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Dental Crowns

 

What is a dental crown?

A dental crown is a restoration or covering designed to strengthen and preserve an existing, damaged tooth. It is custom-made in the shape of a natural tooth and fits over the remaining part of a prepared tooth; for this reason it is sometimes referred to as a “cap”.

 

 

 

 

When might I need a dental crown?

Usually, it is because your tooth has cracked or decayed. If the tooth is significantly damaged and its strength is compromised, then there is not enough support left to hold a filling in place and maintain functionality. A dental crown can also protect and strengthen a tooth after a root filling, or help hold a bridge or denture firmly in place.

 

A dental crown can also be used for cosmetic reasons, to improve the aesthetics of your smile or improve the appearance of a tooth that is discoloured.

Is a dental crown always the best option?

Not if you just want to improve the aesthetics of your teeth, because a dentist needs to grind a significant portion of the original tooth away. Less invasive alternatives include veneers or dental bonding. 
 
 
Crowns are the best option when the strength of the tooth is compromised, since veneers and dental bonding restorations are only as strong as the supporting tooth.
 
 
If the damage to your tooth is not too extensive and the underlying tooth structure is sound, your dentist may recommend a type of dental filling called an “onlay”, sometimes known as a partial crown.  This covers an area (sometimes quite extensive) of the biting surface of the tooth, including the central area between the cusps (the rounded bumps on the surface) and one or more of the cusps themselves.  Unlike a full crown, an onlay preserves more of the existing tooth structure since the tooth does not have to be shaped for the crown to fit over it.

 

What are dental crowns made of?

Dental crowns can be made from a variety of materials, and new materials are constantly being introduced.  The most commonly used are gold and porcelain, either used alone or bonded together; improvements in the strength of porcelain (also known as ceramic) are making this increasingly popular (see The Good Dentist Guide to CEREC). All have advantages and disadvantages, and the material chosen will depend upon the patient’s budget, the position of the tooth and whether the patient is concerned by the appearance of the treated tooth.

 

Dental crowns can be made from a variety of materials, and new materials are constantly being introduced.  The most commonly used are gold and porcelain, either used alone or bonded together; increasingly ceramics (porcelain) are also used (see The Good Dentist Guide  to CEREC). All have advantages and disadvantages, and the material chosen will depend upon the patient’s budget, the position of the tooth and whether the patient is concerned by the appearance of the treated tooth.

Gold crowns

 

Gold is often recommended when the aesthetics of the treatment are not an issue and the main priority is longevity and function. Although more noticeable in the mouth, gold is used to construct very precise crowns, comes with less risk of chipping and less of the tooth is removed in the preparation process.
 
In general, gold crowns are preferred on the back teeth because they are more durable and can withstand the stronger forces placed on them by grinding and biting, and of course gold crowns are less noticeable at the back of the mouth.
 

 

Porcelain crowns

 

Porcelain crowns are very popular and the latest generation of materials has meant that the risk of chipping or breaking is reduced. There is still some risk however, particularly in people who grind their teeth.
 
In general, porcelain crowns are preferred on the front teeth because they are more natural in colour and can be matched exactly to the surrounding teeth, making these a very popular form of dental restoration for patients seeking a more natural look.
 

 

Bonded crowns

Consisting of a precious metal base with porcelain applied in layers over it, a bonded crown combines the durability of metal with a more natural look.

What is the procedure for making and fitting a dental crown?

Once you and your dentist have agreed all the treatment options, it is generally a two-stage process with one to three weeks between visits. 

 

On your first visit the tooth is prepared: your dentist will clean it, remove any decay and shape it so that the crown will fit neatly; this will be done under local anaesthetic and you will not feel any pain.  Impressions of your teeth will then be taken; these will be sent to a dental laboratory to enable a dental technician to fabricate your custom-made dental crown so that it fits perfectly.  Your dentist will fit a temporary crown to cover and protect your prepared tooth until your dental crown is ready.
In some situations a crown can be made on site at the surgery and therefore fitted at the same appointment; see The Good Dentist Guide to CEREC technique.
 
 
On your second visit, your dentist will remove the temporary crown and roughen the outer surface of your prepared tooth to give the dental adhesive a good surface to bond to. Your dentist will then sit the crown in place to check that it fits and is the right colour and shape; once you are both happy with the restoration and how it looks, your dentist will cement the crown firmly into place. 

 

How much does a dental crown cost?

The cost of a dental crown depends upon a number of factors, including the materials used in the construction of the crown and the care and skill used by the dentist and technician to make the crown. Gold crowns are affected by the price of gold; porcelain crowns can be time consuming to build and can require a higher level of skill, particularly if they are to be fitted at the front of the mouth.  For these reasons the cost of a dental crown can vary between £300 and £1,100 per tooth, meaning that there are affordable solutions accessible to most people.

 
 
It is advisable to get a written estimate and treatment plan before beginning any dental treatment.
 

How do I look after my dental crown?

It is important to look after your dental crown as carefully as your natural teeth; although the crown itself cannot decay, decay can occur where the edge of the crown meets the tooth. Practice good oral hygiene and book regular check-ups with your dentist; if you grind your teeth at night discuss this with your dentist for advice on how to avoid potential damage to your dental crown.

How long will my dental crown last?

If looked after properly, a well-made high-quality porcelain dental crown should last for 10 to 15 years, while gold crowns can last even longer.  Your dentist will be able to advise on your particular case. 

 

 






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