What Is a Tooth Crown?

Having a tooth crowned is something which makes most people nervous. This is most likely because the procedure of crowning a tooth is often associated with that of having a root canal! Crowns, however, are done in other situations as well. So just what is a tooth crown?

The short answer is that a tooth crown is an artificial surface — often of ceramic-coated metal or plastic composite — which covers or replaces the natural crown of a tooth. This can be done to correct structural defects in the tooth, for purely cosmetic reasons, or a combination of both. Personally, I have two crowns, and their primary purpose is to restore strength to the affected teeth. They are aesthetically natural looking, but this is a side benefit, especially since they are on back teeth which hardly anyone will see.

Here is a more detailed description of just what a restorative tooth crown is, and how it is installed onto the affected tooth (if there is no root canal treatment to be done):

• In the case of restorations, the first thing that happens is that the natural surface of the tooth is ground down so that the crown can fit onto the tooth without sticking up or out into the mouth. This grinding is done with dental drills and similarly sized grinding tools. The patient’s tooth is made numb for this procedure. This part is not particularly hard to endure, but it does take a lot longer than normal drilling. If you’re a tobacco smoker, smoke those cigs before you go in for this!

• Once the tooth has been ground down enough, the dentist will have the patient bite down on some goopy wax and hold that pose for a few minutes. Finally, after a period of time which is surely shorter than it seems, you’ll be allowed to relax your jaw and the dentist or technician will remove the wax from your mouth. The wax will now have the shape of your teeth embedded into it — including the one which has been prepared for crowning.

• Now, you’ll get a temporary crown. For a back tooth, this will likely be a fairly thin metal tooth-shaped thing with a hollow inside. It may take several attempts before the dentist or technician finds one which fits properly. Alternatively, he may make a plastic one on the spot which will be molded into the shape of the affected tooth. These plastic ones are A LOT easier on the patient, because they are guaranteed to fit the first time. Sadly, some dentists are not convinced that they are strong enough, so you may have to be quite demanding before the dentist’s technician gives up trying to get one of those metal ones to fit. But don’t despair — usually the metal ones are fitted without too much trouble. Just keep in mind that if it does become too much trouble, there is that plastic alternative.

• If the reason you need a crown is because you are having root canal therapy, a.k.a. “a root canal,” the endodontist will normally perform the preceding parts of the crowning procedure as well, before sending you back to your regular dentist for the application of the crown.

• Once you get your temporary crown cemented on, you get to go home. Yay! While you are at home, a dental laboratory will be getting to work. This lab will be using that wax mold you made to form your permanent crown. They will not only take into account the amount of space left by the prepared tooth, but also the teeth around it. This will ensure a good fit of the crown onto the tooth as well as proper contact with the other teeth.

• For a back tooth, this crown will often be made of porcelain-covered metal, but there are other types which may be used instead, like gold. Porcelain-covered metal (also known as “high noble” metal) has the benefits of being natural-looking while giving the extra strength of the metal. Gold, while quite obvious when on a visible tooth, is even stronger.

• After a period of time ranging from a few days to a couple of weeks, your new permanent crown will be ready, and you will go back to the dentist to have it installed.

• Removing the temporary crown is easy. All the dentist will need to do is rock it back and forth a bit and then pull it off. The tooth stub, which has been protected under there during this time, will be quite sensitive. Usually, there is no anesthetic applied for this procedure. This is so you can tell whether the permanent crown is fitting properly, but you may wish you could have a bit of numbing gel at least. Unfortunately, that likely won’t be the case — so gut up.

• Now here’s the part you needed to steel your guts for: The application of the cement for the permanent crown. This made-in-a-gulag-like compound will send a signal through that tooth stub like electricity! Fortunately, the tooth will relax in a couple of minutes. It’s just something you need to be ready for. After the dentist is done applying the adhesive, he/she will push the new crown onto the tooth.

• Once a new crown is on, expect to spend a few minutes biting down and grinding your teeth back and forth — just like you would after a filling — while the dentist adjusts the crown and gets it fitting perfectly. This will take the dentist approximately the same amount of time it takes him to perfect the fit of a filling… perhaps a bit less. Once that’s done, you’ll be asked to bite down onto a piece of cotton for a few minutes to allow the cement to set up better.

• The dentist will likely advise you to avoid chewing on the affected side for a day or two to make sure the cement cures well.

That’s about it! You’ll need to make sure to clean well around your crown when brushing your teeth — even better than you would with a totally-natural tooth. This is because it’s very easy for food residue to get hung up around the sides of the crown where it joins the remaining natural tooth. Making sure this area remains super-clean will help prevent cavities at the root line, thereby helping you avoid needing root canal therapy in the future.

As long as the crown is well cared for, it can last you several years, and you’ll enjoy having a strong tooth in that spot again.

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February 16, 2012
Posted in Health — Knowledge Buff @ 11:15 PM

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