A dental crown functions as a cap that dentists place over a damaged tooth. This restorative device covers the entire visible portion of the tooth, resting at the gum line. Its primary objective is to restore a tooth’s original shape, size, and strength, while also improving its appearance.
Reasons for a Dental Crown
Dental crowns serve various purposes in restorative dentistry, often recommended to protect a weak tooth from further damage, especially if it has extensive decay or large fillings. They also hold together parts of a cracked tooth, preventing further fracture. Crowns also restore broken or severely worn teeth from grinding or erosion.
Crowns provide support for teeth with large fillings where insufficient natural tooth structure remains. They also hold dental bridges in place by capping adjacent teeth. Crowns can also cover misshapen or severely discolored teeth for cosmetic improvement. They are also placed on dental implants as artificial teeth.
Potential Disadvantages and Complications
Temporary tooth sensitivity or discomfort is common after receiving a dental crown. This can occur as the local anesthetic wears off, leading to sensitivity to hot or cold temperatures or pressure for a few days or weeks. The tooth preparation process, which involves removing a portion of the tooth structure, can sometimes irritate the pulp, the soft tissue inside the tooth.
Chipping is a possible complication, especially with porcelain or porcelain-fused-to-metal crowns. Small chips may be repaired, but larger chips often require replacement. A crown can also loosen if the dental cement washes out. This allows bacteria to leak in, causing new decay that may not be immediately noticeable.
Crowns may fall off due to insufficient tooth structure, improper cementation, or excessive biting forces. Rarely, an allergic reaction to the metal alloy can occur, more common with older materials. Porcelain-fused-to-metal crowns may develop a dark line near the gum line, revealing the metal beneath, which can be an aesthetic concern.
The procedure is irreversible; tooth reduction for crown placement is permanent. Once prepared, a tooth will always require a crown or similar restoration. Occasionally, preparation can lead to pulp inflammation or infection, necessitating a root canal if nerve damage is significant. Cost is also a disadvantage, as crowns are often a higher investment compared to other restorative options.
Alternatives to Crowns
For less severe tooth damage or decay, large fillings or dental bonding may be suitable alternatives to a crown. Composite resin fillings can restore cavities, while bonding involves applying a tooth-colored resin to repair chips or change the shape of a tooth. These options preserve more of the natural tooth structure.
When tooth damage is too extensive for a filling but not a full crown, inlays and onlays offer a middle-ground solution. Inlays fit within the cusps (the chewing surfaces) of the tooth, while onlays cover one or more cusps. These custom-made restorations are fabricated in a dental lab and bonded to the tooth.
For purely cosmetic concerns on front teeth, where strength is not primary, dental veneers are an option. Veneers are thin, custom-made shells of tooth-colored materials that cover the front surface of teeth to improve appearance. If a tooth is too severely damaged to be saved, extraction may be necessary. Following extraction, a missing tooth can be replaced with a dental implant (a titanium post surgically placed into the jawbone) or a dental bridge (spanning the gap using adjacent teeth for support).
Maintaining Your Dental Crown
Proper care of a dental crown is important for its longevity and overall oral health. Consistent oral hygiene, including brushing at least twice daily and flossing around the crown, helps prevent plaque buildup and decay at the crown margin. Clean the area where the crown meets the gum line to prevent gum inflammation.
Avoiding extremely hard or sticky foods prevents crown damage, such as chipping or dislodgement. Regular dental check-ups and professional cleanings, typically every six months, allow your dentist to monitor the crown and address issues promptly. If you grind or clench your teeth, especially at night, a custom-fitted night guard can protect your crown and natural teeth.