Dental Crowns - FREQUENTLY ASKED QUESTIONSIs there another way I can have a tooth replaced other than a bridge?
Yes. Dental implants can provide artificial teeth that look natural and feel secure. Dental implants can also be used to attach full or partial dentures. Implants, however, are not an option for everyone. Because implants require surgery, patients must be in good health, have healthy gums, have adequate bone to support the implant and be committed to meticulous oral hygiene and regular dental visits. If you are considering implants, a thorough evaluation by your dentist will help determine if you would be a good candidate.What Problems Could Develop With a Dental Crown?
Discomfort or sensitivity. Your newly crowned tooth may be sensitive immediately after the procedure as the anesthesia begins to wear off. If the tooth that has been crowned still has a nerve in it, you may experience some heat and cold sensitivity. Your dentist may recommend that you brush your teeth with toothpaste designed for sensitive teeth.
Chipped crown. Crowns made of all porcelain can sometimes chip. If the chip is small, a composite resin can be used to repair the chip with the crown remaining in your mouth. If the chipping is extensive, the crown may need to be replaced.
Loose crown. Sometimes the cement washes out from under the crown. Not only does this allow the crown to become loose, it allows bacteria to leak in and cause decay to the tooth that remains. If your crown feels loose, contact our office or email us.
Crown falls off. If this happens, contact our office or email us immediately. Our dentists and staff can then give you specific instructions on how to care for your tooth and crown for the day or so until you can be seen for an evaluation. Your dentist may be able to re-cement your crown in place; if not, a new crown is required.
Allergic reaction. Because the metals used to make crowns are usually a mixture of metals, an allergic reaction to the metals or porcelain used in crowns can occur, but this is extremely rare. Please do kindly inform our staff on any allgeric reactions you may have before any medical or dental treatment.
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. Habits such as grinding or clenching your teeth, chewing ice, biting your fingernails and using your teeth to open packaging puts on greater wear and tear to the crown. On average in general, dental crowns last between 5 and 15 years.Does a Crowned Tooth Require any Special Care?
While a crowned tooth does not require any special care, remember that simply because a tooth is crowned does not mean the underlying tooth is protected from decay or gum disease. Therefore, continue to follow good oral hygiene practices, including brushing your teeth at least twice a day and flossing once a day-especially around the crown area where the gum meets the tooth.How is the crown made?
Your initial appointment requires tooth preparation which will involve and removal of decay and grinding down of the tooth using a specialized instruments. You will then have and impression along with a representation for how your upper and lower jaws come together (bite registration). The color for porcelain crowns will also determined by matching your remaining natural teeth. A Temporary crown will also be made which will somewhat resemble your tooth. Your impression, the shade and bite registration are sent to the lab where they will construct your porcelain crown.
Within 2 weeks or more, it is sent back to our office. When you reture, we will remove your temporary crown and ascertain your permanent crown fits well. Any adjustments are made over your natural tooth. Your dentist will then have you bite down on what look like thick carbon paper to check your bite. If proper contact are not being made correctly or your bite is uncomfortable, your dentist will ligthly drill parts of your crown until the correct contact is made.
The course of treatment described here is one of several options available at our dental clinic. Consult your dentist to find out what the best solution is for you, given your specific condition.
- • First evaluation and crowns tooth preparation
Local anesthesia is first adminstered at the region for crown tooth preparation
- • The natural tooth is reshaped to receive the new dental crown
- • Records are taken and approved with the patient to determine the color, bite, length and shape of the crown
- • An impressionis taken for a replica model of the teeth
This model is sent to a lab where the individual personal crown is fabricated
- • A temporary crown is placed on whilst the permanent crown is made
Fitting of crowns on delivery
- • The temporary crown is removed
- • The permanent crown is fitted and cemented into place on the teeth
- • A quality assurance check is done for any re-adjustments or re-works of the dental crowns
Care of crowns
- • Brush and floss the crowns as recommended by your dentist or dental hygienist.
The answer is seating a crown varies from a few minutes to half an hour. It depends on what specific adjustments the individual dentist wishes to accomplish.
