Natural teeth are composed of a durable combination of calcium, phosphorous, and different minerals. However, they can still be susceptible to damage. The aging process affects the teeth, as do certain habits like diet and oral hygiene. Genetics may also play a role in their development and durability. In some cases, the natural teeth become damaged or weakened beyond repair, and must be reinforced through a restoration process.
What is a Dental Crown?
In dentistry, a crown can refer to two different things. In an unmodified tooth, the crown is the portion of the natural tooth that protrudes visibly from the gum line. A crown can also be a term for a synthetically crafted tooth that is used to cover a damaged or weakened existing tooth.
Sometimes called a dental cap, tooth cap, or porcelain jacket, dental crowns can be made of different materials. Popular crown materials are metals (alloys like gold), porcelain-fused-to-metal, porcelain, resin, or ceramic. The lighter-colored, non-metal materials like e-max appear more natural in the mouth, though porcelain-fused-to-metal can be a compromise between the durability of metal and the natural appearance of porcelain. Newer materials like Zirconia crowns can provide strength, but are metal-free. There are a number of factors to consider when choosing the material of your crown, and Dr. Lazare will offer guidance in this choice. Depending on the craftsmanship of the crown and the skill of the dentist installing the dental crown, these fixtures can last for many years with proper care.
Reasons to Crown a Tooth
Crowns are fitted over the teeth for a number of reasons. Crowns can restore the regular functions of a tooth, like biting and chewing, and can also be fitted for cosmetic reasons, improving the form and appearance of the tooth. Patients experiencing one or more of the following dental issues may be a candidate for a dental crown.
Cracked or Broken teeth
Just like the hard bones of the body, teeth can crack and break. The cusps, or raised areas of molars can break and chip with regular chewing and biting motions. These fractures create vulnerabilities within the tooth and must be protected from oral bacteria that can lead to decay and infection. A tooth may be weak for other reasons, and crowns can provide a strong outer covering that is superior the natural composition of the tooth. In some cases, a broken tooth may be worn or missing much of its regular size and shape, and can benefit from being crowned.
While fillings are a beneficial procedure for many areas of tooth decay, there may be cases when multiple fillings impact a single tooth, or the filling covers a large portion of the tooth. This can leave only a small part of the natural tooth remaining. Due to the tooth’s size and the fact that the remaining structure is mainly composed of filling material, a crown can strengthen the area. In this case, the placement of a crown will begin with the removal of old, failing restorations and recurrent decay.
Anchoring a Dental Bridge
In cases where patients may not wish to have a dental implant placed, or are not candidates for this minor surgery, a bridge may be crafted in the affected area. A bridge replaces a missing natural tooth with an artificial tooth, and relies on the adjoining teeth on either side to stabilize it. Crowns may be created to cover three teeth at a time – the missing tooth and the teeth on either side of it. The crowns are typically attached and installed as a single unit.
Crowns can also be fitted over teeth to improve oral aesthetics. In some cases, teeth do not fully develop, or come in misshapen. Teeth may also be badly discolored and cannot be restored to a lighter shade through whitening treatments. Dr. Lazare specializes in both general dentistry and cosmetic dentistry, and can expertly perform an undetectable, natural-looking crown for a tooth.
Crowning a Dental Implant
In many cases, a root canal is able to preserve a tooth so it can remain in the mouth with a synthetic root structure that replaces the infected nerve tissue. While the tooth is technically dead and not receiving any nutrients through a blood supply, it can still blend in with the rest of the teeth. When the tooth cannot be saved, however, a dental implant may be needed to replace the root.
Typically, implants are composed of two main components – a screw that is implanted into the jaw bone to replace the tooth’s root, and a crown that is secured onto the screw. The new artificial tooth is permanently in place in the mouth, secured into the bone and with a crown visible above the gum line.
The Difference between Crowns and Veneers
While a crown can improve the look of a tooth, it is seen as a structural fix while a veneer provides more of a cosmetic enhancement. A crown covers the entire tooth, or what remains of the tooth. It can treat a number of dental issues and functions as the tooth once did in the mouth. Veneers are typically composed of layered of porcelain or another material that is affixed to the front of the tooth and does not provide a full coverage cap.
Undergoing the Dental Crown Procedure
Patients will need to schedule two appointments to have a crown placed. During the first visit, Dr. Lazare will thoroughly examine the tooth and may take X-rays to ensure the overall structure is healthy. In some cases, a patient might need to first undergo a procedure like a root canal to address other aspects of the tooth’s structure.
