A premolar is a tooth located between the pointed canine teeth and the molars, with a dual function of grasping and grinding food. A dental crown is a custom-made, tooth-shaped cap placed over a tooth to restore its shape, size, strength, and appearance. A premolar crown is a specific restoration designed to fully encase a damaged premolar, protecting the underlying tooth structure from further harm while re-establishing its function.
Why Premolars Need Crowns
A crown is recommended for a premolar when the tooth has sustained damage that a simple filling cannot repair. Extensive tooth decay can weaken a premolar, and placing a large filling in such a tooth can increase the risk of fracture under normal chewing pressures. A crown covers the entire tooth, holding it together and distributing forces evenly.
Premolars are also susceptible to cracks from the significant biting forces they endure. A crown acts as a reinforcing band, binding the fractured parts of the tooth together and preventing the crack from spreading further.
Following a root canal treatment, a premolar often becomes brittle and more prone to breaking. A crown provides the necessary reinforcement to prevent a fracture of the treated tooth. A crown is also the most durable solution when a large, old filling fails and there is not enough healthy tooth structure to support a new one.
Materials Used for Premolar Crowns
The choice of material for a premolar crown is influenced by the tooth’s visibility and the heavy forces it withstands during chewing.
- All-ceramic crowns, often made from lithium disilicate, offer superior aesthetics. Their color and translucency can be matched precisely to surrounding teeth, and modern ceramics are strong enough for the functional demands of premolars.
- Zirconia is another ceramic known for its exceptional strength and durability, making it highly resistant to chipping. It can be made to look natural and is a good option for people who grind their teeth, though its hardness can wear on opposing teeth.
- Porcelain-fused-to-metal (PFM) crowns have a metal alloy substructure for strength, covered with a layer of tooth-colored porcelain. A potential drawback is that the porcelain can chip, or a dark metal line may become visible at the gumline if gums recede.
- Metal alloys, such as gold or palladium, offer the highest durability and are very gentle on opposing teeth. The primary disadvantage is their metallic color, which most people find unappealing for a visible tooth.
- Composite resin crowns are a less expensive option but are not as durable. They are more susceptible to wear and staining and are often considered a more temporary solution for back teeth.
The Premolar Crown Placement Process
Getting a premolar crown involves two separate dental appointments. During the first visit, the dentist examines the tooth and administers a local anesthetic. The tooth is then reshaped by removing a layer of the outer enamel from the top and sides to create space for the crown.
After the tooth is prepared, an impression is taken using dental putty or a digital intraoral scanner. This model is sent to a dental laboratory where the permanent crown will be custom-fabricated. The dentist uses a shade guide to select a color for the crown that matches the adjacent teeth, and a temporary crown is placed to protect the tooth.
The second visit occurs once the permanent crown is ready, usually a couple of weeks later. The temporary crown is removed, and the dentist places the new permanent crown to check its fit and bite. After any minor adjustments are made, the crown is permanently bonded to the tooth using a strong dental cement.
Aftercare and Longevity of Premolar Crowns
It is common to experience some temporary sensitivity to hot and cold temperatures after a crown is placed. The bite should feel even and comfortable; if it feels “high” or uneven, contact the dentist for an adjustment to prevent discomfort or damage.
The underlying tooth is still vulnerable to decay, particularly at the margin where the crown meets the tooth surface. Daily brushing and flossing are necessary to keep this area clean and prevent cavities. Regular dental check-ups allow a professional to inspect the crown and the health of the surrounding gums.
Certain habits can affect the lifespan of a crown. It is advisable to avoid chewing on very hard items like ice or hard candy and to not use your teeth as tools. For individuals who grind their teeth (bruxism), a custom-fitted nightguard is often recommended to protect the crown.
The lifespan of a premolar crown can range from five to over fifteen years. Longevity depends on the material used, the patient’s oral hygiene, the biting forces it is subjected to, and consistent dental care. If a crown feels loose, chips, or if pain develops around it, a dental visit is necessary.