It is up to the dentist to do any final modifications to the prescription crown that he/she ordered to be manufactured. It also depends on the specific type of crown and the specific requirements of the luting or cementing agents used. I hope this gives you more useful information.
Thank you for a great question. Yes, it is possible to have a metal crown that has no nickel.
The specific metal crown that I most highly recommend for anywhere in the mouth that the patient will allow is a gold crown. The specific gold that I use is made by a company called Jensen and this product is called JVRT gold.
This alloy or gold material has no nickel.
I have taken advil which doesn't seem to help but sinus medication seems to help some. The pain is bad enough to keep me awake at night.
It is not normal for a tooth to be sore as you describe. There are many possibilities. The temporary could be ill-fitting and impinging on your gum tissue, the temporary could be leaking badly, the tooth could be infected, or the bite could be off to mention just a few.
I am nearing retirement and my dentist noticed a shadow (decay) under a crown on my x-rays. So, we will be replacing that crown, but as we talked, he mentioned that we should consider replacing 3 additional crowns soley because they are between 15 and 20 years old. Is this a good idea?
The reason we are even considering the additional 3 crowns is that I currently have 50% insurance coverage on crowns and will not have insurance at all after retirement.
These are some good questions. There is no rule of thumb for how long a crown should last.
The factors involved with longevity are the specific materials used, the type of crown, the quality of the laboratory engaged in the manufacture, the competence of the dentist and the level of cooperation the patient was able to exhibit during the procedure.
Gold crowns will outlive porcelain crowns three to one. Insurance companies, which are not known for their generosity, will pay for a new crown in five years.
Different studies indicate crowns lasting from 4-10 years depending again on the materials and the study. Certainly excellent oral hygiene can improve the life expectancy, however everything man makes fails. Car tires, shoes, stereos and yes dental repairs wear out.
Dental restorations are subjected to 24/7 of being bathed in salvia, pushed and shoved on and generally used surrounded by bacteria just waiting for their turn at further destruction.
Relative to your second question, just because something is old does not mean it needs to be replaced. A good basic tenet is: if it is not broken do not fix it. If there is still wear left on the tires of your car that is not compelling reason to replace them prematurely unless you are extremely proactive.
The permanent crowns were put on about 3 weeks ago and I have since gone back three times for bite adjustment. It has helped some all three times but the problem is still there. My dentist has even sent me to an endodontist (hope this is spelled correctly)to see if I needed a root canal. The endodontist has seen me on two different occassions and says that there is no evidence for a root canal.
The pain is not constant only when I chew down on these crowns which leads me to believe that it has to be these crowns. Emotionally I don't think that I can bear this much longer. I think that I should let you know that the fillings in the teeth prior to the dental work did not cause pain and I was able to chew fine before all of this crown work.
In your opinion do you (like myself) think that the problem here is with the crown (I think #19) and perhaps with the impressions that were made or the lab when making the crown. I was at my dentist's office for the third attemp to adjust these just this morning and needless to say I am at my wits end. He has suggested that I wait one more month to see if it gets better but he has got to know that this isn't just going to go away.
Like I said it is not a constant throbbing pain, it only happens when I chew (or try) to chew on the left side. Any help or suggestions would be greatly appreciated.
Right off the bat you need to know that not all teeth read the textbooks. Which is to say they do not always behave the way we collectively think they should and that they normally do. Every time you work on a tooth it is a trauma and once in a while the teeth just take the final insult before they "talk back". This is like the straw that broke the camels back. Having said that, her are some thoughts that might lead to you to an answer.
It is possible you have a crack in one of these teeth. The pressure of biting down opens this crack enough to cause pain. A crack is almost always a diagnosis by default as they can not be seen. What I mean by this is everybody in the world looks at a tooth, everyone gets aggravated at everybody involved and no one can find the answer. Only out of desperation the patient gets the tooth removed and the oral surgeon shows you the crack in the extracted tooth. This is not likely the case but it is possible.
