Porcelain Crowns

Simply put, a crown is a small tooth-shaped cap that your dentist will use to cover one of your teeth. Crowns are used to restore the strength, size, and shape of a tooth. It will be custom-made by your dentist out of a durable material.

Every tooth is basically made up of two parts called the crown and the root. For people who brush and floss regularly, the roots of your teeth are concealed by the gum line, just like how a tree’s roots are under the soil. The crown is simply the part of the tooth that you can see. Your teeth aren’t even bones (they are stronger than them); the crown is made up of a calcified tissue called dentin covered by a shiny external layer of enamel. Just like the natural tooth structure, a crown will cover the entire tooth from the gum line up to protect the sensitive pulp and nerves contained inside of it.

Why Would I Need a Dental Crown?

As we mentioned in the last section, the crown is meant to protect the internal structures, like the nerves, of your tooth. A crown made by your doctor serves the same purpose. Specifically, you might need a crown in one of the following situations (this isn’t a complete list but just the most common reasons):

1. Dental bridge: Like an actual bridge, a dental bridge is a partial denture that is meant to link the empty gap between two teeth. If left alone, neighboring teeth will shift toward the gap and this will cause pain and/or change your bite strength.

The two teeth on either end of the bridge are called abutments and they will either be false teeth or, you probably guessed it, your dentist will have your natural teeth outfitted with crowns to increase their strength and stability.

2. Root Canal Therapy: Many years ago, if your tooth was infected or damaged it would need to be removed. In the 21st century, your dentist has special techniques to save your natural teeth instead of extracting them.

While tooth enamel is stronger than bone, it’s not indestructible: There are oral bacteria that live in your mouth and feed off mostly sugar and food particles. Bacteria produces acids that erode the enamel slowly. Over time, the acid will form a hole called a cavity and those bacteria will invade and inflame the soft pulp and roots inside causing discomfort and pain. Regular brushing and flossing remove the bad bacteria and reduces the risk of cavities.

3. Cracked or Fractured Tooth: Human teeth are very strong and meant to last your entire life. The body naturally helps maintain your teeth with saliva. Saliva prevents the build-up of cavity-forming bacteria by washing them away and keeps the mouth less acidic so the teeth can naturally re-mineralize themselves with calcium. But sometimes non-cavity damage can be so severe that only a dentist can repair your tooth.

Cracked tooth syndrome is exactly what is sound like; the outer enamel of the tooth is broken or fractured. This can be caused by anything that places excessive stress on your teeth.

What is the Process of Getting a Dental Crown Like?
From start to finish, a dental crown procedure will almost always take two visits. The first visit, which usually takes around 30 minutes to an hour, will consist of three steps and they are:

1. Preparing the tooth.
2. Taking an impression of the tooth.
3. Placing a temporary crown.

On the second visit, your dentist will install the finished crown with cement. This trip normally is done in about 20 to 30 minutes.

Let us talk more specifically about what your dentist is going to do on the first visit.

Tooth Preparation: While the term might sound strange, all “preparing” the tooth means is shaping it so the permanent crown will fit correctly. Tooth prep can be divided into the following steps:

1. Numbing the tooth: The dentist will want to numb, or anesthetize, the tooth and the gum tissue that envelopes it.

Before the injection, your dentist will apply a numbing agent, usually a gel, to the injection site so that you will not feel the prick of the needle as much. Then he will slowly insert the needle into the injection point and start depositing anesthetic. Then he will advance the needle a few millimeters and deposit more anesthetic. He will repeat this process until the entire injection site it totally numb. He does it this way to ensure the needle is only passing through numbed tissue which minimizes pain.

Also, it is best not to struggle or squirm since that will make it more difficult for him to direct the needle accurately and if he or she misses they will have to start all over again.

2. Shaping the Tooth: To be effective, there is a minimum thickness required of every crown. While it varies depending on the material (more on this later), most crowns need be at least 2 millimeters thick. When the tooth is prepped, the dentist is going to file away enough of your tooth material so that crown can fit without the risk of slipping.

Also if your tooth has any areas of decay the dentist will file these away to prevent them from spreading. If you have had a root canal, he or she may also remove the filling if it appears loose or otherwise unstable.

To shape the tooth, your dentist will use a cylindrical tool called a bur. This is a highly precise instrument that will help him or her to trim away just enough of your dental material for optimal crown placement.

In rare instances of severe tooth decay or a very bad fracture, there might not be enough tooth left on which a crown can be affixed. If the crown does not have enough tooth supporting it, then there is a huge chance that it will break off. To prevent this he or she will “build-up” your tooth with a core.

A core is a nothing more than permanent dental restoration material that is used to reconstruct a tooth close to its original proportions. The core is normally made of the resin that is used to make white cavity fillings or dental amalgam (the metal used in silver-colored cavity fillings). Even with a core, the dentist may still need to trim some of your natural teeth if the shape is not conducive to crown placement.

