Crowns are dental restorations otherwise known as "caps" which are coverings that
fit over teeth. Crowns may be necessary because of broken down old fillings, fractured,
chipped or sensitive teeth. Crowns are also used to improve the appearance of natural
teeth that are malformed, malpositioned or discolored.
Crowns are made of natural looking porcelain and are made to improve your overall
smile or to blend in with your own teeth. Sometimes an underlying metal shell is
used under the porcelain if additional strength is needed.
Some of the indications for a crown are:
- A previously filled tooth where there now exists more filling than tooth. The existing
tooth structure becomes weakened and can no longer support the filling.
- Extensive damage by decay.
- Discolorations and compromised esthetics.
- Root canal - After root canal, teeth tend to become brittle and are more apt to
fracture. These teeth need to be protected by a crown.
- Bridges - When missing teeth are replaced with a bridge, the adjacent teeth require
crowns in order to support the replacement teeth.
Crowns strengthen and protect the remaining tooth structure and can improve the
appearance of your teeth. Crowns can be made from different materials which include
the full porcelain crown, the porcelain fused-to-metal crown and the all-metal crown.
You and your dentist will decide which type is appropriate, depending upon the strength
requirements and esthetic concerns of the tooth involved.
Fitting a crown requires at least two appointments. During your first visit, the
tooth is prepared for the crown, an impression or mold is made of the tooth, and
a temporary crown is placed over the prepared tooth. At the subsequent visit, the
temporary crown is removed and the final crown is fitted and adjusted and cemented
The first visit begins by giving you a local anesthetic. Depending upon the type
of local anesthetic used, you can expect to be numb for one to four hours. If your
anesthesia should last longer, do not be concerned. Not everyone reacts to medication
in the same manner. One word of caution : While you are numb, please be careful
not to bite your lip or tongue. A soft diet or no meal at all while you are numb
is probably a good idea. If your child has been the patient, please watch them carefully
to be sure they do not play with their tongue or lip while it is numb.
Once you are numb, your dentist will prepare your tooth in a very specific way in
order to maximize the retention and esthetics of your new porcelain to metal crown.
After the tooth is fully prepared, we proceeded with the impression stage. We used
a thin piece of retraction cord which is placed around your tooth in order to get
the impression material under the gum where the crown ends. Please rest assured
that this small piece of cord was removed prior to the end of today's visit.
Should you experience any discomfort you can take a mild analgesic (Tylenol™, Advil™,
Anacin™, etc.) as long as there is no medical contraindication based upon your medical
history. Typically, you can take anything you would normally take for a headache.
If the discomfort persists, please call your dentist.
Once the impression stage is completed , your dentist or his assistant will place
a temporary (transitional ) crown (or bridge if multiple teeth were involved) on
your tooth. These plastic (acrylic) restorations are placed on teeth to protect
them and the gum tissues between dental visits. The temporary cementing medium used
is designed to allow the easy removal of the temporary at your next scheduled visit.
There are a couple of additional facts you should know about regarding the care
of your temporary crown:
- Home care is extremely important while your temporary crown is in place. The health
of your gum tissue and the success of your final treatment restoration depends upon
it. PLEASE do not be afraid to clean your teeth between visits. With a minimal amount
of home care, you should be able to maintain the continued health of your teeth
and gum tissue during the time required to fabricate your new crown.
- Sometimes, even with meticulous care, temporary crowns or bridges may become loose
between visits. If this should occur, please place the temporary crown or bridge
back on your tooth immediately. Putting a drop of Vaseline™ in the temporary crown
or bridge will very often increase the retention and hold the temporary in place
until you can schedule an appointment. Once again, REPLACING THE TEMPORARY CROWN
IMMEDIATELY IS VERY IMPORTANT ! It only takes a short time for teeth to move if
the temporary is not put back into its proper position. This could affect the final
restoration significantly and may necessitate new impressions and a great deal of
time. If you can not replace the temporary crown yourself, put it in a safe place
and call the office. We will be happy to recement it for you at the earliest possible
At that time, the temporary crown is removed and any temporary cement is cleaned
from the prepared tooth. Your dentist will fit the final crown, check for accuracy,
adjust for any bite discrepancies and evaluate the esthetics. If all of these factors
are acceptable, the crown is cemented to your tooth. It is not unusual for the new
crown to be mildly sensitive to cold temperatures for a few weeks. However, if the
sensitivity is severe, does not subside, or if the bite feels uncomfortable, contact
your dentist. Further adjustments to the crown may be necessary.
We hope that this brief instruction sheet will answer most of your questions regarding
crowns. Following these simple guidelines will help provide you with the finest
in dental care. If you have any questions regarding this or any other procedure,
please contact your dentist.