Dental Crowns

A crown is a tooth-shaped “cap” that is placed over a tooth to cover the tooth in order to restore its shape and size, strength, and improve its appearance.

The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.

Most dentistry looks like dentistry. At Edward B. Coffey, DDS MS – Encinitas Dental Art, our goal is to provide dentistry that is undetectable. We replace existing crowns and fillings with restorations that look and feel like your natural teeth.

When damage to a person’s tooth is extreme, and apparently beyond repair, we can use porcelain, porcelain fused to metal, or gold crowns to make the smile appear “as new”. This is an extremely reliable technique for repairing the most severe of dental problems, even permanently replacing missing teeth to offer a complete smile and a functional bite.

Dr. Coffey is renowned for the quality of his work and the fantastic changes he makes for people using this technology. These treatments are used for a long-lasting correction of major dental problems.

Why is a dental crown needed?

 A dental crown may be needed in the following situations:

  • To protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth
  • To restore an already broken tooth or a tooth that has been severely worn down
  • To cover and support a tooth with a large filling when there isn’t a lot of tooth left
  • To hold a dental bridge in place
  • To cover misshapened or severely discolored teeth
  • To cover a dental implant
  • To make a cosmetic modification

What types of dental crowns are available?

Permanent crowns can be made from stainless steel, all metal (such as gold or another alloy), porcelain-fused-to-metal, all resin, or all ceramic.

  • Stainless steel crowns are prefabricated crowns that are used on permanent teeth primarily as a temporary measure. The crown protects the tooth or filling while a permanent crown is made from another material. For children, a stainless steel crown is commonly used to fit over a primary tooth that’s been prepared to fit it. The crown covers the entire tooth and protects it from further decay. When the primary tooth comes out to make room for the permanent tooth, the crown comes out naturally with it. In general, stainless steel crowns are used for children’s teeth because they don’t require multiple dental visits to put in place and so are more cost-effective than custom-made crowns and prophylactic dental care needed to protect a tooth without a crown.
  • Metals used in crowns include gold alloy, other alloys (for example, palladium), or a base-metal alloy (for example, nickel or chromium). Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum. Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, metal crowns rarely chip or break. The metallic color is the main drawback. Metal crowns are a good choice for out-of-sight molars.
  • Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown’s porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown’s porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth.
  • All-resin dental crowns are less expensive than other crown types. However, they wear down over time and are more prone to fractures than porcelain-fused-to-metal crowns.
  • All-ceramic or all-porcelain dental crowns provide better natural color match than any other crown type and may be more suitable for people with metal allergies. However, they are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.
  • Temporary versus permanent. Temporary crowns are made at our office, whereas permanent crowns are made in a dental laboratory. Temporary crowns are made of acrylic or stainless steel and can be used as a temporary restoration until a permanent crown is constructed by a lab.
  • Zirconia or milled crown is a very hard ceramic that is used as a strong base material in some full ceramic restorations. Zirconia crowns allow light to pass as a normal tooth would and that gives a natural look, unlike other metal cores that block the light. They are digitally constructed either in an office that has the software and hardware to produce them or in a dental lab.

How long does it take to fit a dental crown?

Fitting a tooth for a crown usually requires two visits with Dr. Coffey. The first visit takes approximately one hour and involves examining and preparing the tooth, and placing a temporary crown. The second visit involves placement of the permanent crown, which takes about half an hour.

First Visit: Examining and preparing the tooth

At the first visit in preparation for a crown, Dr. Coffey may take an x-ray to check the roots of the tooth receiving the crown and surrounding bone. If the tooth has extensive decay or if there is a risk of infection or injury to the tooth’s pulp, a root canal treatment may need to be performed either by Dr. Coffey or an endodontist before the crown can be started.

Before the process of making a crown begins, Dr. Coffey will anesthetize (numb) the tooth and the gum tissue around the tooth. Next, the tooth receiving the crown is filed down along the chewing surface and sides to make room for the crown. The amount removed depends on the type of crown used (for instance, all-metal crowns are thinner and require less tooth structure removal than all-porcelain or porcelain-fused-to-metal ones). If, on the other hand, a large area of the tooth is missing (due to decay, damage, or if the tooth has a root canal), the tooth may also need a core buildup or prefabricated post and core to “build up” the tooth to support the crown.

After reshaping the tooth, Dr. Coffey will use a paste or putty to make an impression of the tooth to receive the crown. Impressions of the teeth above and below the tooth to receive the dental crown will also be made to make sure that the crown will not affect your bite. The impressions are sent to a dental lab where the crown will be manufactured. The crown is usually returned to our office in two weeks. If the crown is made of porcelain, Dr. Coffey will also select the shade that most closely matches the color of the neighboring teeth. During this first office visit, he will make a temporary crown to cover and protect the prepared tooth while the crown is being made. Since temporary crowns are made of acrylic and are held in place using a temporary cement, Dr. Coffey suggests the following precautions be taken:
  • Avoid sticky, chewy foods (chewing gum, caramel), which have the potential of grabbing and pulling off the crown.
  • Minimize use of the side of your mouth with the temporary crown. Shift the bulk of your chewing to the other side of the mouth.
  • Avoid chewing hard foods (raw vegetables), which could dislodge or break the crown.
  • Slide floss out-rather than lifting out-when cleaning your teeth. Lifting the floss out, as you normally would, might pull off the temporary crown.

Second Visit: Receiving the permanent dental crown

At the second visit, Dr. Coffey will remove the temporary crown, check the fit and color of the permanent crown, and make any necessary final adjustments. If everything is acceptable, and you are happy with the look of the new crown, a local anesthetic will be used to numb the tooth and the new crown is permanently cemented in place.

Key Benefits of Dental Crowns

  • Replaces missing teeth
  • Offers support to misshapen teeth or badly broken teeth
  • Looks completely natural
  • Fixes “smile” and functional chewing problems

What are the capabilities of crowns?

Crown and bridges are a very reliable solution for major dental problems caused through accidents, diseases or wear and tear. Major problems can usually be corrected using these techniques. Material used in these repairs is either high-grade porcelain or porcelain bonded to gold. A higher strength of the porcelain and gold materials is recommended to treat the most serious of dental problems. Where accidental damage has occurred, resulting in lost teeth, or where teeth have broken away through excessive wear, or as the result of old fillings breaking, crowns and/or bridges can be used as a long-term solution.

Many people have unexplained pain from filled back teeth, which is usually due to hairline cracks in the chewing part of the tooth. Placing crowns on these teeth relieves the pain and allows a return of full dental function for these teeth. In front teeth, older fillings can both weaken the teeth and cause “appearance” problems due to staining or chipping. Porcelain crowns and bridges are suitable in cases where porcelain veneers are not. In teeth with root canals, crowns can prevent breakage.

How long do dental crowns last?

Dental crowns are as close to permanent as dental treatment can get and on average, they can last between 5 and 30 years. The life span of a crown depends on the amount of “wear and tear” the crown is exposed to, how well you follow good oral hygiene practices, and your personal mouth-related habits (you should avoid such habits as grinding or clenching your teeth, chewing ice, biting fingernails, and using your teeth to open packaging).

If you would like to schedule a FREE consultation for dental crowns (x-rays not included) with Encinitas Dentist, Edward B. Coffey, DDS MS – Encinitas Dental Art, please call us at (760) 942-7272.  Hablamos Español.