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Dental Crowns & Bridges:

A Detailed Guide

This guide covers dental crowns, meant for anyone interested in finding out if crowns are right for them.

In this guide, you’ll learn details of dental crowns, including:

  • What dental crowns are
  • Why crowns may be needed
  • Who are good candidates for crowns
  • How crown procedures go
  • & lots more

Interested in learning more? Let’s dive in.

Felipe - Batch 1 - Dentist Joke - King Crowned
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Part 1

Intro to Dental Crowns

About dental crowns

For those who have suffered tooth decay, physical trauma (such as a broken tooth), or a failed restoration, crowns are a reliable, long-term solution.

A dental crown is a protective cap that gets placed on your existing tooth like a sheath (hence, your tooth being “crowned”). Acting as a tough outer shell, it helps restore your tooth’s strength and appearance.\

There are a variety of materials (from porcelain to metals) which can be used for crowns, and with today’s technology they can be crafted to appear just like your natural teeth.

In the case of same-day crowns, dental crowns can be placed within one visit with computer-generated 3D crowns; for traditional crowns, they are placed during separate visits, with the first visit for the crown prep and the second visit for the crown placement.

History of Crowns

As early as 2,000BC, golden caps for teeth have been found in the Phillipines. Historians believe that not only were these early crowns helpful for tooth decay (which was undoubtedly more common before modern medicine), but also symbolized wealth, power, and status; typically, chiefs and the political ruling class wore such crowns.

Similarly, around 700BC, an ancient Italian civilization known as the Etruscans wore golden dental crowns, also symbolizing luxury and wealth. These early crowns were held in place by wrapping a wire around neighboring teeth, quite similar to dental bridges!

Modern dentistry steadily continued its evolution in Europe, with the first porcelain dentures being developed in 1770. Then, in 1903, Dr. Charles Land introduced the first all-porcelain dental crown, which he patented in 1889; this is the first modern rendition of a crown which is known today.

Nowadays, after more improvements, crowns are made from various materials (porcelain, ceramics, metal alloys, and so on). In the 1990s that the first-ever crowns without a metal base were made. Since then, there has been a rise in ceramic dentistry and computer-generated 3D crowns. Today, dentists can choose crowns from different ceramic materials like porcelain, zirconia, etc. Non-ceramic crown materials are available as well.

Part 2

Do You Need A Crown?

Dental crowns may be needed for a variety of reasons, from fragile teeth, to a root canal treatment.

Due to decay or physical trauma, a tooth may be on the verge of cracking.

In this case, a crown can reinforce the tooth and help prevent it from breaking.

Although tooth cavities are typically treated with fillings, if the cavity is severe and dense, fillings may not be reliable for the long-term.

This is when Dr. James Park may recommend you to have a dental crown instead.

To help reinforce a root canal of an infected area, Dr. Park may recommend receiving a crown.

For a solution to cover missing teeth, Dr. Park may recommend a dental bridge.

This involves crowning the teeth adjacent to the missing tooth area to hold the bridge in place.

Another reason for receiving a crown may be purely cosmetic; a misshapen tooth may match the rest of your smile better with a crown.

Part 3

Dental Crown Materials

6 - types of crowns

As dental crown technology has evolved throughout the years, there are now a variety of materials suitable for crowns.

These can include porcelain, metal, zirconia, composite reason, ceramic, or even a combination of materials.

Choosing Your Crown Material

The most suitable material is chosen after considering a range of criteria including:

  • The location of the tooth which needs a cap,
  • The health of the tissue around the tooth needing the crown,
  • How much the tooth requiring the crown shows while speaking or smiling,
  • The remaining size of the natural tooth,
  • Whether the tooth is a molar, premolar, incisor, canine, and so on (since functions of these different types of teeth differ from one another),
  • And the colour of the teeth surrounding the target tooth.

Dr. Park will analyze your teeth based on those criteria and choose a material for the dental crowning based on the analysis.

You are free to discuss your personal preferences with the Dr. Park when during this decision-making time. He can then suggest whether or not that crown material will be right for you.

Common Materials for Crowns

Crowns made completely of porcelain are extremely popular.

