A provisional, or temporary, crown covers and protects a tooth prepared for a permanent restoration. This temporary solution is a necessary intermediate step while a dental laboratory fabricates the final crown. The provisional crown maintains proper spacing, prevents the prepared tooth from shifting, and protects the sensitive underlying structure from bacteria and temperature changes. It also provides function and natural appearance during the waiting period.
Removing Excess Cement
The immediate technical step after seating the provisional crown is the complete removal of any excess temporary cement. Cement is intentionally over-filled to ensure a complete seal, but remaining material traps plaque and bacteria, leading to irritation and inflammation of the surrounding gum tissue (gingivitis). This cleanup is crucial for cement that flows into the subgingival area below the gum line.
Dentists use fine instruments, such as explorers, scalers, and specialized curettes, to gently scrape away hardened cement from the crown margins and tooth surface. Dental floss ensures the cement is cleared from the contact points where the provisional crown touches adjacent teeth. The goal is to promote a smooth interface and gum health.
Ensuring Proper Fit and Function
Once the excess cement has been removed, the dentist performs a series of checks to ensure the provisional crown functions correctly and comfortably.
Occlusion Check
The most important check is occlusion, which evaluates how the crown interacts with the opposing teeth when the patient bites down. Articulating paper, a thin colored paper, is used to mark areas of heavy contact, known as high spots. These high spots indicate where the crown is hitting too forcefully and must be carefully adjusted and polished down. Failure to adjust high spots can cause discomfort, trauma, or cause the temporary crown to become dislodged.
Proximal Contacts and Marginal Fit
The dentist also examines the proximal contacts, ensuring the provisional crown fits snugly against the adjacent teeth. Proper contact prevents food from packing between the teeth, which would otherwise irritate the gums. The marginal fit, where the crown meets the prepared tooth structure, is closely inspected to ensure a seamless seal. Margins must be flush to the tooth to protect the underlying dentin and pulp, as a poor seal allows bacteria to leak underneath, potentially causing decay or sensitivity. A final polish is applied to the adjusted areas to create a smooth surface that resists plaque accumulation.
Final Steps Before Leaving the Office
The concluding phase focuses on patient education and scheduling. The patient receives comprehensive home care instructions specific to the temporary restoration. Patients are advised to avoid hard, sticky, or chewy foods, such as gum or caramel, which could pull the lightly cemented crown off.
Instructions for brushing and flossing are reviewed, recommending that floss be pulled out sideways from under the contact point rather than snapping it upward, which could dislodge the temporary. The patient is informed about what to expect, such as mild, temporary sensitivity, and what issues require an immediate call to the dental office (e.g., severe pain, swelling, or crown dislodgement). Finally, the appointment for the insertion of the permanent crown is confirmed.