What is a crown?
A crown is an artificial restoration that fits over the remaining part of a prepared tooth, making it strong and giving it the shape of a natural tooth. A crown is sometimes known as a 'cap'.
 
Why is a Dental Crown Needed?
A dental crown may be needed when at least one of the following occurs:

1. To protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth
2. To restore an already broken tooth or a tooth that has been severely worn down
3. To cover and support a tooth with a large filling when there isn't a lot of tooth left
4. To hold a dental bridge in place
5. To cover misshaped or severely discolored teeth
6. To cover a dental implant
 
What Types of Crown Materials are Available?
Permanent crowns can be either metal, porcelain-fused-to-metal, all resin, or all ceramic.

1. Metals used in crowns include gold alloy, other alloys (for example, palladium) or a base-metal alloy (for example, nickel or chromium). Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum. Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, they rarely chip or break. The metallic colour is the main drawback. Metal crowns are a good choice for out-of-sight molars.
2. Porcelain-fused-to-metal dental crowns can be colour matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown's porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown's porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth.
3. All-porcelain dental crowns provide the best natural colour match than any other crown type and may be more suitable for people with metal allergies. However, they are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.
 

What steps are involved in preparing a tooth for a crown?

Preparing a tooth for a crown usually requires two visits - the first step involves examining and preparing the tooth, the second visit involves placement of the permanent crown.

1. Examining and preparing the tooth. At the first visit, our dentist may take a few x-rays to check the roots of the tooth receiving the crown and surrounding bone. If the tooth has extensive decay or if there is a risk of infection or injury to the tooth's pulp, a root canal treatment may first be performed.
Before the process of making your crown is begun, our dentist will anesthetize your tooth and the gum tissue around the tooth. Next, the tooth receiving the crown is filed down along the chewing surface and sides to make room for the crown. The amount removed depends on the type of crown used. (If, on the other hand, a large area of the tooth is missing our dentist will use filling material to "build up" the tooth enough to support the crown.
After reshaping the tooth, our dentist will use impression paste or putty to make an impression of the tooth to receive the crown. Impressions of the teeth above and below the tooth to receive the dental crown will also be made to make sure that the crown will not affect your bite.
The impressions are sent to our dental laboratory where the crown will be manufactured. The crown is usually returned to our dentist's office in less then a week. If your crown is made of porcelain, our dentist and you will choose the shade that most closely matches the colour of your neighbouring teeth.
2. Receiving the permanent dental crown. At your second visit, our dentist will check the fit and colour of the permanent crown. If everything is acceptable, a local anaesthetics will be used to numb the tooth and the new crown is permanently cemented in place.
 
How Should I Care for My Temporary Dental Crown?

Because temporary dental crowns are just that ­ a temporary fix until a permanent crown is ready, most dentists suggest that a few precautions be taken with your temporary crown. These include:

1. Avoid sticky, chewy foods (for example, chewing gum, caramel), which have the potential of grabbing and pulling off the crown.
2. Minimize use of the side of your mouth with the temporary crown. Shift the bulk of your chewing to the other side of your mouth.
3. Avoid chewing hard foods (such as raw vegetables), which could dislodge or break the crown.
4. Slide flossing material out-rather than lifting out-when cleaning your teeth. Lifting the floss out, as you normally would, might pull off the temporary crown.
 
 
What Problems Could Develop With a Dental Crown?

1. Discomfort or sensitivity. Your newly crowned tooth may be sensitive immediately after the procedure as the anaesthesia begins to wear off. If the tooth that has been crowned still has a nerve in it, you may experience some hot and cold sensitivity. Your dentist may recommend that you brush your teeth with toothpaste designed for sensitive teeth. Pain or sensitivity that occurs when you bite down usually means that the crown is too high on the tooth. If this is the case, call our dentist. He or she can easily fix this problem.
2. Chipped crown. Crowns made of all porcelain can sometimes chip. If the chip is small, a composite resin can be used to repair the chip with the crown remaining in your mouth. If the chipping is extensive, the crown may need to be replaced.
3. Loose crown. Sometimes the cement washes out from under the crown. Not only does this allow the crown to become loose, it allows bacteria to leak in and cause decay to the tooth that remains. If your crown feels loose, contact us.
4. Crown that falls off. Sometimes crowns fall off. Usually this is due to an improper fit or a lack of cement. If this happens, clean the crown and the front of your tooth. You can replace the crown temporarily using dental adhesive or temporary tooth cement that is sold in stores for this purpose. Contact us immediately. Our dentist will give you specific instructions on how to care for your tooth and crown for the day or so until you can be seen for an evaluation. Our dentist may be able to re-cement your crown in place; if not, a new crown will need to be made.
5. Allergic reaction. Because the metals used to make crowns are usually a mixture of metals, an allergic reaction to the metals or porcelain used in crowns is extremely rare.
6. Dark line on crowned tooth next to the gum line. A dark line next to the gum line of your crowned tooth is normal, particularly if you have a porcelain-fused-to-metal crown. This dark line is simply the metal of the crown showing through.
 