This is partly due to their aesthetic; they appear quite similar to natural teeth. They are capable of looking as per the shape, size, and color of your natural teeth.

However, as they are not too strong, they cannot be used for long periods continuously and also need to be taken care of when in use. This is why these crowns are not suitable for people suffering from bruxism, which causes excessive clenching or grinding.

Complete porcelain is slightly more expensive than other porcelain-based options that may be fused with other materials to make it stronger. Though, this might not provide as aesthetically identical a result that of pure porcelain crowns.

Since they are not as resilient as other solutions, complete porcelain is frequently used for front restorations only, as they cannot bear as intense chewing or biting.

Porcelain crowns are free from metals or toxins, and are rarely known to cause any allergies.

  • These dental crowns fit well for the front teeth. The texture of Ceramic Porcelain-based crowns blends easily with your natural teeth. These can be given a color as per your natural teeth. As these crowns tend to be dainty when exposed to the heavy force due to chewing, they are best suited for front teeth and not for molars or premolars.

These dental crowns are durable as they comprise of metal. The porcelain, on the other hand, tends to make the teeth appear realistic. These crowns are one of the most popular as well as pocket-friendly and have been working well for around fifty years now. A porcelain brown is known to provide a realistic appearance. However, as this crown is not of porcelain alone but is fused with metal instead, the crown has a thin grey line near the gum line. This might hence hinder a completely realistic look that a porcelain crown is capable of providing. The crown may also wear down early if you are habitual of clenching your teeth too often.

Gold crowns are very strong and do not comprise of gold alone. They are instead a blend of other metals like copper. This is why they are strong and highly immune. Hence, they are considered a good choice for back restorations. These crowns tend to last long if used with vigilance. But, they are not preferred by many people due to the golden color, which appears to be quite a cliche. They do not tend to look a percent similar to the real teeth. However, if you opt for a gold crown, only a minor portion of your natural tooth needs to be removed to crown it. Also, gold crowns wear out slowly, just like real teeth. But, some people might experience swelling or other allergies as a side-effect of the gold crown.

These crowns are strong as metal crowns while they appear to be natural, just like porcelain. Despite being strong are free from metal and hence free from the infections mental Browns are entitled to. This is why these new material crowns are being adored. Cutting and shaping zirconia crowns is easier as compared to crowns made of other materials. This enables the entire procedure to be carried out in less time. Zirconia crowns are strong; therefore, it is entitled to strong force against another tooth, can lead to damaging the tooth that was clenched along with the crowned tooth. They are long-lasting and do not wear down easily.

These crowns are complete ceramic crowns made of lithium disilicate. E-max is the recent material being used for preparing dental crowns. These crowns are extremely durable and appear to be just like your real teeth. What adds to the plus points of these lithium disilicate crowns is that they can be used effectively for both front and back restorations. However, these crowns are expensive. Unsuccessful crowning has been reported by many professionals, especially when dealing with multiple crownings.

Part 4

Types of Crowns

3 - about the procedure

Traditional Crowns

Traditionally, dental crowns require at least two seatings.

The first appointment involves an X-ray and other necessary analysis of the tooth that needs to be crowned. Dr. Park can then formulate an idea of your crowns’ requirements, such as its material, size, color, and shape.

Based on this information, Dr. Park sends a request to the dental labs, which prepares the dental crown for you. As the process of making the dental crown at the lab might take a day or more, Dr. Park will place a temporary crown in the meantime, fixed in place with an adhesive. This is similar to putting on a smaller, spare tire while you wait for your car’s main tire to be fixed by a mechanic.

After receiving the crown, complete with the customized specifications from the lab, Dr. Park will seat the permanent crown on your tooth during the second appointment.

One Day / Same Day Crowns

Some people prefer one day or same-day crowns to save on time, and they have become quite popular

Same-day crowns are highly convenient compared to traditional crowns prepared in the lab. The one-day crowning requires just a single visit to the dentist — unlike the traditional crowning, which demands at least two seatings.

Prepared by the dentist himself with the help of the computer setup and intraoral camera, a three-dimensional image of the ideal tooth is designed on the computer. This computer-created design is typically then manufactured via a CEREC machine; a complex machine called the Chairside Economical Restoration of Esthetic Ceramics (CEREC) which is operated by the dentist.

