum tissue during the time required to fabricate your new crown.
• Sometimes, even with meticulous care, temporary crowns or bridges may become loose between visits. If this should occur, please place the temporary crown or bridge back on your tooth immediately. Putting a drop of Vaseline™ in the temporary crown or bridge will very often increase the retention and hold the temporary in place until you can schedule an appointment. Once again, REPLACING THE TEMPORARY CROWN IMMEDIATELY IS VERY IMPORTANT! It only takes a short time for teeth to move if the temporary is not put back into its proper position. This could affect the final restoration significantly and may necessitate new impressions and a great deal of time. If you can not replace the temporary crown yourself, put it in a safe place and call the office. We will be happy to recement it for you at the earliest possible moment.

Second Appointment

At that time, the temporary crown is removed and any temporary cement is cleaned from the prepared tooth. Your dentist will fit the final crown, check for accuracy, adjust for any bite discrepancies and evaluate the esthetics. If all of these factors are acceptable, the crown is cemented to your tooth. It is not unusual for the new crown to be mildly sensitive to cold temperatures for a few weeks. However, if the sensitivity is severe, does not subside, or if the bite feels uncomfortable, contact your dentist. Further adjustments to the crown may be necessary.

We hope that this will answer most of your questions regarding crowns. Following these simple guidelines will help provide you with the finest in dental care. If you have any questions regarding this or any other procedure, please contact your dentist.