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Dental Crowns

crownsWhat is a dental crown?
A dental crown is a restorative device that covers a tooth in order to either repair a broken tooth, strengthen a decayed tooth, or improve a tooth’s cosmetic appearance. A crown completely covers the visible area of a tooth, creating a new outer surface.

There are three primary types of crowns:

Resin and Porcelain Crowns
This type of crown has the most natural appearance and is the most common among cosmetic dentists. Made from pure ceramic, or a new reinforced composite resin, it is nearly indistinguishable from natural teeth. Resin and porcelain crowns are metal-free and quite resistant, but capable of chipping when not properly taken care of.

Gold Crowns
Gold crowns are appropriate when appearance is not a priority. Gold is an extremely workable metal, which makes gold crowns a more precise fit than any other type. Gold crowns will not chip in any way.

Porcelain Fused-to-Metal Crowns
Porcelain fused-to-metal crowns have a very natural appearance and are extremely durable. However, since they have a metal substructure, they require an opaque below the porcelain. Occasionally a darker line will be visible at the edge of the crown, near the gum as the gum-line recedes with age.

What is the difference between the four types of crowns?
Gold crowns are the strongest, and the simplest to install. Unfortunately, they are not as aesthetically pleasing as porcelain crowns. For most people, this is a serious cosmetic drawback, and the reason why gold crowns are usually used only on the back teeth. Less of the existing tooth is removed for a gold crown.

Porcelain and resin crowns are by far the most natural-looking crowns available, often indistinguishable from real teeth. They are harder to fit into the gum line, and the porcelain is more susceptible to chipping, however a trained cosmetic and general dentist will be able to complete this procedure easily and teach you how to care for your crowns. Porcelain crowns typically remove more of the original tooth, but create a dazzling smile as a result.

Porcelain fused-to-metal crowns have a natural appearance, and are less susceptible to damage than strictly porcelain crowns.

What is the crown application procedure like?
The crown application procedure depends on which crown you will be receiving.

There are typically three steps to applying a crown:

In the first part of the procedure, a mold is taken of the tooth which will be crowned. The mold is sent to a laboratory, and used to create the crown. Also, before a crown can be placed, a filling must be put in place, to stabilize the tooth structure from any further decay.

In the interim period between the first and second appointment, which is usually about three weeks, a temporary crown will be placed in your mouth. The color of the cement affects the color of the crown, so great care must be taken to select the cement which fits in naturally among the color of the rest of your teeth.

In the second part of the procedure, the laboratory-created crown is bonded to the tooth or teeth. First, the dentist uses either water or glycerin to place the crown onto the teeth. This non-permanent attachment is to check the crowns fit, shade and color. The color of the crown can be adjusted based upon the shade of dental cement used, but cannot be altered after the crown is cemented. Once the correct color is determined, the crown is ready to be attached permanently with dental cement. The cement is sandwiched between the crown and the tooth, then a special light is applied. This light initiates the release of a catalyst, which hardens the cement and permanently affixes the crown.

How much do crowns cost?
The average cost is around $1,500 each. Crowns are more expensive, because placing them is more time consuming. Also, while insurance may cover some of the costs, typically it does not cover them all. That is why, you should discuss with your dentist all of your options and review financing information if necessary.

What can I expect?
Porcelain crowns — when properly placed by a qualified cosmetic dentist — are virtually indistinguishable from real teeth. They require regular brushing and flossing, just like real teeth. Also, anything that can chip a real teeth can potentially also chip a ceramic crown.

If you have gold fillings (usually in the back of your mouth) you can expect a high degree of durability. Gold is stronger than ceramic crowns. Gold is even stronger than natural teeth.

If you have porcelain fused-to-metal crowns, you can expect basically the same durability as ceramic crowns. However, over time, a slight, metal line may become visible between your crown and gumline. This is because gums tend to recede as you age.