This is why it is called one day or same-day crown. The procedure uses CAD/CAM technology that speedens the process yet provides well-fitted crowns.

Hygiene of Your Dental Crown

Please note that having a dental crown covers your tooth but does not prevent it from decaying; you are still prone to getting tooth decay, similar to before having a crown.

Without proper care of your dental crown, the adhesive tooth cement used to place it can steadily wear away, possibly leading to a loosening of the crown. With such gaps, there is a small possibility of food getting stuck to your crown, which can increase chances of tooth decay or cavities.

If such a case happened, Dr. Park would treat the decay and re-crown the tooth.

How to Care For Temporary Crowns

1. Minimize the Use of the Temporary Crown

Try avoiding chewing with the side of your mouth where the temporary tooth has been placed.

2. Eat Food that Requires Less Chewing

Stay away from food that requires lots of chewing, for instance, sticky foods or foods made of refined wheat flour. These foods are capable of sticking to and pulling off the temporary crown. Hence, such foods should be averted. Also, avoid hard foods such as nuts. These foods can cause breakage of the temporary crown.

3. Take Care of Your Oral Hygiene

Take extra care while brushing or flossing your teeth. Do not brush too hard over the temporary crown. While flossing, also be mindful as the floss could tangle with the temporary crown and loosen it.

Traditional Vs. Same Day Crowns

Strength

These crowns are customized with the fusion of required materials to prepare the crown in the lab. Therefore, these crowns tend to be stronger than the ceramic one-day crowns, which tend to wear out easily.

Aesthetic appearance

The traditional crowns appear to be realistic. The extent to which they appear to depend on the material chosen. However, as these crowns are prepared by experts in the lab, they tend to be more similar to your natural teeth in size, shape, and color.

Waiting Period

You need to wait until your crown is prepared. You will have to revisit your dentist after the crown has been made to fix it at the target site. Until then, you might need to get a temporary crown.

Temporary Crown

During the waiting period, you might need to get a temporary crown on the target site until the actual crown is made. The temporary crown is uncomfortable due to its ill fit and needs extra care and makes the teeth more prone to the cavity as the food might get stuck inside the space of a temporary crown.

Convenience

The process of preparing and laying these crowns is easy for the dentist; on the other hand, it takes only up to an hour. Hence, the patients feel comfortable with this as it requires a single visit and hence saves time.

Comfort

Not only is this method of crowing less time consuming, but it is also less painful as compared to the traditional crowning. You might need lesser injections than you would need during traditional crowning.

Safety

Traditional crowning is subject to a waiting period. During this period, a temporary crown is set in your mouth to fulfill the purpose for the time being. The temporary crown is not a proper fit and therefore has gaps for food to penetrate and get glued to the teeth. Hence, increasing the risk of a cavity and other infections. One day crowns are safe in this aspect as well.

Not As Strong

While the traditional crowns are made out of materials that are most suitable according to the affected site, one-day crowns are made of ceramics. Hence, these crowns are not strong enough and tend to wear out faster than traditional crowns.

Not As Aesthetically Identical

The traditional crowns except that of metals can be given a shade as per your natural teeth. One-day crowns can not be given any color of your choice. You will instead have to stick to the choices you have. Therefore, despite being realistic in appearance, the crowns do not seem to go with your natural teeth color.

Not For Everyone

The one-day crowns may not suit everyone. In some severe cases, the dentist is bound to go with traditional crowns only.

Onlays & 3/4 Crowns

These crowns are used to cover only a portion of the tooth instead of the entire tooth.

This method of crowning is different from the traditional approach. Instead of conventionally covering the entire tooth with a crown, only the necessary portion is covered. 

Part 5

About The Procedure

8 - risks of getting a crown

Here’s a brief overview of how a traditional crowning procedure goes. As mentioned before, traditional crowns take two appointments spaced about two weeks apart (with the total sitting time in the dentist’s chair of about 1.5 to 2 hours).

Note that for same-day crowns the procedure is similar, although no temporary crown is needed.

Steps of the Dental Crown Procedure

Dr. Park will begin by numbing (using local anesthesia) the area where the crown will be placed.

