What Is a Dental Crown?

Dr Advocate Avatar IconUpdated: September 1, 2022
By: Dr. Advocate

A tooth is an amazing structure and serves a critical role - in helping us eat! If you lose part of a tooth through a cavity or tooth fracture, they don’t regrow, and untreated can affect chewing and eating enjoyment. That’s where crowns come in. Crowns, or caps, are tooth-like solid replacements that protect from wear, fracture, or discoloration. There are many types of crowns, and each has a functional purpose.

After root canals, crowns are predominantly required to protect the weak and brittle remaining tooth structure. Because the nerve tissue provides nutrients to the tooth, the tooth requires reinforcement for longevity and durability after the nerve is removed. Sometimes, crowns are needed if large fillings fracture, cavities form under existing crowns, or the original crown fits poorly, causing hot or cold sensitivity. If the cavitation is too large, there may not be enough tooth remaining to support a subsequent filling.

Crowns are also fastened to implants to restore function and prevent adjacent teeth from drifting into the space. Lastly, crowns can also be used for esthetic purposes to mask imperfections or discolorations.

Recommended Reading: Sports Mouthguard: Protect Your Teeth, Braces & Lips


What happens during treatment?

Before committing to treatment, be sure you understand why you need a crown. Did the tooth need a root canal? Does the tooth have a cavity that’s too large for a filling? Did your filling fracture? Also, discuss with your clinician treatment alternatives such as a bridge if an adjacent tooth is missing, or extraction is a more cost-effective alternative if you are limited financially.

Central Incisor preparation process for dental crowns or Veneer placement | My Dental Advocate

After the anesthetic is administered, the clinician will verify that you’re adequately numb. Due to the dense cortical bone, it takes longer for the lower teeth to numb than the porous maxillary jaw. If you have issues keeping your jaw open during procedures, ask the dental assistant for a bite block to rest your jaw open.

The clinician will first remove minimal tooth structure from all surfaces so that the crown fits snugly and will not interfere with your bite or adjacent teeth upon delivery. The amount of tooth structure that’s removed depends on the type of crown being placed. For example, porcelain fused to metal (PFM) and ceramic crowns require more tooth structure removal than zirconia or gold crowns. After the cavity or existing filling is removed, the dentist will place a build-up to replace the missing tooth structure.

After the tooth is prepared, an impression will be taken conventionally (gooey material) or digitally. The dentist can accurately take a digital scan if a ceramic or zirconia crown is planned, followed by design, fabrication, and delivery. If the digital scan is unsatisfactory, the clinician can quickly re-scan the tooth until it’s satisfactory.

Digital, same-day crowns are efficient, cost-effective, and no temporary crown is needed. A temporary crown will be fabricated after the impression is inspected and approved if a conventional impression is required. Avoid crunchy and sticky foods until your final crown is delivered. Crown fabrication will take 1-4 weeks, depending on the laboratory and desired crown material.



What crown material is best?

Crown materials have evolved over the years. Gold and PFM crowns have been preferred for decades because of their strength and predictability. However, ceramic and zirconia crowns have grown in popularity because of their strength and predictability. Let’s compare the four most common types of crowns.

Gold

Pros

  • Minimal tooth structure removed
  • Non-abrasive to opposing teeth
  • Cleansable/difficult for plaque to adhere
  • Strong and durable
  • Best for posterior teeth

Cons

  • Requires conventional impression
  • Requires temporary crown
  • Requires second visit
  • Unsightly
  • Prone to wear if gold content is high

Porcelain fused-to-metal (PFM)

Pros

  • Inexpensive
  • Only 1 or 2 impressions needed
  • Successful track record
  • Esthetically pleasing

Cons

  • Prone to fracture
  • Abrasive to opposing teeth
  • Metal allergy is possible
  • Requires conventional impression
  • Requires temporary crown

Ceramic

Pros

  • Most esthetic
  • Bonded for added strength
  • Same day delivery possible
  • Digital impression

Cons

  • Expensive
  • Technique sensitive
  • More tooth structure removed
  • Fractures are possible

Zirconia

Pros

  • Extremely strong
  • Same day delivery possible
  • Digital impression
  • Best for posterior
  • Bonded for added strength
  • Minimal tooth structure removed

Cons

  • Expensive
  • Abrasive to opposing teeth
  • Limited track record

Considerations

Dental crowns bridge of 3 teeth over molar and premolar illustration | Ceramic Dental Crowns are bestCeramic crowns are favorable because of their strength, aesthetics, and same-day delivery capability. Many clinicians are now equipped with a scanning machine that precisely scans the tooth after drilling is completed. Chairside scanning allows the clinician to digitally send the images to the lab or fabricate the crown in the office and deliver it within 2-3 hours. The clinician is in complete control of each step and can make modifications on the fly if an error arises.

