Our goal at Braeside Dental Centre is for you to keep your natural teeth for as long as you need them. Our hope for you is to maintain your dental health with the least amount of treatment over your lifetime. Historically, crowns or caps, as they are sometimes known, have been excellent choices for maintaining structural integrity and optimal functioning of the teeth. Crowns help us to preserve teeth that are badly damaged from decay (infection), fractured from too much force being applied either from macro trauma (accident) or micro trauma (clenching and grinding), discoloured significantly and bleaching is not an option, or to help achieve the optimal form (so that best function can be achieved).
What is the best dental crown for me?
There is no one type of crown that is best in all situations. Like most jobs, we have our favourite tools to get it done, but there are tools better suited to certain jobs than others. If it were a front tooth that is very visible, I would lean towards an all porcelain/ceramic crown. With porcelain or ceramic crowns, an excellent lab technician (one who fabricates the crown at the dental laboratory) and attention to all the fine details, we can make a crown that is almost life-like (I say almost because nature has been working at it for thousands of years and we have only been at it for 50 or so years). However, there are some disadvantages to all porcelain crowns, the most prominent being less strength. If I am looking for something that is the best compromise between strength, function and aesthetics, I would pick a different type of crown. For example, the teeth on the side, that do not require optimal aesthetics, may be done with porcelain fused to metal crown. The porcelain baked on them can fracture, but they are still stronger than straight porcelain crowns. If the tooth we are working on is all the way in the back and not visible to anyone but myself, then I would consider a straight gold crown. This is only if someone is open to it. It is not for everyone, but it will have the greatest longevity, best ability to preserve the remaining tooth structure, and softens the forces on the apposing tooth. Zirconia crowns are another material that have become popular over the last few years, as they can be milled and provide great strength. However, due to the nature of Zirconia, it tends to be less flexible. As I have seen many materials come and go over the 30 years or so of being a dentist, I have become very accustomed to techniques and materials that are evidence based and are in the best interest of my patients’ health. Please do not hesitate to have a discussion with us in which we decide together which type of crown is best for you.
Is it necessary to have a crown after a root canal? Do all teeth with crowns have a root canal?
Usually root canals are performed because the nerve inside the tooth has either become infected or so inflamed it causes pain and cannot heal on its own. This generally happens when a tooth is structurally compromised or the infection has gotten too close, or into, the nerve. Therefore, teeth that have had root canals tend to be compromised and need a crown to restore optimal form, function, colour, and alignment. Fortunately, it is not common to have to have a root canal after a crown. It does occur occasionally, as we are working within a biologic system and when a tooth is compromised structurally, signs and symptoms can become present.
Is getting a crown painful?
We will do everything we can to make the procedure as comfortable as possible. The crown usually takes two appointments to complete. During the first appointment, here at Braeside Dental Centre, we will use a devise called a Wand. This is a special instrument that will help deliver the anesthesia (freezing) in a way that most of our patients find much more comfortable. I have been asked many times what just happened after the patient just received the freezing. To a lot of surprise, I tell them that they just got the freezing. To which they say, “no needle?”. Not quite, but a lot more comfortable. Once the tooth is frozen, there should be no discomfort during the procedure. The patient will leave the first appointment with a temporary crown that is secured with a soft cement. We ask patients to be careful with this temporary crown, as it is designed to come off after a couple of weeks. Most patients tell us that the procedure was better than they expected and after a couple of days things are back to being mostly normal. Once in while, it may take a little longer for the tooth to settle down. This usually occurs when the decay was very deep and close to the nerve or if someone grinds and clenches their teeth (it can cause further trauma to the tooth). After a couple of weeks, the patient returns for us to deliver the crown. During the delivery, we generally do not freeze the area, as sensitivity is limited to a shorter period of time. Once the process is complete, the crown will be installed and the tooth’s form, function and aesthetics will be reestablished, so patients can simply forget that it was done.
How long do crowns last? Do crowns last forever? Are they permanent?
Like any man made material, there is a limit to its longevity. I usually tell people that the only thing that was meant to last forever was their own natural teeth and they don’t last forever either. There have been many studies regarding the longevity of dental crowns. I have seen studies suggest their longevity anywhere from 7 – 15 years. Personally, I have found the mean/average number to be higher. I have seen crowns last up to 30+ years. In the end, the average or mean time is just that: an average. As it happens though, none of us are “average”. Regardless, crowns can last a very long time, if properly looked after. This would include brushing and flossing regularly, having your teeth cleaned professionally with a fluoride application after, and reducing the amount of functional or para-functional load placed on them. In other words, by reducing the day-to-day stresses we place on both our crowns and our natural teeth, they will last longer and serve us better.
How much does it cost to get a crown?
Without having a look at what needs to be done, it is difficult to know what procedures are required to restore the tooth back to its original form and function. There are many factors that will determine the cost of the crown. The cost may depend on the materials used, the size of the tooth being restored, and the difficulty of providing the care (just to name a few). Generally, crowns are more expensive than getting fillings. This is because when doing crowns, the damaged tooth structure or infection has to be removed in what is referred to as a build-up (a filling under the eventual crown) and the crown is placed over this. Once we have a look at what needs to be done we can provide you with a clear estimate.
How do I look after my new crown?
Just like you would look after your own natural teeth! This means brush and floss them twice a day. Ideally, brushing and flossing also after any meals or drinks helps as well. Just make sure you come in for your regular maintenance appointments, have fluoride varnishes painted on, and try not to put too much stress on your teeth.