This helps to make the procedure pain-free, since the tooth and surrounding gums will be extremely numb.

In case your permanent crown is made of porcelain, Dr. Park will help you find a shade of ceramic which matches your surrounding teeth.

To help decide on a shade, Dr. Park and you can view physical samples of porcelain shades, high-definition photographs, or use special devices to determine your tooth’s shade.

Before crowning the tooth, the dentist shapes your existing tooth so the crown can fit over top of it. By tapering your tooth in this way, Dr. Park can not only remove any decay that is present (as well as filling material that is loosely placed), but also ensure that the crown will retain to the tooth sturdily and reliably.

Dental cement alone isn’t strong enough to hold a crown in place for the long term; thus, this shaping of the natural tooth plays a strong role in retaining your crown.

Impressions of your teeth are then taken to ensure the crown fits properly. This is usually done with a putty-like material which dentists refer to as “impression material”.

Afterwards, your impression will be sent to the dental lab, where they’ll create a cast of your impression (using plaster); this cast, which acts as a copy of your mouth, will be used to accurately manufacture your crown.

This step is where traditional crowns require two visits, since the turnaround time for dental labs to do this usually takes about two weeks at most.

While waiting for the dental lab to create your crown, Dr. Park will place a temporary crown to protect your tapered tooth (where the crown will be placed). Usually, the temporary crown will functionally perform the same tasks and aesthetically be quite similar to your permanent crown, although with a less durable material.

The temporary crown will be set in place using “temporary” cement, which can be easily removed during the following appointment.

During the second visit, Dr. Park will carry-on with placing the permanent crown.

First, this will involve removing the temporary crown. Again, some local anesthetia will be applied (although typically it’s quite a painless process for patients to remove their temporary crown and have their new crown placed). Following this, Dr. Park will clean the area of any remaining temporary cement on your tooth.

Your permanent crown will then get placed, with Dr. Park making minor adjustments (such as trimming and buffing) until he is satisfied with its fit and the way it interacts with your neighboring teeth.

Finally, Dr. Park will show you its appearance with a mirror and ask your opinion on the crown; feel free during this time to make any comments or ask any questions about the crown. Once you are completely satisfied with the feel and appearance, Dr. Park will cement the permanent crown in place.

After the permanent crown’s placement, the extra cementing will be removed.

Dr. Park and his assistants will fully guide you through the dos and don’ts during your first weeks following the procedure, including recommended foods to eat or mindfulness of your crown.

As well, we’ll be following up with you in coming days to ask how the crown feels, ensuring its proper fit and function.

Risks of Crowns

Although crowns are fairly low-risk, by educating yourself with any possible adverse outcomes, you can be more mindful of your body and help mitigate any irregularities.

After the completion of the procedure, the effect of local anesthesia will go away. Therefore, you may begin to experience pain, discomfort, and uneasiness. In case of severe pain and inability to eat and chew efficiently, you should contact your Dr. Park. He can help suggest ways to alleviate the pain, and advise you on your diet and recovery routine.

Although crown materials are typically quite resilient and tough, small cracks can appear. Fortunately, cracks in crowns can easily be repaired.

In some cases, however, you may need a replacement of the initial crown.

If crowns feel loose, you should contact Dr. Park. He can either refit the crown’s adhesive, or redesign it to fit comfortably and sturdily.

Left untreated, loose crowns can collect food particles and become a source of tooth decay; therefore, this should be fixed as soon as possible.

An allergic reaction to crowns are very rare. However, with complete metal crowns or a crowns with infused metals, there are chances of allergies and infections caused by these metals.

Should this happen, contact Dr. Park and he can refit the crown with a different, non-allergic material. 

In some cases, after brushing or flossing too hard, the crown’s tooth cement wearing down, or physical trauma (like falling off a bike), the crown may come off. 

If this happens, take care of the area of your crown and please contact Dr. Park; he can refit your crown and also provide any suggestions for care of your crown. 

If you have a metal-infused crown, a dark streak could appear that may be the visible metal part of the crown. If that is not the case, the dark streak may be a sign of decay underneath the crown. Also, it may be due to gum recession,  resulting for example from forceful brushing or grinding.