Another more possible scenario is the insult I mentioned above could be enough to cause the tooth to "die" slowly in which case the endodontist can not make this determination early on as the tooth still responses normally to their tests. Only later in the process is this found to be the case. In between times, as in all situations in life, one of three things can happen; it stays the same, gets better or gets worse. Option one stinks, option two is great and option three at least leads to a good diagnosis and a plan of attack.
The most probable scenario is trauma from your biting habits or the different directions we all can move our teeth in the movements of chewing functions. This especially true if you clench and grind as the vast majority of us do as a result of everyday stress. Sometimes another set of eyes is a good thing. This is not, I repeat this is not, a slight to your attending dentist. If you have not completely lost confidence in your dentist, ask him for a referral to either a periodontist or prosthodontist. Both of these specialists have great knowledge in some of the finer and finickier aspects of bite issues.
The next more drastic step would be to remove the crowns, re-temporize them, inspect them and give them a chance to cool down. It is possible the cement used COULD have an influence in the problem.
The scenario: my dentist had recommended I crown (no root canal needed) this back molar, since the filling was very large and very old. I am now experiencing some fairly uncomfortable sensitivity to hot and cold, as well as problems with the bite (feels like the crown is too long, even though he shortened it a great deal and the crown no longer has natural-looking and feeling indentation along its surface, it's almost completely flat).
It upsets the tooth to chew on nuts, seeds, crunchy foods, soft foods are okay. The space in between the gum and the top of the crown is visible, about one millimeter or so. At the permanent fitting, the dentist encouraged me to rub the gum to bring it down to cover the space, but didn't say much else.
I hesitate to go back because the permanent crown placement was unpleaseant (felt as if the nerves were being stimulated and jangled as he kept poking into that empty space with metal prong). Does this sound normal? Answer: There is not necessarily any right or wrong answer. ANYWHERE a dentist can leave a margin (end of the crown or cap and the beginning of the untouched tooth - or in other words, the end of man's work and the beginning of God's work) above the gum line it is to the advantage of the patients oral health.
The reason for this is rather than burying the margin under the gum line and leaving it "exposed" or above the gum line, the margin can be easily cleaned. Therefore the crown or cap will last a great deal longer and the gum tissue will be much happier. This is especially true with a gold crown which is a functional and not a cosmetic restoration.
Please remember when God's work (your original equipment), does not last a lifetime, everything a dentist does is a compromise and the more easily cleaned the restoration the greater the longevity and therefore your return on investment.
Obviously, if it is front tooth, we want to "bury" the margin under the gum line for maximum esthetics. This frequently and unpredictably backfires as the gum tissue and porcelain are poor neighbors, not very biocompatible and you frequently see the gum tissue recede from this insult and a black line or the natural tooth exposed which compromises the intended esthetic effect.
If the crown is in the back of your mouth the esthetic requirement is not so great. Additionally the wearing of a temporary may make the tissue recede. This was not intended but just how the patient's individual tissue responded. The sensivitity around the neck of the tooth normally diminishes with time after a crown procedure. A tooth paste for sensitive teeth may be one solution. Another is a good, healthy, non-confrontational conversation with your dentist.
What is the purpose of replacing a crown on a tooth with a root canal already done? What are the benefits for my tooth? I thought he might be money-hungry.
Answer: If you have decay under your tooth's crown and want to retain or keep the tooth, it will positively require a new crown. If the decay is not treated you will eventually lose the tooth as it will become non-restorable.
Once a tooth has had a root canal (and you will never feel any discomfort or pain in that tooth again), it drys out inside, becomes brittle and has lost its primary source of resistence to decay ... that of moisture.
Therefore it is imperative that you get this tooth restored sooner rather then later. Your dentist is not money hungry but merely has your best interests at heart.
I have not had this question before and really do not have a definitive answer.
However, to be sure, the more effecient you are with your oral hygiene and in particular your floss, the longer your crown will last and the healthier your gums will be.
I am curious about this apparent chemical reaction and even if your gold crown is not of the highest gold content, the assumption made is still there should be no concern. Check with your dentist to insure you do not have a food impaction area.
