A provisional crown, often called a temporary crown, is a restorative cover placed on a prepared tooth while a patient waits for a permanent, custom-made crown to be fabricated. This restoration acts primarily as a protective shield and placeholder, utilized for a short period, typically ranging from a few weeks to a few months. This article will cover the importance of the provisional crown, how it is placed, and the necessary steps patients must take to maintain it.
The Purpose and Function of Provisional Crowns
A primary role of the provisional crown is to protect the underlying tooth structure after it has been reduced and shaped by the dentist. The freshly prepared dentin is highly sensitive to thermal changes, such as hot and cold liquids, and exposure to air. The temporary material seals the exposed surfaces, significantly reducing this post-operative sensitivity. This barrier also prevents oral bacteria and saliva from contaminating the tooth’s inner layer.
Maintaining the correct spatial relationship within the mouth is another significant function of this temporary restoration. After the tooth preparation, the surrounding teeth can begin to drift or shift their position. The provisional crown occupies the space previously held by the natural tooth, preventing neighboring teeth from moving into the gap. This ensures that the permanent crown, when fabricated, will fit precisely.
Beyond protection and alignment, the temporary crown restores a patient’s ability to chew and speak comfortably. It allows for near-normal function while waiting for the permanent fixture. Furthermore, the provisional crown offers an immediate aesthetic solution, particularly when a front tooth is involved, preserving the appearance of the smile during the interim period.
The Placement Process
The process begins with the preparation of the tooth to create a uniform foundation for the final crown. The dentist carefully reduces the circumference and height of the tooth, removing enough enamel and dentin to accommodate the thickness of the final restoration material. This shaping step ensures the permanent crown will sit flush with the gum line and integrate correctly into the patient’s existing bite.
Once the tooth is prepared, an accurate replica of the area is captured to guide the laboratory fabrication of the final crown. This may involve taking a physical impression using a putty-like material or utilizing an intraoral scanner to create a precise digital model. It is from this impression or scan that the dental lab will engineer the permanent restoration to the exact specifications of the prepared tooth.
The provisional crown is then created, often molded directly in the mouth using a pre-existing impression or template taken before the tooth reduction. The material, typically an acrylic or composite resin, is shaped and cured to ensure it fits the prepared tooth tightly and matches the surrounding teeth.
Finally, the temporary restoration is secured onto the prepared tooth using a specialized temporary dental cement. This cement is formulated to provide sufficient retention for several weeks but remains easily removable when the patient returns for the permanent crown placement. The ease of removal is a deliberate feature, distinguishing it from the stronger, long-lasting adhesive used for the final restoration.
Daily Care and Precautions
Maintaining the provisional crown requires specific adjustments to daily habits, particularly regarding diet. Patients should avoid consuming excessively hard or crunchy foods, as these can fracture the temporary material. Sticky items, such as caramel or chewing gum, pose a significant risk because they can pull the provisional restoration directly off the prepared tooth. Chewing should primarily be done on the side of the mouth opposite the crown to minimize direct stress.
Proper oral hygiene must continue around the temporary crown, but with modified techniques. Brushing should be done gently, using a soft-bristled brush. When flossing, rather than pulling the floss upward and possibly lifting the crown, the patient should thread the floss through and then pull it out horizontally from the side. This simple modification prevents accidental removal of the temporary fixture.
Addressing Common Concerns
Patients may experience slight, temporary sensitivity to temperature changes or minor irritation of the surrounding gum tissue immediately following the procedure. This is often a normal reaction to the tooth preparation and typically subsides within a few days. However, if sensitivity becomes severe, throbbing, or persistent, it warrants a call to the dental office for assessment.
The most significant concern is the provisional crown becoming loose or falling off due to the temporary nature of its cement. If this occurs, the patient should immediately retrieve the crown. Contact the dental office immediately for re-cementation and to avoid chewing on the exposed, prepared tooth until it is re-covered.