Dental Crowns — Literally Everything You Need to Know
Your dentist has recommended a dental crown, but you don’t know what to do.
Sometimes it’s not as easy as saying okay, let’s go ahead and get this sorted. It can be an expensive treatment, and you need to make sure you get it right.
The first step is to learn exactly what a dental crown is and why your dentist recommended it. It’s then important to understand your options, the procedure, and the risks associated with dental crowns to ensure you make a fully informed decision.
Once you have the answers to your questions and fully understand the treatment, you can decide whether to go ahead with your dentist’s recommendation.
In this article, you’ll find literally everything you need to know about dental crowns.
What Is a Dental Crown?
Dental crowns are hollow shells that fit snugly over your tooth as a hat fits over your head. Dental crowns are a bespoke treatment prepared by your dentist and then handmade by a dental technician to restore the shape and size of a tooth or for cosmetic reasons to improve the appearance of your teeth.
They are sometimes referred to as dental caps and cover every part of the tooth above the gum line. Dental crowns can be made from different materials, including porcelain, metal, or ceramic. The type of dental crown you choose will depend on the location of the tooth and the biting surface.
In general, crowns are usually placed on teeth that are visible when you smile. They are an excellent way to improve the appearance of your teeth and give you a natural-looking smile.
Your dentist can help you choose the right type of crown for your needs. In general, all crowns serve the same essential purpose: to improve the appearance and function of your smile.
Why Are Dental Crowns Needed?
Dental crowns are a fantastic way to improve the overall health of your teeth while also providing a cosmetic improvement. Dental crowns can be used for both structural and appearance purposes. For example, if you have a tooth that is damaged or decayed, a dental crown can be used to cover and protect the tooth. This not only helps improve your tooth’s function but also prevents further damage from occurring.
Structurally, they protect a weakened tooth. For example, teeth with fillings that keep breaking or root canal-treated teeth may be crowned to improve their longevity. They are also used to build up severely worn teeth from grinding or erosion.
Cosmetically, they completely mask how your tooth underneath looks. If you have large ugly fillings or severely stained teeth, a dental crown will block them out and freshen up the appearance. They’re bespoke-made, so you can choose the colour and shape to suit your taste.
Functionally, dental crowns can be used to hold a bridge in place or sit on a dental implant.
There are a few different types of dental crowns available, so it is essential to talk to your dentist about which type is right for you. Dental crowns are a great way to improve your smile, so don’t hesitate to ask your dentist if they are right for you.
Common Types of Dental Crowns
Dental crowns are a crucial part of dental care. They can restore a tooth’s function and structure and improve its appearance. Dental crowns are placed on the natural tooth, covering it to create a new surface. There are different types of dental crowns, depending on the location and type of tooth being treated. There are three main types:
Metal crowns
Dental crowns can be made from various materials, but metal crowns are one of the most popular types. Metal crowns are usually an alloy and are either gold or silver coloured (although gold crowns for teeth rarely have much gold in them these days due to the high price).
Metal dental crowns are considered the strongest type of dental crown and are also the most expensive. However, they can last for many years, and their strength makes them ideal for teeth that experience a lot of wear and tear. And because there’s no porcelain, dentists don’t have to shave away as much of the natural tooth.
Metal crowns are strong and durable, making them a good choice for restoring back teeth, and they can also withstand biting and chewing forces better than other types of crowns. However, metal crowns are not as natural-looking as other types of dental crowns, so they are usually only used on back teeth.
Porcelain bonded over a metal core
These have the same metal layer as above but with a porcelain coat over the top. They’re great for front or back teeth, but because of the extra layer, it means losing more of your natural tooth. Dental crown glue attaches the crown to the tooth. They’re still strong but can be prone to chipping.
The biggest drawback of this kind of dental crown is the metal core can cause a grey appearance at your gum line. Gums naturally recede over time, and this will show the metal. However, porcelain-bonded dental crowns have many benefits. They are strong and durable and can be matched to the colour of your natural teeth — they can last for many years with proper care.
Although they look more natural than metal dental crowns, light can’t pass through them due to the metal core, so they might look more opaque than your natural teeth.
Fully porcelain crowns
Whether you need to protect a weakened tooth, support a dental bridge, or cover a misshapen or discoloured tooth, fully porcelain crowns can provide the perfect solution. These crowns offer the most lifelike appearance, as they allow light to pass through in the same way as your natural teeth.
This makes them an excellent choice for front teeth or any visible tooth that needs to be repaired. In addition, porcelain is a very strong and durable material that can withstand the forces of daily chewing and biting. If you want a natural-looking and long-lasting solution to your dental problems, fully porcelain crowns may be the perfect option.
Zirconium crowns
Zirconia is a white metal that looks similar to porcelain. Zirconium dental crowns are especially popular as they provide many of the same benefits as traditional metal crowns but with a more aesthetic appeal. Zirconium is a strong yet lightweight material that closely resembles the colour of natural teeth.
