Wisdom teeth, also known as third molars, are the last set of adult teeth to emerge, typically appearing at the very back of the mouth during the late teens or early twenties. A dental crown is a tooth-shaped cap that dentists place over a tooth to restore its form and function. This restorative cap aims to improve the tooth’s shape, size, strength, and overall appearance. When cemented into place, a crown fully encases the visible portion of the tooth, providing protection.
Situations Leading to Crown Consideration
A dentist might consider placing a crown on a wisdom tooth when it has significant decay. If a cavity is too large for a standard filling, or if decay has compromised a substantial amount of the tooth’s structure, a crown offers necessary support, especially when insufficient tooth material remains.
Fractures or cracks in a wisdom tooth can also lead to crown consideration. Such damage can weaken the tooth, and a crown serves as a protective barrier to prevent further breakage. Crowns are additionally used to restore teeth that have experienced extensive wear, often due to constant chewing forces. After a root canal procedure, a crown is frequently recommended to safeguard the tooth, as it may become more fragile.
Key Factors in the Decision
The position and functionality of the wisdom tooth are primary considerations for crowning. If the tooth is fully erupted, properly aligned, and has an opposing tooth for chewing, it might be a suitable candidate for a crown. Conversely, if the tooth is impacted, meaning it is trapped below the gum surface or growing at an unusual angle, crowning may not offer a practical benefit.
Oral hygiene and the patient’s ability to maintain the crowned tooth also play a role. Wisdom teeth are located far back in the mouth, which can make them difficult to clean thoroughly. Limited access increases the risk of future decay or gum disease around a crowned tooth, potentially shortening its lifespan.
The long-term prognosis of the tooth is carefully assessed to determine if a crown is a reasonable investment. This evaluation includes the tooth’s overall health, surrounding bone, and potential for future issues like decay or gum disease.
The financial investment of a crown is another practical consideration, weighed against its long-term benefits and alternative treatments like extraction. A patient’s overall health can also influence the decision. Certain systemic health conditions, including diabetes or autoimmune disorders, can affect healing processes and the body’s response to dental work. Such conditions might elevate the risk of complications or impact the success rate of a crown, prompting the dentist to explore other options.
Alternative Approaches and Extraction
For minor tooth decay, a standard dental filling can be a suitable solution. Fillings are typically employed when the cavity is small and has not significantly compromised the tooth’s structure. If the decay is confined to the outer enamel, a filling effectively restores the tooth’s surface.
In some cases, particularly if a wisdom tooth is asymptomatic and not causing immediate issues, observation may be an initial approach. This involves routine dental check-ups and X-rays to monitor the tooth’s condition over time. This approach is reserved for minor concerns not showing progression.
Extraction is often recommended for wisdom teeth in various circumstances. This includes recurrent infections, such as pericoronitis, which is inflammation of the gum tissue around a partially erupted wisdom tooth where food and bacteria can accumulate. Severe impaction, where the tooth is trapped and growing at an awkward angle, frequently requires removal to prevent pain, damage to adjacent teeth, or the development of cysts.
Extraction is also advised if the wisdom tooth is non-functional, challenging to clean, or contributes to the crowding of other teeth. If a wisdom tooth’s roots are positioned very close to important nerves, a coronectomy, where only the crown is removed and the roots are left intact, might be considered to reduce the risk of nerve damage.