In case the dark streak is due to the metal-infused material of your crown and you are not happy with it, you can replace the crown with a different material, such as all-porcelain or zirconia, giving it a different appearance.

In general though, it is best to seek Dr. Park’s opinion to understand the reason behind the dark streak. 

Part 6

Cost of Crowns

5 - cost of a crown

Factors of Crown Costs

Material

Different materials of dental crowns are subject to different costs. Generally, all-porcelain crowns cost the most, followed by all-metal crowns, and then crowns fused with a blend of varying materials.

Surrounding Procedures

Also, prices vary based on lead-up procedures which may be necessary to properly diagnose your need of a crown (for example, an X-Ray or dental exam).

Weight of the Crown

Finally, the actual weight of the crown material is another factor. For example, a small crown on your lower, central incisor would use much less material (and therefore be less expensive) than a full crown on a molar.

Typical Ballpark Cost of Crowns

Since crown costs vary based on the material, lead-up procedures, and weight of the material, rarely are two crowns for the same patient identical in cost (let alone crowns for two different people).

Therefore, it’s just not possible to accurately predict your cost for a crown; though, by visiting your dentist (or our office, in case you live in Calgary), you obtain an accurate estimate of the cost.

Generally speaking, you can expect the cost of a crown in Calgary to range somewhere between $1,200 to $2,000, with some cases going below or above that range.

Alberta Dental Association (ADA) Fee Schedule

Our Calgary office, Glenbrook Dental Centre, follows the ADA Fee Schedule for dental crowns.

Each year, the ADA recommends a baseline fee guide for everything from fillings to implants. In addition to making it easier for dentists to know how to charge, it helps patients guard against being over-charged.

Even if from year to year the ADA recommends lowering the cost for crowns, we follow that guideline and lower our costs.

Part 7

FAQs

7 - faq

A dental crown is a cap, or a covering for your tooth, used to restore its strength or appearance.

Typical reasons for getting a crown include tooth decay / cavities, physical trauma (leading to a cracked or damaged tooth), following a root canal (to reinforce your tooth), or for aesthetic restoration.

Depending on the reason for your crown, alternatives may be available.

For example, if you need crowns to fit a dental bridge (which can cover a missing tooth), an implant may also work. Or, if your crown is for aesthetic purposes, a veneer may also work.

It’s best to discuss this with Dr. Park to brainstorm a comprehensive list of solutions for your case.

The cost of crowns varies not only with each individual but also with the tooth being crowned. Weight of the crown material, the material chosen, and any lead-up procedures needed all are dependent on your unique case.

As quite a rough ball-park, the cost lies between $1,200-$2000.

Our office at Glenbrook follows the Alberta Dental Association fee schedule for every procedure, so you can feel safeguarded from any over-charging.

Most of the dental crowns that are used today are either completely made of ceramics or are ceramics blended with metal. These have quite a natural appearance and are quite unnoticeable.

Metal crowns are more visible, which is why materials such as porcelain are so popular.

Initially, you might feel a slight discomfort with the crown. Eventually, you will get used to the crown and feel much more comfortable with it.

However, if you feel that discomfort continues even after weeks have passed or you feel that the crown is loose or is slightly chipping, please do not hesitate to contact us.

Following your appointment, Dr. Park will make recommendations for your post-procedure routine, including extra care while brushing or flossing, and dietary adjustments.

Complete recommendations will come directly from Dr. Park and his assistants following your appointment. However, reliable recommendations include not chewing in the area of your crown, refraining from sticky or hard foods, and taking great care while brushing and flossing in the crown area.

Usually, the lifespan of a crown is between 5-15 years depending on the material as well as its usage. After this time, it’s ordinary to have a fresh crown placed to restore its sturdiness and protective purposes.

If proper oral hygiene is maintained, a porcelain crown can last for 10-15 years.

All-metal crowns can last up to 20 years.

Being the strongest non-metal crowns, zirconia crowns have a lifespan of around 10-25 years.

Part 8

Booking Your Appointment

4 - scheduling your booking

Request An Appointment

Discover how our team at Glenbrook Dental can guide you along your dental health path. When you request an appointment, our receptionist will return your message within 1 business day. Her name is Marj.

Part 9

Further Readings

9 - related info2

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