WHAT YOU NEED TO KNOW BEFORE YOUR CROWN APPOINTMENT

WHEN DO I NEED A CROWN?

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1. After root canal treatment - Your tooth can become more brittle after root canal treatment. If it is the case that more than 60% of your natural tooth is missing. Clinical studies show that a definitive filling such as a crown is required for long term success of the root canal treatment. Speak with your dental professional.


2. Large chip - before this turns into a root canal, from bacteria, infection. Your dentists will advise you how to prevent such severe consequences. Protecting the tooth with a crown maybe an appropriate treatment, especially where the chip is large. Left untreated, you will likely have pain in the future. In severe cases, common pain medication won’t be able to contain it. This is not an experience you will want to have!


3. Protection for weak teeth at risk of cracking or that have already cracked - Large composite restorations (white fillings), usually those taking up more than 60% of the tooth, are at high risk for future fracture. This is especially true for back teeth, who’s function is chewing and breaking food. In these cases, the daily wear & tear push the white filling material beyond its physical limit. Your dental professional may have discussed crown treatment with you. Many patients “leave it”, because initially, “nothing seems to be wrong”. When you notice signs such as discomfort, pain, cracks, sharpness, they are signs to seek the advice of your dentist.


4. Replacing teeth that have decayed - first, the dentist will have to treat the decay, also check if there are early signs of root canal treatment. Small chips in the tooth if not treated, will get larger, ultimately becoming infected. After removal of decay, if more than 60% of your tooth structure is missing, dental crowns will be discussed with you, as an option to permanently restore teeth back to health and esthetics.

Metal Crown

Metal Crown

Ceramic Crown

Ceramic Crown

5. Replacing a metal crown - usually for aesthetic reasons, as time passes, the metal of the tooth shows below the gums. The gum area can also discolour with a black line around the crown, usually caused by an allergic reaction from the metal. A very common allergic reaction but one that 0could be very aesthetically displeasing. This can be treated easily by replacing the metal-containing crown, with a metal-free crown (also known as all-ceramic crown). As the newer crown metals don’t contain metal, there would also be no issues with metal allergies associated with older style metal crowns.


6. Cover teeth that are discoloured or poorly shaped - usually from an injury, from certain medications (tetracycline staining) or genetics conditions at birth. Teeth can be naturally discoloured or poorly shaped. Instead of just putting up with it, you can improve your smile by having crowns or veneers. Poorly shaped teeth can also be treated with clear aligners, however the treatment can be many months /years. Instead, crowns or veneers can be replaced in just one or two simple appointments.

7. To replace missing Teeth - your dentist can opt for a bridge or an implant. There are many considerations and you should discuss this with your dental professional. Implants offer the advantage of being potentially more conservative (if the neighboring teeth, do not have any fillings), and the treatment is contained to the missing area. Bridges on the other hand, have the advantage of no surgery, faster (completion on average 1-2 weeks), and is generally less costly. Speak with your dental professional for the best option for you individual circumstance.

Why do I Need A Crown?

Keeping your natural tooth for as long as possible is always your best option. Once 40-60% of your tooth is no longer natural it will need stronger protection. Like a helmet for your natural tooth.

Crown being placed on a prepped tooth

Crown being placed on a prepped tooth

What does it mean to prepare my teeth?

To make space for the crown to fit the natural tooth, we need to prepare the underlying tooth structure. This can involve removing already diseased tooth structure in some cases, and leaking large fillings in others. Modern dental crown materials such as zirconia, are upto 4 times stronger than ceramic crowns. This means the preparation can be much more conservative. Speak to your dental professional for the best material in your individual situation.

What happens at the initial crown appointment?

The dentist will firstly assess whether you require a crown. In addition, they may take small x-rays to ascertain if adjunct procedures such as root canal treatment or a “core restoration” is required. If there are no complications, the dentist will discuss the findings with you.

At this appointment, you can discuss with the dentist any concerns, such as aesthetics, choice of material, conservative removal of tooth. Upon answering your questions and coming to a suitable arrangement, the dentist will then proceed with the crown preparation.


 

FILLINGS VS CROWNS

Fillings today are commonly white in color, and are generally made from composite resin materials. The indication for fillings are restorations where 60% or less of the natural tooth structure is missing. In these instances, fillings can be an excellent option to replace missing teeth. Clinical studies show that white fillings usually need to be replaced within a 3-5 year period.

Crowns today are commonly made from modern materials such as ceramic, or zirconia. Metal containing crowns have decreased in popularity (although they use to be quite common), due to metal allergies and the long term recessing of the gum, resulting in a “black line”. Crowns are generally indicated where 60% or more natural tooth structure is missing. In these cases, a white filling, cannot be the definitive treatment. Clinical studies show that the average crown are in service for 10 or more years.

If you are confused about whether a filling or a crown is more suitable for you, speak with your dental professional. An intra-oral photo can be taken, clearly demonstrating how much tooth structure is missing. This can be a tool to assist your dentist in formulating the best treatment for you.