Ceramic crowns are prone to fracture, though. Crown fractures happen if the fabricated crown is not thick enough in heavy load areas, which are often seen in the back of the mouth, particularly the molars, because of their lower height, high degree of bite force, and limited thickness crowns that can be applied there. In these cases, a zirconia crown would be better suited. Zirconia is the strongest type of crown material and can be digitally scanned. Gold is also a favorable option; however, a conventional impression is required, which may be uncomfortable for many patients.

Related: Best MDA Recommended Products


Final thoughts


Crowns are essential to repair and protect teeth. Unfortunately, they can be expensive, and understanding the different material options can make your head spin. Have you recently been diagnosed with needing a crown? Were you hoping a filling could be completed instead? My Dental Advocate’s team of board-certified dentists can provide a second opinion on your planned treatment. We look forward to bringing you peace of mind by verifying your treatment plan, suggesting an alternative, or just answering your questions.


Dr Advocate Avatar IconAbout the Author

Dr. Advocate is an actual board-certified dentist with clinical practice experience and a mission to provide accurate dental patient education. He believes everyone should access easy-to-read dental resources presented in layman’s terms with relevant, up-to-date dental research and insight to improve their oral health.




Are crowns necessary | Dental crown premolar tooth assembly process.illustration | My Dental Advocate

What Is a Dental Crown?

Dr Advocate Avatar IconUpdated: September 1, 2022
By: Dr. Advocate

A tooth is an amazing structure and serves a critical role - in helping us eat! If you lose part of a tooth through a cavity or tooth fracture, they don’t regrow, and untreated can affect chewing and eating enjoyment. That’s where crowns come in. Crowns, or caps, are tooth-like solid replacements that protect from wear, fracture, or discoloration. There are many types of crowns, and each has a functional purpose.

After root canals, crowns are predominantly required to protect the weak and brittle remaining tooth structure. Because the nerve tissue provides nutrients to the tooth, the tooth requires reinforcement for longevity and durability after the nerve is removed. Sometimes, crowns are needed if large fillings fracture, cavities form under existing crowns, or the original crown fits poorly, causing hot or cold sensitivity. If the cavitation is too large, there may not be enough tooth remaining to support a subsequent filling.

Crowns are also fastened to implants to restore function and prevent adjacent teeth from drifting into the space. Lastly, crowns can also be used for esthetic purposes to mask imperfections or discolorations.

Recommended Reading:
Sports Mouthguard: Protect Your Teeth, Braces & Lips


What happens during treatment?

Before committing to treatment, be sure you understand why you need a crown. Did the tooth need a root canal? Does the tooth have a cavity that’s too large for a filling? Did your filling fracture? Also, discuss with your clinician treatment alternatives such as a bridge if an adjacent tooth is missing, or extraction is a more cost-effective alternative if you are limited financially.

Central Incisor preparation process for dental crowns or Veneer placement | My Dental Advocate

After the anesthetic is administered, the clinician will verify that you’re adequately numb. Due to the dense cortical bone, it takes longer for the lower teeth to numb than the porous maxillary jaw. If you have issues keeping your jaw open during procedures, ask the dental assistant for a bite block to rest your jaw open.

The clinician will first remove minimal tooth structure from all surfaces so that the crown fits snugly and will not interfere with your bite or adjacent teeth upon delivery. The amount of tooth structure that’s removed depends on the type of crown being placed. For example, porcelain fused to metal (PFM) and ceramic crowns require more tooth structure removal than zirconia or gold crowns. After the cavity or existing filling is removed, the dentist will place a build-up to replace the missing tooth structure.

After the tooth is prepared, an impression will be taken conventionally (gooey material) or digitally. The dentist can accurately take a digital scan if a ceramic or zirconia crown is planned, followed by design, fabrication, and delivery. If the digital scan is unsatisfactory, the clinician can quickly re-scan the tooth until it’s satisfactory.

