Porcelain crowns have been used to restore problem teeth since at least the early 20th Century. Crown technology has gradually progressed from the early use of precious metals like gold or silver to more life-like porcelain crowns, often with a metal interior for added strength. Today, most crowns are all-porcelain, made with newer materials that not only look attractive but can endure under the pressures of daily chewing or biting.
While crowns are often part of restorations for missing teeth, they’re also commonly used to cap or fit over a viable tooth with structural or appearance problems. Here are 4 situations where a crown could improve a tooth’s form and function.
Traumatized teeth. A significant blow to the face or mouth could generate enough force to chip away or fracture a significant amount of structure from a tooth. If the root remains healthy and firmly attached within the jaw, however, a crown can replace the missing structure and restore the tooth’s function and appearance.
Root canal treatments. Root canal treatments remove infected or dead tissue within a tooth’s pulp chamber, its inner core, and the root canals. The procedure rescues the tooth but can in the process significantly alter the tooth’s structure and appearance. A crown not only restores the tooth but also provides added protection against further decay or tooth fracture.
Teeth with multiple fillings. We can effectively treat cavities caused by tooth decay by filling them. But with each filling we must remove more of the decayed structure and shape the cavity to accommodate the filling. After a number of times, a tooth may not have enough structure left to support another filling. If the tooth is still viable, a crown could solve this dilemma.
Abnormally developed teeth. Teeth sometimes don’t erupt in the jaw as they should and may be only partly visible. The tooth not only looks out of place but it can’t fully function like a normal tooth. Capping an abnormally developed tooth with a crown will help normalize it and allow it to blend in with surrounding teeth.
If you would like more information on crown restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Crowns & Bridgework.”
If we could go back in time, we all probably have a few things we wish we could change. Recently, Dr. Travis Stork, emergency room physician and host of the syndicated TV show The Doctors, shared one of his do-over dreams with Dear Doctor magazine: “If I [could have] gone back and told myself as a teenager what to do, I would have worn a mouthguard, not only to protect my teeth but also to help potentially reduce risk of concussion.”
What prompted this wish? The fact that as a teenage basketball player, Stork received an elbow to the mouth that caused his two front teeth to be knocked out of place. The teeth were put back in position, but they soon became darker and began to hurt. Eventually, both were successfully restored with dental crowns. Still, it was a painful (and costly) injury — and one that could have been avoided.
You might not realize it, but when it comes to dental injuries, basketball ranks among the riskier sports. Yet it’s far from the only one. In fact, according to the American Dental Association (ADA), there are some two dozen others — including baseball, hockey, surfing and bicycling — that carry a heightened risk of dental injury. Whenever you’re playing those sports, the ADA recommends you wear a high-quality mouth guard.
Mouthguards have come a long way since they were introduced as protective equipment for boxers in the early 1900’s. Today, three different types are widely available: stock “off-the-shelf” types that come in just a few sizes; mouth-formed “boil-and-bite” types that you adapt to the general contours of your mouth; and custom-made high-quality mouthguards that are made just for you at the dental office.
Of all three types, the dentist-made mouthguards are consistently found to be the most comfortable and best-fitting, and the ones that offer your teeth the greatest protection. What’s more, recent studies suggest that custom-fabricated mouthguards can provide an additional defense against concussion — in fact, they are twice as effective as the other types. That’s why you’ll see more and more professional athletes (and plenty of amateurs as well) sporting custom-made mouthguards at games and practices.
“I would have saved myself a lot of dental heartache if I had worn a mouthguard,” noted Dr. Stork. So take his advice: Wear a mouthguard whenever you play sports — unless you’d like to meet him (or one of his medical colleagues) in a professional capacity…
Losing a tooth affects not only your smile but your overall dental health too. A dental implant solves both issues: it replaces the whole tooth, including the root, to merge durability with a life-like appearance.
For teenagers with a missing tooth, however, an implant may not be a good idea, at least until they've physically matured. Although their permanent teeth have usually all come in by puberty, the jaws and facial structure continue to develop into early adulthood. An implant placed too early could appear misaligned when the jaw fully matures.
The best approach for teens is a temporary replacement until they're physically ready for an implant. There are two good options: a removable partial denture (RPD) or a fixed bonded bridge.
Common among adults, an RPD is also a viable replacement for a teenager's missing tooth. An RPD consists of a prosthetic (false) tooth set in a nylon or acrylic base that resembles gum tissue. Metal clips formed in the RPD fit over adjacent teeth to hold the appliance in place; this also makes it easy to remove for cleaning or sleep time. We typically recommend an acrylic base for teens because it's easier to adjust if the RPD's fit becomes loose.
To hold it in place, a traditional bridge uses crowns on either side of the replacement tooth to bond over the natural teeth next to the open socket. Because this requires permanently altering the support teeth, we recommend a bonded bridge that doesn't.
This modified bridge uses wing-like strips of dental material on the back of the false tooth that project outward. With the tooth in place, we bond the extending portions of these projections to the back of the adjacent teeth, which secures the false tooth in place.
Of the two options, the bonded bridge is more comfortable, buys the most time and looks the most natural. But it will cost more than an RPD. Bite issues, teeth grinding, overall gum health or your child's level of hygiene conscientiousness could also nix it as a viable option.
Either choice will effectively replace your child's missing tooth until it's time for a permanent restoration. We'll help you weigh all the factors to determine which one is best for your situation.
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
So, you're about to have a tooth capped with a crown. Do you know what you need to know before you undergo this common dental procedure?
Here's a short true or false quiz to test your knowledge of dental crowns.
All crowns are the same. False — while all crowns have the same basic design — a life-like prosthetic tooth fitted over and bonded or cemented to a natural tooth — their compositions can vary greatly. Early metal crowns consisted mainly of gold or silver and are still used today. Porcelain-fused-to-metal (PFM) crowns — a metal interior for strength overlaid by a porcelain exterior for appearance — became popular in the latter 20th Century. Although still widely used, PFMs have been largely surpassed by newer all-ceramic materials that are stronger than past versions.
Crowns can differ in their artistic quality. True — all crowns are designed to replicate a natural tooth's function — in other words, enable the tooth to effectively chew again. But a crown's appearance can be a different story, depending on how much attention to detail and artistry goes into it. The higher the individual craftsmanship, the more lifelike it will appear — and the more expensive it can be.
With digital milling equipment, dental labs are obsolete. False — although technology exists that allows dentists to produce their own crowns, the equipment is not yet in widespread use. Â The vast majority of crowns are still produced by a trained technician in a dental laboratory. And just as you base your choice of a dentist on your confidence in and respect for them, dentists look for the same thing in a dental lab — good, reliable and consistent results.
Your insurance may not cover what your dentist recommends. True — dental insurance will typically pay for a basic, functional crown. Aesthetics — how it will look — is a secondary consideration. As a result, your policy may not cover the crown your dentist recommends to function properly and look attractive. A new crown, however, is a long-term investment in both your dental function and your smile. It may be well worth supplementing out of pocket your insurance benefit to get the crown that suits you on both counts.
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