“The dentist told me I needed a crown, and I was like, I know, right!”
A dental crown is used to entirely cover or “cap” a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. It will usually be recommended when the remaining tooth structure is limited or weakened, where a simple filling will not be sufficient to protect it.
You may be advised to have a crown in the following circumstances:
- Greater natural tooth destruction through decay
- If you have had a large filling in the past
- If you have had root canal therapy
- If your tooth is badly cracked or worn
- Over the top of a dental implant
Dental crowns are available in wide range of dental materials, including ceramic, precious metals and porcelain fused to metal. Modern crowns are strong, durable and aesthetically pleasing, with most people preferring to choose all-ceramic dental crowns as they look more like natural teeth. These generally last many years longer than a standard filling as they wrap around the tooth and help to hold it together.
Dental bridges are used when one or more teeth are missing and a fixed tooth replacement option is desired. Crowns are formed either side of the missing tooth area where false teeth connected to these fill the spaces. The false teeth sit over the top of the gum where chewing forces are distributed to the neighbouring bonded teeth.
As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the colour of your natural teeth.
Dental Crown and Bridge Procedure
Fitting a crown or bridge involves two appointments.
- The first stage is designed to remove any decayed or damaged tissue and prepare the teeth for crowning. The decayed tissue is removed and the teeth is cleaned thoroughly and shaped. An impression is taken which is sent to the lab for the crown to be fabricated. A temporary crown is fitted until the next visit.
- The completed crown is received from the lab and fitted onto the tooth. The tooth is cleaned and the crown is cemented in place. Some minor adjustments are commonly made. Now you’re able to chew into your steaks without fear of your tooth fracturing.
What are the alternatives?
You can opt for fillings instead of crowns, just keep in mind that fractures have a higher chance here and these teeth may need repair quite frequently. In the case of root canal treated teeth, chances of fractures lower into the roots become higher particularly without the support of a crown. If this occurs the tooth may become non-restorable and may require extraction.
Instead of a bridge you can opt for a partial denture, which is a removable plate to replace the missing teeth. This may be ideal if there are multiple missing teeth in different locations, particularly if you are keeping to a budget. Alternatively, you may consider implants, where a screw is inserted into the bone and a crown is constructed over the top. This option is more expensive and time consuming, but preserves the neighbouring teeth as they will not need to be filed down to hold the supporting crowns. Or you could leave the space as is, some people tolerate this quite well, whereas others find the decreased ability to chew and clean more impeding. Whether to go for partial dentures, bridges, implants, or leaving the space, the decision is determined on a case by case basis, where your dentist will provide you with more information to what may suit your circumstance better.
How long do they last?
Whilst crowns provide a much stronger option to fillings, there is nothing stronger than your own natural teeth. They are the next best thing though. A crown should typically last 5 to 10 years, but in many cases they can last decades. There are several factors which determine this: previous damage to the teeth, gum disease, parafunctional habits like grinding and clenching, a heavy bite or missing teeth in other areas leading to increased load on the teeth worked on, the integrity of supporting teeth in bridges, oral hygiene, aesthetic satisfaction with changes in surrounding teeth, quality of materials, execution of crown and bridge preparation, and cements used. The longevity of crowns and bridges cannot always be predicted but with good oral care you should receive a long lasting desirable result.