Treatment involves covering the tooth above the gum-line with a cap (crown). The purpose of a crown is to strengthen a tooth damaged by decay or previous restorations, protect a tooth that has had root canal treatment or improve the way your bite fits together. Crowns may also be used to restore or improve the appearance of damaged, discolored, misshapen or poorly spaced teeth.
Treatment for a traditional lab-fabricated crown involves two phases, including preparation of the tooth and completion of treatment. In preparing a tooth for a crown, some of the tooth above the gum-line is removed to create the foundation for the crown. CEREC crowns are generally done in a single visit, with no temporary needed.
Treatment is completed in several steps. A temporary crown is usually placed with a temporary cement while the new crown is being created. Once a temporary crown has been placed, it is essential to return to have the new crown placed as soon as it is ready. Because a temporary crown is not intended to function as well or for as long as a crown, failing to return promptly could lead to the deterioration of the temporary crown, resulting in decay, gum disease, infections and problems with your bite.
At a later appointment the new crown is placed with a special dental cement. A crown is placed only once you have approved the size, shape and color.
CEREC® 3D porcelain crowns are precision-fabricated in one visit of a superior material that acts like natural tooth structures (enamel and dentin).
Benefits and alternatives
The proposed treatment is intended to restore or improve the appearance and strength of your teeth as well as the way your bite fits together. Depending on your needs, alternative treatments include extracting damaged teeth or correcting your bite with orthodontic treatment instead of placing crowns. There is no alternative to a crown for protecting a weak tooth that has received root canal treatment.
1. Reaction to anesthesia: To keep you comfortable while your tooth is being prepared , you will receive a local anesthetic. In rare instances patients have an allergic reaction to anesthetic, which may require emergency medical attention, or find that anesthesia reduces their ability to control swallowing , which increases the chance of swallowing foreign objects during treatment.
2. Irritation to nerve tissue: Preparing a tooth may irritate the nerve tissue (called the pulp) in the center of the tooth, leaving your tooth feeling sensitive to heat, cold or pressure. Treating such irritation may involve using special toothpaste or mouth rinses or possibly treating the pulp itself (called endodontic or root canal treatment).
3. Stiff or sore jaw joint: Holding your mouth open during treatment may temporarily leave your jaw feeling stiff and sore and may make it difficult for you to open your mouth wide for several days afterwards. Treatment also may leave the corners of your mouth red or cracked for several days.
4. Changes to your bite: A crown may alter the way your bite fits together and make your jaw joint feel sore. This may require adjusting your bite by altering the biting surface of the crown or adjacent teeth.
5. Gum disease. The lower edge of a crown is usually designed to rest near the gum-line, which may increase the chance of gum irritation, infection or decay. Proper brushing and flossing at home, a healthy diet and regular professional cleanings are essential to helping prevent these problems.
Consequences of not performing treatment
If you do not have restorative treatment, existing problems caused by the shape or position of your teeth could result in further discomfort and possible damage to your jaw joints. For teeth that have received root canal treatment, failure to place a crown could lead to pain, infection and possibly the premature loss of the tooth. Decayed cracked or broken teeth or teeth with previous inadequate restorations could continue to deteriorate, causing pain, further decay, infection, deterioration of the bone surrounding the tooth and eventually, the premature loss of teeth.
Gold or Porcelain?
Crowns are the technical name for caps and they come in basically two forms . The oldest and most obvious crowns are gold. Gold crowns have even been found in Egyptian mummies that are similar to those made today. They are usually but not always limited to the back teeth. The other type of crown is the porcelain crown. These are usually used to restore broken down front teeth. There are two types of porcelain covered crowns used today: the traditional porcelain to metal crown and the all porcelain crown. The gold crown is all metal, and the porcelain crown is a metal shell with porcelain heat-fused directly to this shell. There are other types of porcelain but this porcelain fused to metal is the most common. Other dental offices will use other metals such as silver, nickel or other alloys but we use only yellow gold for gold crowns and High-Noble platinum/gold alloys for the porcelain crowns due to the risk of allergic reaction to the less expensive alloys.
More and more frequently, patients are requesting porcelain crowns for back teeth. Though very strong, this type of crown was originally designed for the lighter biting forces found in front teeth. Back teeth, with their grinding and crushing action, are better restored with gold as it will not fracture or crack like porcelain is liable to do under heavy biting forces. The drawback of gold is that it is just that, gold, and quite often visible when you open your mouth to speak or eat.
Porcelain, on the other hand, is practically invisible, blending with your other teeth and so not drawing attention to itself. The newer platinum alloys and porcelains are better than ever at resisting stress and fracturing, but the risk of fracture is real. The type of crown you choose to restore a badly broken-down tooth depends on your eating habits such as chewing ice, hard candies, and pencils for instance; how important the esthetics are to you personally; whether the tooth to be crowned is easily visible in your mouth; whether you grind your teeth at night or clench during the day and other factors which can increase or decrease the possibility of damage to your porcelain crown.
If you need a crown, make sure to answer any and all of your questions and decide with you on the best course of action for your particular situation.