Temporary Crown: Most dentists will send your impressions to a lab where your crown is handcrafted by a specialist called a ceramist. This process takes about two weeks. Obviously, you need to eat and drink in the meanwhile so what are you to do to protect your tooth? There is no need to worry; your dentist has you, and your tooth, covered…literally!

At the end of this first visit, your doctor will give you a temporary crown. Like a regular crown, this is mean to protect your tooth and make it easy for you to bite food. Your dentist will custom-make your temporary in the office while you wait. It probably will not match the color of your other, natural teeth perfectly. Once installed, do not chew anything for at least thirty minutes so the cement can solidify.

You will probably notice some sensitivity around the crowned tooth, especially after have eaten or drunken something that is either hot or cold. That is perfectly normal and this will go away once the permanent crown is fixed. Also take care not to brush and floss too hard around the temporary crown or you may weaken the cement and cause it to fall out. If your temporary crown ever comes out, call your dentist immediately so he or she can re-cement it for you.

Here are some tips to help you care for your temporary crown:

1. Just like regular teeth, some foods you eat will stick to it. The cement on your temporary allows your dentist to easily remove it when your crown is ready. But sometimes sticky foods can pull it out of place too. Avoid foods like taffy, chewing or bubble gum, and caramel.

2. While you are at it, avoid hard foods like ice cubes, apples, carrots, and hard candies which could break and/or dislodge the temporary.

3. Your best bet when eating is to avoid using that side of your mouth where the temporary is much as possible.

4. Be very careful when you floss! Instead of sliding it up and down between your teeth, slowly move it out to the side by letting go of one end of the floss.

5. Rinse your mouth with salt water 3 times daily. Mix one tablespoon of table salt with 8 ounces of water. This reduces sensitivity along the gum line.

6. If you do not have one already, get and use a soft bristle toothbrush to reduce the risk of swelling and irritation (the tooth preparation process will slightly agitate your nearby gums).

Even if you take all the temporary crown care precautions listed above there is still a chance that it might fall out. If it is very loose and/or falls out, call your dentist immediately to have it re-cemented! This is very important: Even in just an hour or two, the teeth near the prepared tooth can shift which means your finished crown will not fit properly. Then you will need to spend more time in the chair getting another impression done.

If you cannot get to the office to get it replaced the same day then buy a tube of over the counter dental adhesive such as Recapit or Dentemp. All you do is apply some of the adhesives to the base of the crown and place it back over the tooth. Do not use ordinary household or craft glue as those products can be toxic.

Let us fast forward two weeks to the second dentist appointment. This visit can be divided into 3 of steps:

1. Temporary Crown Removal: Your dentist will remove the temporary crown. After that, he or she will also remove any residual cement from your tooth as well.

2. Evaluate the Crown: Next he or she will, place, or seat, the crown on the tooth. He will ask you to bite down and visually inspect how the crown touches against neighboring teeth. He may reseat the crown several times until he is satisfied with it.

If you do not like the color or the fit does not feel comfortable, then tell you dentist: After the crown is cemented it is very difficult to remove it.

3. Cementing Your Crown: After having adjusted the crown for fit, the dentist will cement it into place. First, he will place a layer of cement in the crown and re-seat it on your tooth. Once seated, the dentist will remove any excess cement from the sides. And now you have a brand new crown!

Benefits of Porcelain Crowns

Damaged teeth can be the source of both physical and aesthetic problems, both of which can be addressed with the placement of porcelain crowns. The porcelain is color-matched to surrounding natural teeth to make the crowns a virtually undetectable part of your smile. The crowns also add strength and restore functionality to damaged teeth. With the proper care, porcelain crowns can last for up to 15 years.

Which material is best?

Both the “look” and function of your crowns are considered when choosing the material most suitable for you. Your dentist will consider the tooth location, the position of the gum tissue, the amount of tooth that shows when you smile, the color or shade of the tooth and the function of the tooth.

Crowns are made from a number of materials. Gold alloys or precious alloys, porcelain or ceramic, acrylic or composite resin or combinations of these materials may be used. Porcelain attached to a durable metal shell is commonly used because of its strength. Crowns made entirely of porcelain may look better; however, they usually are not as strong. In the process of making the crown, the porcelain is colored to blend in with your natural teeth.

Possible Complications of Porcelain Crowns

Teeth that have been repaired with porcelain crowns may be sensitive for a few days after the placement of the crowns. Special care must be taken with porcelain crowns, as they may chip or crack. Special toothpaste may also be recommended by Dr. Harrison. If your porcelain crowns start to feel loose, the adhesive may have lost some of its bonding power. If this happens, call Dr. Harrison right away to fix the problem.

Contact Us for More Information about Porcelain Crowns

Our Natick Dentist would be happy to create an individualized treatment plan based on your specific needs. Please feel free to explore the other sections of our website to read about porcelain veneers, composite fillings, teeth whitening, or the restoration of dental implants – all offered by our cosmetic dentistry practice. If you think you might benefit from porcelain crowns, contact us to schedule an appointment today. We also serve other nearby communities like Sherborn, Dover, Wellesley, Framingham, Wayland, Needham, Ashland, Holliston, and Southborough.