As a result, zirconium crowns are often used to restore front teeth or to improve the appearance of a smile. In addition, zirconium is non-reactive and hypoallergenic, making it a safe choice for people with allergies or sensitivities. And unlike porcelain-bonded to metal crowns, which sometimes leave that visible grey line along the gumline, zirconium crowns give a more natural-looking smile.
What’s the Procedure for Getting Dental Crowns?
So, it’s been established that your tooth needs a dental crown to prolong its longevity.
Your dentist in Bournemouth will do two tests on this tooth. Firstly, they’ll take an x-ray to check if the root is healthy and can support the crown. Secondly, they’ll test the tooth to make sure it’s alive and well, usually with a cold substance not unlike when you bite into ice cream.
The tests are positive. Great.
Let’s get the tooth crown procedure started.
The procedure is split into two appointments, the preparation stage and then the fitting stage.
You will likely need a local anaesthetic for the preparation unless your tooth has had root canal treatment. After your tooth has gone numb, the dentist will reduce the tooth in size and shape it to fit the crown. They’ll then take impressions or digital scans, which they’ll send to a lab technician, who will take the crown.
Lastly, they’ll fit a temporary crown for the next ten days or so until your crown fitting appointment. Together, you and your dentist in Bournemouth will look at colours and shades and make a joint decision on what matches the surrounding teeth.
At the crown fitting appointment, the temporary crown will be removed and the cement cleaned off. The dentist will then try the permanent crown on your tooth and check it fits well. If the dentist is happy with the fit, they’ll show you the crown in the mirror to ensure you’re pleased with the appearance.
Make sure you are happy before you give the go-ahead to glue it. Once it’s cemented, it’s not coming off again.
What’s a Post Crown?
Sometimes you may not have enough tooth structure left to place a crown. A post crown is a tooth restoration used when the tooth structure is broken or heavily decayed and the crown will need extra support. The post is placed in the tooth before the crown is cemented into place. The type of post crown that you need will depend on the location of the tooth and the amount of tooth structure that is remaining.
The procedure is usually carried out under local anaesthetic, which numbs the area around the tooth. First, your dentist will assess the damage to your tooth and decide if a post is the best way to restore it. If they think a post is necessary, they’ll drill into the tooth to remove any decay and any old fillings.
Once the decay has been removed, your dentist will clean the inside of the root canal before inserting the post. The post is usually made of metal, and it’s inserted into the root of the tooth to act as a support beam. Once the post is in place, it’s built back up and prepared in the usual way explained above. In some cases, a post may be used to support a dental bridge. This is where a false tooth (or teeth) is suspended between two healthy teeth, supported by posts on either side.
Does Getting a Crown Hurt?
After a local anaesthetic, you’ll feel the sensations of water and vibration on your tooth, but no, it won’t hurt. Many people are hesitant to pursue cosmetic dentistry procedures because they worry about the pain. The truth is that every patient experiences pain differently; some report feeling minimal discomfort while others may feel more.
The procedure usually takes about an hour, and patients can usually return to regular activities afterwards. Of course, it is important to follow your dentist’s post-procedure instructions to ensure optimal results and minimise any discomfort. If you are considering cosmetic dentistry, don’t let fear of pain hold you back — talk to your dentist to learn more about what you can expect.
How Do You Care for a Temporary Crown?
Temporary dental crowns are rubbish.
And they’re supposed to be! They need to come off easily to be replaced with a permanent crown. The cement is poor because dentists need to make sure none of it stays on your prepared tooth. If they used a good cement, the permanent crown wouldn’t fit as well.
For this reason, it’s common for temporary crowns to fall off. This isn’t necessarily a problem, so don’t panic. Call the surgery and tell the receptionist. The dentist may want to recement it, but they may just ask you to wait.
If a temporary crown falls off, the main issue will be sensitivity. This is annoying, but it’s not a long-term problem and will settle once the permanent crown is cemented.
If you can, it’s best to avoid eating entirely on the side or area of your mouth with the temporary crown. Sticky, hard, and chewy foods will pull it off, so avoid these if you do have to bite on them. You do need to brush the temporary crown, but try to be more gentle than normal.
How Do You Care for a Permanent Dental Crown?
While dental crowns are not as strong as natural teeth, they can last for many years with proper care. You should brush and floss dental crowns just as you would your natural teeth to prevent decay and gum disease. Metal crowns may also require special care to avoid staining.
Generally, dental crowns can be treated like any other tooth. Eat and drink as usual and forget they’re there.
Your brushing regime shouldn’t change either. Ensure that you brush your dental crowns twice daily. In addition, you should also clean between the crowns with dental floss or interdental brushes. Taking these steps can help keep your dental crowns healthy and free from plaque and tartar.
How much do dental crowns cost?
The cost of a tooth crown depends on which type you go for.
If you have a crown on the NHS, it’ll mean you get what’s necessary for dental health and no more. The crown will stabilise and prolong the tooth’s life but won’t be the most attractive work of art you’ve ever seen.
