Crowns
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| Why a crown? |
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A crown can be done for any number of reasons:
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- broken tooth
- root canal treated tooth (to protect it from
breaking)
- large old filling (that can no longer support
the tooth)
- reshape tooth (for appearance and/or improved
bite)
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| A filling really only repairs a small hole. To
rebuild, reshape, or protect a substantial part of your tooth,
a filling just won't do the job, and a crown is preferred. A
crown is also called a cap. |
| Sometimes, a filling is not sufficient for
long-term strength, yet there is quite a bit of healthy tooth. In
this instance a partial crown or inlay is appropriate. |
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A bridge is constructed to replace a missing tooth,
and is made of crowns that are invisibly joined together.
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| Making a Crown |
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The tooth is reshaped or "prepared", often including rebuilding
part of the tooth with a crown buildup. The amount
of enamel removed is exactly the thickness of the crown
(about 0.5-2 mm, depending on materials used: less
with all metal, more with porcelain). A mold is made
of this tooth (the mold usually includes adjacent teeth
and the teeth that this one bites against). From
this mold the laboratory constructs your crown (the porcelain
color is matched to your tooth). While the crown
is being constructed you have a temporary crown on your
tooth. It takes about 10 working days before your
crown is back from the laboratory. At the second
appointment, the crown is bonded on your tooth (you may
need to have anesthesia and/or nitrous oxide if your tooth
is sensitive).
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| What is a crown made of? |
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A crown can be made from different materials: all porcelain,
gold alloy (white or yellow), porcelain and gold alloy,
other metal combinations. Different
situations often suggest different materials to be used
depending on durability,
esthetics, and physical limitations - this is determined
in concert with your wishes. When a porcelain
crown is made, the shade(s) of your adjacent teeth
will be used for the new crown, so that it is indistinguishable.
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| Care of your temporary crown |
| The temporary crown is usually made of plastic
(it can also be metal), and is not intended
for long-term wear - usually for 2-6 weeks (longer in certain
situations). It is to protect the tooth from sensitivity
(temperature, touch), protect the gums, and to hold the bite
(keep the adjacent and opposing tooth from shifting). A
temporary crown is like a temporary tire, it is sufficient
for short-term, careful use.
Brush, floss, Water-Pik, clean, etc. as usual, except,
when you floss pull the floss through instead of up/down, so as not
to dislodge the temporary crown. Avoid sticky things that could
pull off your temporary crown.
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| Care of your tooth and gum |
The gum is often a little irritated next to the crown.
A salt water rinse is very helpful - a teaspoon of salt in
a warm glass of water, rinsed gently a couple times a day,
until your gum feels better. Advil, aspirin, or Tylenol
before the anesthesia wears off is always helpful.
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| What if the temporary crown comes off? |
If it is only a day or two
before your visit to try in your new crown, and the tooth
is not sensitive, you can leave it out - BUT save it! If
the time is greater before your appointment, you can put
it back in temporarily with Vaseline, but call to have it
recemented. Without the temporary crown on, adjacent
and opposing teeth can shift, sometimes so much that the
permanent crown won't fit.
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| What's next? |
| At your next appointment, the temporary crown
is gently removed. If your tooth is sensitive, you
may require some anesthesia (or laughing gas). Your
new crown is tried in to check it for: fit, color, shape
and appearance, bite, fit between teeth, seal against your
tooth. If everything is correct and it meets your approval,
it is cemented with a long-term cement. Treat the crown
as if it is your own tooth, especially for cleaning. It
is not uncommon to experience a little sensitivity to cold
after getting a new crown, but this should diminish quickly
(over a couple weeks). |
| There is a process available for making a
permanent crown in one-visit. At this time we feel that this
type of crown (Cerec) does not yet meet the accuracy and
esthetics that our laboratory can create. If and when it
does, we look forward to offering this service. |