There are no cracks and it doesn't bother me at all, although the dentist had a "watch" on it due to age. He suggested that since it was not shaped properly, food might slough off and get under it, causing gum problems.
Is this a legitimate issue and do I really need a new crown or can I wait until it bothers me?Answer:
Those are great questions however, without seeing the case, I can only give you generalities.
Porcelain crowns fracture with a great deal of frequency. A fracture of the exterior porcelain surface does not condemn the crown to replacement unless it is a cosmetic problem or results in significant food impaction.
The latter will result in periodontal compromise to the gum tissue and underlying bone and it is not worth trying to squeeze a few more years out of the crown.
If however, it is not a cosmetic issue, the fractured part does not drive your tongue nuts, and the external remaining anatomy is such that you can still keep your gum area clean then postponing replacement until the crown fails because of recurrent decay is not a bad option.
Positively, you do not want to wait until it hurts.
By then you have created a bigger and more expensive problem probably involving a root canal, further structural compromise to your tooth, and threatening its' long term prognosis. Good luck!
When the crown was put in my mouth I did not look at it beforehand as I just trusted my dentist to have ordered the correct one. Anyway I got a few blocks from the dentist office and took a look at it and there is a dark line on both of them at the top.
I immediately turned around and went back in and asked why I had this after being told this would not show a dark line. The dentist told me it was my root showing. I have not been able to find anything on the internet to support this. Could it actually be the root and if so why would the crown not have been made to cover the roots?
Answer: I must admit I am a little confused by the content of your question however, my answer may be of significant insight.
A porcelain crown is different than a gold inlay. I assume that you had a porcelain to gold crown with gold being the under casting metal material. I also assume these are back teeth. Additionally, I assume that the areas in question are on the inside however there is little difference save cosmetic considerations.
What you are looking at positively is part of the root of the tooth. There is no compelling reason to cover any or all of the root unless this is a front tooth and the front showing part of a front tooth. A dentist does not wish to "bury" the margin or ending point of his crown below the gum line unless he has to.
Frequently we have to either because there is decay or a pre-existing restoration below the gum line or there is insufficient tooth structure left to help retain or keep the crown in place and from falling off.
Jamming the margins under the gum line serves no function save the above. Putting the margins below the gum line unnecessarily, only further complicates the patient's ability to keep it clean. Margins above the gum line or what you might call high water margins provide easy access to your tooth brush.
This results in a greater return on your investment, as the restoration or crown, in this case, lasts longer and much fewer periodontal or gum problems result.
Additionally, since everything man makes fails (remember, Mother Nature's work did not last you a lifetime), the more tooth structure left around a tooth for the future replacement crown the more likelihood another crown can be made on this same tooth. I hope this information helps you understand the process. Good luck!
Is this a normal result from the crown? I am not having any pain, but there is a slight amount of swelling.
The color around your gums is a sign of inflamation. Inflamation is like irritation. Something is irritating your gums and causing your swelling and color changes.
Some of the possible causes could be a crown that does not fit perfectly, but is still serviceable, a crown that has recurrent decay around the margins, a mild allegoric reaction to any of the other metals in the specific gold alloy used for your crown, or inadequate oral hygiene.
I suggest you try to become an "oral athlete" over the next week to ten days. Try to really floss and brush around this tooth 100%. If things do not improve let your dentist check it. He/she may or may not be able to improve the situation.
My dentist has done some adjustment on it and told me the X-ray looks perfect both for the crown and root canal. But I can feel the crown doesn't seem tightly hooked up with the underneath. I can shake it.
When I told my dentist about it, he doesn't believe me. I don't know what's going wrong. This tooth has made me suffer longer than a year--2 times filling, then root canal then crown.
Answer: First I should tell you that not all root canal teeth read the textbooks. This is to say that not all teeth follow the same post-operative course.
Not infrequently, teeth will remain sensitive-despite the fact that the nerve is gone - for months after treatment. In these unfortunate circumstances, the infection that was at the base of the tooth has some final last gasps and will be tender to percussion or biting down forces.