How Long Do Dental Crowns Last?

On average, dental crowns last between 5 and 15 years. The life span of a crown depends on the amount of "wear and tear" the crown is exposed to, how well you follow good oral hygiene practices, and your personal mouth-related habits (you should avoid such habits as grinding or clenching your teeth, chewing ice, biting your fingernails and using your teeth to open packaging).
 
Does a Crowned Tooth Require any Special Care?

While a crowned tooth does not require any special care, remember that simply because a tooth is crowned does not mean the underlying tooth is protected from decay or gum disease. Therefore, continue to follow good oral hygiene practices, including brushing your teeth at least twice a day and flossing once a day-especially around the crown area where the gum meets the tooth.

Why should I replace missing teeth?

Your appearance is one reason. Another is that the gap left by a missing tooth can mean greater strain is put on the teeth at either side. A gap can also mean your bite, is affected, because the teeth next to the space can lean into the gap and alter the way the upper and lower teeth bite together. This can then lead to food getting packed into the gap, which causes both decay and gum disease.

How are missing teeth replaced?

This depends on the number of teeth missing and on where they are in the mouth. The condition of the other teeth also affects the decision. There are two main ways to replace the missing teeth. The first is with a removable false tooth or teeth a partial denture. The second is with a fixed bridge. A bridge is usually used where there are fewer teeth to replace, or when the missing teeth are only on one side of the mouth.

What is a partial denture?

This is a plate with a number of false teeth on it. It may be all plastic or a mixture of metal and plastic. Both types may have clips (clasps), to help keep the denture in place in the mouth. Depending on where they are, some of these clips may show when you smile or open your mouth.

What are the replacement teeth made of?

Usually plastic, and occasionally porcelain. Each replacement tooth is made specially, to get the right shape, colour and size for you.

What is the difference between a plastic partial denture and one that contains metal?

Plastic partial dentures are less expensive to make. But unless they are designed very carefully they can damage the teeth they fit against. Metal partial dentures are usually from an alloy of cobalt and chromium and they are much stronger. They are lighter to wear and can be supported by the remaining teeth. Although the base is metal, they have gum-coloured plastic and natural-looking teeth fixed to them. They are more expensive than the plastic ones.

How do I choose the best type for me?

Be guided by your dentist. He or she will know the condition of your remaining teeth. In most cases a metal-based partial denture gives the best result, but the higher cost may make you decide against it.

How do I look after my denture?

You should remove the denture from your mouth for cleaning. You'll be shown how to clean it by your dentist or hygienist, probably with a small toothbrush and toothpaste, or by soaking it in cleansing solution. If you have a metal-based denture you'll need to choose a cleaning solution that's suitable for metal.

Should I take my denture out at night?

Yes. Leave it in water to stop it warping.

What is the alternative to a partial denture?

The main alternative is a fixed bridge. This is made by putting crowns on the teeth at either side of the space, and then joining these two crowns together by placing a false tooth in the space. This is all made in the laboratory and then the pieces are cemented into place with special adhesives. The bridge can't be removed.

Can I always have a bridge to replace missing teeth?

Yes, if you have enough strong teeth with good bone support. Your dentist will help you decide which is the best way of replacing them within your budget.

What are bridges made of?

Bridges usually made of a precious metal. If the bridge will show, porcelain is then bonded to the base. Sometimes, there are other non-precious metals used in the base for strength.

How do I look after my bridge?

You need to clean your bridge every day, to prevent problems such as bad breath and gum disease. You also have to clean under the false tooth every day. Your dentist or hygienist will show you how to use a bridge needle or special floss, as a normal toothbrush cannot reach.

Are there other methods for fixing false teeth?

There are other methods, such as using a combination of crowns and partial dentures that can keep the retaining clips out of sight. These are quite specialised dentures, so you should ask your dentist about them.

Can I have teeth which attach to the jawbone?

Yes. By having implants. The success of this technique means you may be able to replace missing teeth without crowning other teeth. Our leaflet on implants explains this in detail. Remember that it's as important to care for your remaining teeth as it is to replace the missing ones.