Generally speaking, on the NHS, metal crowns are used for back teeth and porcelain bonded to metal crowns are used for teeth you can see when you smile. NHS dental crowns cost £282.80 at the time of writing this (August 2022).
If you’re after a great-looking crown, it’s worth paying for it privately. After all, dental technicians are highly skilled craftsmen. For private dental crowns, they sit for hours, painting shades and layers on with brushes to make it look incredible. It’s the work of an artist and this incurs the extra cost.
Prices can start from £500 for a privately made porcelain bonded crown, and if you’re after a top-of-the-range all-ceramic crown, expect to be looking in the region of £1200.
But it’s like anything in life, you get what you pay for, and the difference between standard and premium crowns is significant.
The cost of porcelain crowns is generally much lower than the cost of metal ones. Additionally, some occasions require core preparation of teeth before crowns are inserted. Sometimes, dental professionals may require gingivectomy or minor gum surgery where parts of gummy tissue are cut out from the mouth, and any dental implants are removed for a softer aesthetic appearance or overall improved dental health.
Potential Dental Crown Problems
When you get a dental crown, it’s vital to take care of it so that it lasts as long as possible. However, some potential problems can occur with dental crowns that you should be aware of.
Gum recession
It’s no secret that our teeth change as we age. In addition to getting longer (hence the term “long in the tooth”), the margins of dental crowns can begin to show at the gum line. This is due to gum recession, a common condition that occurs over time. While this may not be a major issue for some crowns, it can be a problem for porcelain bonded to metal crowns.
This is because the gum line will appear grey in this area. Fortunately, some steps can be taken to prevent or reduce gum recession. For example, brushing and flossing regularly can help to keep gums healthy and prevent further recession. In addition, regular dental checkups are essential for keeping an eye on the health of your gums. If you’re concerned about gum recession, talk to your dentist about your options.
Galvanic action
Galvanic action is an issue that can occur when different metals touch each other. For example, if a gold crown comes into contact with an amalgam filling, there may be a slight electric current between them. This can cause discomfort or even pain for the patient. In severe cases, galvanic action can lead to tissue damage.
As such, dentists are aware of this potential problem and take steps to avoid it. One way to do this is to ensure that dental crowns are made of the same type of metal. Another solution is to use a dental resin that is non-conductive and does not allow for the flow of electricity between different metals.
Loss of tooth life
When a dental crown is placed, the tooth is prepared by removing some of the outer enamel. In some cases, this can result in the loss of blood supply to the tooth, which can eventually lead to the death of the tooth. While this is relatively rare, it is something that can happen. If a tooth dies, it may eventually need root canal treatment or even removal. However, with proper dental care, most teeth that have had dental crowns placed will continue to function just fine for many years.
Loosening crowns or debonding
Dental crowns are an effective way to restore a tooth that has been damaged. However, over time dental crowns can become loose and fall off. This is more common for post crowns. If this happens, you should see a dentist as soon as possible.
They will be able to examine the tooth and determine if the dental crown needs to be replaced or if it can be rebonded. In some cases, the crown may just need to be tightened. However, if the dental crown is severely damaged, it may need to be replaced.
Chipping
Chipping can occasionally occur with porcelain dental crowns. The problem is that they’re difficult to repair, if not impossible. If it’s not an aesthetic concern, the dentist can smooth them off. Otherwise, you’ll usually have to pay for a replacement.
Dental crowns are designed to be durable and long-lasting, but they can still be susceptible to chipping if they’re not taken care of properly. If you have a dental crown that has been chipped, you should see a dentist right away so they can assess the damage and determine the best course of treatment.
How Long Do Dental Crowns Last?
There is no one-size-fits-all answer to the question of how long dental crowns last. The lifespan of a dental crown depends on many factors, including the material used, the location of the tooth, and the patient’s oral hygiene habits. Porcelain crowns, for example, typically last between 5 and 15 years, while metal crowns can last for 25 years or more.
In general, dental crowns located in the back of the mouth tend to last longer than those in the front since they are less likely to experience wear and tear. And, of course, patients who take good care of their teeth and gums by brushing and flossing regularly can expect their dental crowns to last longer than those who do not. With proper care, most dental crowns will provide many years of function and beauty.
Finally…
Remember, every case is unique. What’s right for your friend may not be perfect for you.
If you’re considering dental crowns, you probably have a lot of questions. And that’s totally understandable! Dental crowns are a big commitment, and you want to make sure they’re the right choice for you.
The best way to get all the information you need is to ask your dentist. They’ll be able to tell you everything you need to know about dental crowns, from the pros and cons to the cost and dental crown procedure. And if you have any specific questions about dental crowns for yourself, they’ll be more than happy to help.
So if you’re considering dental crowns, don’t hesitate to ask your dentist all the questions you have. They’ll be more than happy to help you make the best decision for your smile.
AUTHOR
Dr Gareth Edwards BDS (Hons) MFDS RCPS (Glasg) is a Poole and Bournemouth-based dentist who qualified with honours. He has a keen interest in aesthetic dentistry and orthodontics. For more information, click here.