Dr. Lazare will first provide localized numbing injections and can then begin the tooth-shaping/preparing process. Though the tooth will be reduced in size, material is added to the tooth to build it back up if an excess amount of tooth must be removed.
After the tooth has been prepared to receive the crown, Dr. Lazare will take an impression or digital scan of the mouth. This mold/scan is then sent to a dental laboratory that specializes in the fabrication of dental crowns. The experts at the lab will create a crown that will fit well over the remaining tooth structure and with the rest of the teeth. They will ensure the crown is the appropriate height and will not interfere with the patient’s bite.
A temporary crown, generally composed of stainless steel or an acrylic mixture, is bonded into place to allow normal function until the permanent crown is placed. During the second dental appointment at Dr. Lazare’s office, the temporary crown is replaced with the permanent crown, which will be cemented into place and adhered to the remaining natural tooth. The crown is now a permanent fixture in the mouth that replaces the missing tooth structure.
Recovering from a Dental Crown Procedure
Following the tooth preparation process and the placement of a temporary or a permanent crown, patients may notice some minor discomfort or irritation in the mouth. If this is the case anti-inflammatory medications can reduce swelling or soreness. After a temporary crown has been placed, a patient should be careful to avoid certain types of foods that are sticky or hard to avoid dislodging the fixture. Once a permanent crown is in place, patients are typically asked to refrain from these foods for 24 hours. It may take some time to adjust to the crown, though minor adjustments or a replacement crown may be necessary if the cap feels unnatural in the mouth.
Caring for Crowned Teeth
A crown is composed of durable synthetic materials that don’t require much special maintenance. The natural tooth is layers below, and remains adequately protected by the cap. It is, however, important for patients with one or more crowns to maintain good oral health, as issues can develop at or below the gum line, or in the surrounding teeth. A daily brushing and flossing regimen is necessary to avoid complications of the crown or the remaining healthy teeth, and to prevent future repairs.
Candidates for Crowns
During his exam, Dr. Lazare will determine if a patient meets the criteria to undergo a crowning procedure. Typically, a crown is performed when the natural tooth has been damaged in some way and requires the strength and protection of a cap, or could benefit from improved aesthetics. Sometimes crowns are performed with other treatments like a root canal, dental implant, or bridge procedure.
FAQs about Dental Crowns
Are dental crowns similar to veneers?
While both alterations can be composed of porcelain or resin, they are intended for different purposes. Crowns replace the full surrounding portion of the tooth, while veneers are applied to the front surface of the teeth to improve dental aesthetics. Veneers don’t offer the strength or support provided with crowns. Additionally, crowns support different dental procedures while veneers are typically performed as a standalone cosmetic treatment without medical necessity.
Is it painful to undergo crown placement?
Dr. Lazare will administer numbing injections when necessary, and the local anesthetic will block the patient from feeling any discomfort during the preparation for the crown or its placement. After either dental visit, there may be some residual discomfort and swelling that can be controlled with over-the-counter pain medications and a temporary adjustment to chewing and biting.
Do crowns look realistic?
Crowns are created by dental laboratory experts to look like real teeth. They will be similar in color, shape, and size to the natural tooth. Dr. Lazare’s goal is to enhance a patient’s smile, not detract from it with artificial-looking tooth replacements.
How are crowns installed?
During two separate appointments, patients will visit Dr. Lazare’s NYC office to undergo preparations for the crown, and then have the fixture permanently cemented into place. First, the tooth is prepared, a process that involves the removal of some of the natural tooth structure to prepare for the dental cap. A temporary crown is secured over the shaped tooth until the next appointment, about two weeks later. At this second visit, a custom-created crown is fit and adhered to the prepared tooth.
Marc E. Lazare, D.D.S., M.A.G.D. – General and Cosmetic Dentist
Dr. Lazare’s Upper East Side dental office provides his patient base with technology-driven dental care. He is an expert in dental medicine, recognizing and promoting the importance of oral health, while creating aesthetic fixes for optimal results. Dr. Lazare educates other on dental issues through his two dental apps, book and published literature.
Dr. Lazare is accepting dental crown patients at his New York, NY practice. Appointments can be booked by phone at 212-861-2599, or an email to [email protected].