Teeth that have lost significant structure above the gum line due to trauma or decay often cannot be made strong enough for normal biting pressure or esthetics with composite bonding. In cases like these, a more permanent solution becomes necessary. A crown or “cap” is the solution for this type of problem. The crown is created in a lab by specialists who will match the crown to your natural teeth. The crown covers the entire tooth above the gum line and is permanently cemented in place.
A crown will give additional strength to a damaged tooth allowing it to function normally. A crown can be made using a variety of materials and processes depending on the qualities that are most important for the patient. In cases where strength is a priority, all-porcelain crowns with zirconia might be the best choice. Porcelain-fused-to-metal crowns (PFMs) have a metal base covered by layers of porcelain giving them a more natural appearance. Gold is the most durable, but not very esthetic for a tooth that shows up in your smile! All options will be discussed with you if a crown is in your future.
To receive a crown, you will make two visits to the dentist. On the first visit (about 1 1/2 hours), the tooth will be prepared to receive the new crown. The dentist will take an impression after the prep and send it off to the dental lab to have the crown made. You will leave the office with a custom temporary crown in place. This temporary is made of plastic and will closely match the surrounding teeth. In about two weeks, you will return to the dentist to have your permanent crown cemented. This appointment takes about 45 minutes.
Crowns can also be used to replace missing teeth. This type of restoration is called a bridge. In the case of one missing tooth, like we described above, the dentist will prepare the healthy teeth on either side of the missing tooth for crowns. An impression for the bridge will be taken and sent off to the lab where a three-unit bridge will be made. When permanently placed, the two outer crowns, called abutments, will be cemented over the healthy teeth, and the middle crown, called the pontic, will replace the missing tooth. The number of abutment teeth and pontics necessary to replace missing teeth depends on how many teeth are missing and the health of the surrounding teeth and bone structure. All of this will be discussed at length prior to beginning any work. If the bridge is not an option for you, the doctor will provide alternative treatment ideas.
Just like your natural teeth, crowns and bridges need dental care. Brushing, flossing, and regular check-ups are a must if you wish to protect your investment.