A dental crown is a tooth-shaped cover placed over a damaged or decayed tooth. This restorative device protects the remaining natural tooth structure from further fracture and restores the tooth’s original shape, size, and function. Crowns are typically necessary following a large filling, a root canal procedure, or when a tooth is severely worn down or cracked. Determining the right professional and the best material is crucial for this custom-made, long-term restoration.
Identifying the Right Dental Professional
The most common setting for receiving a dental crown is a private general dentistry practice. General dentists routinely perform crown preparations and placements, making them the primary and most accessible provider for uncomplicated cases. They are trained to diagnose the need for a crown and oversee the entire process, from preparing the tooth to cementing the final restoration.
For more challenging scenarios, such as full-mouth reconstruction, extensive aesthetic needs, or complex bite issues, a prosthodontist may be the ideal choice. A prosthodontist is a specialized dentist who completes an additional three years of advanced training focused exclusively on the restoration and replacement of teeth. This specialization provides expertise in the materials science and biomechanics necessary for intricate crown and bridge work.
Another avenue is through dental school teaching clinics or community health centers. These settings offer restorative services performed by dental students or residents under the direct supervision of licensed faculty. While appointments may take longer due to the instructional nature of the setting, the fees for procedures are often reduced significantly compared to private practices. This option is valuable for individuals seeking quality care at a lower cost.
Crown Material Options and Longevity
The crown material impacts its aesthetics, durability, and expected lifespan, often guided by the tooth’s location. All-ceramic or porcelain crowns are favored for visible teeth because they mimic the translucent appearance and color of natural enamel. While modern ceramics like lithium disilicate (E-max) and zirconia offer impressive strength, traditional porcelain can be susceptible to chipping under heavy biting forces.
Zirconia, a type of ceramic, is a popular modern alternative that combines the aesthetic appeal of porcelain with high fracture resistance. Zirconia crowns are suitable for both front and back teeth, often lasting 10 to 15 years or more with proper care. Gold and other metal alloys (e.g., palladium or nickel-chromium) remain the most durable option, often lasting 20 years or longer due to their resistance to wear and fracture. These are recommended for back molars where chewing forces are greatest and aesthetics are less of a concern.
A compromise between aesthetics and strength is the Porcelain Fused to Metal (PFM) crown, which uses a metal substructure covered by porcelain. PFM crowns offer substantial durability, typically lasting 10 to 15 years, but they may show a dark metal line at the gum line as tissue recedes. The least durable option is the all-resin crown, which is affordable but prone to wear and fracture, making it generally appropriate only for temporary use.
Practical Factors Influencing Provider Choice
After considering providers and materials, the selection process involves practical considerations for a specific dental office.
Financial Considerations
Verifying dental insurance coverage is a primary step, as many policies limit the materials or frequency of crown placement, affecting the final out-of-pocket expense. You should inquire about the practice’s fee schedule for different material types and whether they offer financing or payment plan options.
Experience and Logistics
Assess the provider’s experience with the specific crown material you are considering, especially newer technologies like same-day ceramic crowns. Seek out patient testimonials and reviews that mention restorative work to gauge the quality of their past results. Logistical elements, such as the convenience of the office location and appointment availability, are also important for a multi-step procedure.
Final Consultation
Ask your prospective provider about the dental laboratory they use, as the quality of the lab technician significantly influences the fit and appearance of the final crown. Consulting with two or more dentists allows you to compare proposed treatment plans, material recommendations, and cost estimates. This comparison ensures you make a fully informed decision that balances clinical necessity with your aesthetic and financial preferences.