This almost always goes away. If a specialist treated the tooth for the root canal then going back to see them for a double check is a good idea. If the tooth was treated for the root canal by your general practitioner, ask him or her if they could refer you to a root canal specialist for a double check.
I do not know your periodontal status but again, not infrequently a tooth will feel loose or not connected during this acclimation process. Nothing truly may be "going wrong". You have along tough dental ride and your perceptions "may" be getting the better of you. Trust your dentist and try to weather the storm. Good Luck.
Quite frankly I had forgotten about the dentistry until I awoke one morning with terrible pain in my front teeth. I have since had the crowns raised but the front teeth still hurt when I try to eat. So I am still existing on liquids and very soft food.
Do you think I have permanently damaged the front teeth and who do I seek for help? A neurologist? A neuromuscular specialist? I am at my wits end and need help badly.
Answer: It is almost impossible to make crowns too low and then make them higher or need ones higher. I know that may not sound like the answer you'd like, however a couple of things for you to think about while we are on this subject.
Your mouth is like a hinge. For instance, a door can not close all the way if there is an object, big or small, i.e a chair or a pencil, in the way. For you to be able to close all the way down, a crown has to fit relatively perfect or you would never, I repeat never, have "forgotten" about your bite.
I suggest you consider moving on about concerns over your bite and deal with the issues of your front teeth still hurting when you bite down. With regards to that the word "still" means you must have omitted that from the first half of your note.
I do not believe you have permanently damaged your front teeth. In most likelihood there is no relationship between these symptoms and your crowns. My best remote diagnosis is that you are clenching and grinding your teeth at night, like most people, and are completely unaware of the situation.
This is a stress related activity and not one you can change without the use of a night guard made by your dentist. The second possible issue involved with your pain, could be any one of the front teeth has a nerve problem.
I suggest you go back to your dentist, give him your list of complaints, and see what he thinks. Broach the subject of a possible referral to a endodontist. An endodontist is a root canal specialist and they can easily tell if one of your teeth is going south.
I'm concerned with pregnancy. If I am pregnant I will know the day of the procedure of putting in my porcelain/permanent tooth. I wasn't concerned because they said it would take 2 weeks for the whole procedure, but it's been dragging...so I continued trying unaware that it would take this long.
If I AM pregnant, can I finish getting the crown put in? Do they have to numb me or do you think with some heavy breathing and meditation I can pull through with the cementing of the tooth?
Answer: Please do not worry about this situation. Most dentists, most of the time, do not numb up their patients to put on a crown.
It is almost always a very easy process that involves minimal momentary, if any discomfort. If in your given ituation, after you ask your dentist, he/she needs to get you numb this will not interfere with your pregnancy. Good luck and have a healthy newborn!
Q: Gold Inlay Substitute: Is there a good substitue for gold inlays? Mine has come loose twice and now I fear it has cracked.
You want to put a crown on your tooth yesterday!
After a root canal the tooth loses all its' vascularity or moisture. The tooth becomes dried out or desiccated and brittle much the same way a branch dries out and can be easily snapped in half.
By the time the average person has had a root canal, there are almost always other structurally compromising things going on with the tooth ....from fracture to decay.
After a root canal, your tooth is extremely vulnerable to fracture and if you do not crown your tooth this will happen. Then you will have your tooth extracted, wasted your money on the root canal and have a much bigger problem with much greater expense.
Assuming the original gold casting fit well to begin with, when your gold inlay came out the first time the tooth or the casting may not have been 100% cleaned prior to re-cementation. This would allow for a less accurate fit the second time around and therefore a reduced bond strength.
Additionally if a gold casting is tin plated-a process that can be done in the office taking two minutes-the bond strength is significantly improved. It is unlikely that your gold inlay or casting has cracked.
Without seeing it or your tooth everything is a guess. You may just be in the market for a new casting.
What holds the average inlay is an extremely well designed and precision preparation providing a design form to resist displacement and dislodgement. This is usually accomplished by frictional retention of near parallel walls to the preparation.
A well designed gold casting continues to be the undisputed quintessential restoration of choice in the absence of significant cosmetic considerations.