Digital, same-day crowns are efficient, cost-effective, and no temporary crown is needed. A temporary crown will be fabricated after the impression is inspected and approved if a conventional impression is required. Avoid crunchy and sticky foods until your final crown is delivered. Crown fabrication will take 1-4 weeks, depending on the laboratory and desired crown material.



What crown material is best?

Crown materials have evolved over the years. Gold and PFM crowns have been preferred for decades because of their strength and predictability. However, ceramic and zirconia crowns have grown in popularity because of their strength and predictability. Let’s compare the four most common types of crowns.

Gold

Pros

  • Minimal tooth structure removed
  • Non-abrasive to opposing teeth
  • Cleansable/difficult for plaque to adhere
  • Strong and durable
  • Best for posterior teeth

Cons

  • Requires conventional impression
  • Requires temporary crown
  • Requires second visit
  • Unsightly
  • Prone to wear if gold content is high

Porcelain fused-to-metal (PFM)

Pros

  • Inexpensive
  • Only 1 or 2 impressions needed
  • Successful track record
  • Esthetically pleasing

Cons

  • Prone to fracture
  • Abrasive to opposing teeth
  • Metal allergy is possible
  • Requires conventional impression
  • Requires temporary crown

Ceramic

Pros

  • Most esthetic
  • Bonded for added strength
  • Same day delivery possible
  • Digital impression

Cons

  • Expensive
  • Technique sensitive
  • More tooth structure removed
  • Fractures are possible

Zirconia

Pros

  • Extremely strong
  • Same day delivery possible
  • Digital impression
  • Best for posterior
  • Bonded for added strength
  • Minimal tooth structure removed

Cons

  • Expensive
  • Abrasive to opposing teeth
  • Limited track record

Considerations


Dental crowns bridge of 3 teeth over molar and premolar illustration | Ceramic Dental Crowns are best

Ceramic crowns are favorable because of their strength, aesthetics, and same-day delivery capability. Many clinicians are now equipped with a scanning machine that precisely scans the tooth after drilling is completed. Chairside scanning allows the clinician to digitally send the images to the lab or fabricate the crown in the office and deliver it within 2-3 hours. The clinician is in complete control of each step and can make modifications on the fly if an error arises.

Ceramic crowns are prone to fracture, though. Crown fractures happen if the fabricated crown is not thick enough in heavy load areas, which are often seen in the back of the mouth, particularly the molars, because of their lower height, high degree of bite force, and limited thickness crowns that can be applied there. In these cases, a zirconia crown would be better suited.

Zirconia is the strongest type of crown material and can be digitally scanned. Gold is also a favorable option; however, a conventional impression is required, which may be uncomfortable for many patients.

Related: Best MDA Recommended Products


Frequently asked questions (FAQ)


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Yes, crowns are a prime location for cavities to develop because of the junction between the crown and tooth structure. This location is a common area for plaque to occur, which may lead to cavity formation. If the margin of the crown is above the gum line, it can be readily cleaned. Also, cavities are more susceptible if the crown fits poorly or has a gap where bacteria can congregate, known as an open margin.

Crowns fall off for various reasons; however, the most common reasons are recurrent decay, minimal remaining tooth structure, and sticky foods. If a crown falls off and no decay is present, your clinician should be able to re-cement the crown. Sometimes issues are discovered when crowns come off because x-rays cannot penetrate the material and visualize potential problems under the crown.

If your crown falls off and you’re unable to get to the dentist, you can leave it off and keep it safe or if it's causing you discomfort, place toothpaste in the crown and temporarily re-cement it. Drug stores have a temporary cement that can be used; however, sometimes, the dentist cannot remove the crown because of the strong bond.


Final thoughts


Crowns are essential to repair and protect teeth. Unfortunately, they can be expensive, and understanding the different material options can make your head spin. Have you recently been diagnosed with needing a crown? Were you hoping a filling could be completed instead? My Dental Advocate’s team of board-certified dentists can provide a second opinion on your planned treatment. We look forward to bringing you peace of mind by verifying your treatment plan, suggesting an alternative, or just answering your questions.


Dr Advocate Avatar Icon
About the Author

Dr. Advocate is an actual board-certified dentist with clinical practice experience and a mission to provide accurate dental patient education. He believes everyone should access easy-to-read dental resources presented in layman’s terms with relevant, up-to-date dental research and insight to improve their oral health.



Related Topics


Cavities

Extractions

Fillings

Root Canals

X-Rays


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