Understanding Procedures:Crowns

A tooth may need to have a crown if it is cracked, fractured, or weak. Crowns are also placed typically after a tooth has had a root canal in order to make sure that it stays strong. Finally, crowns are sometimes put on a front tooth in order to change its shape or color.

The process of getting a crown usually involves two appointments. The first appointment is the longer of the two. The dentist will begin by numbing the tooth like many other dental procedures so that you are comfortable during treatment. Typically, once numb, all that you will notice during the procedure will be vibration. If there is ever anything more than that, please let your dentist know – a little more anesthetic usually will make sure that you are comfortable. At this point, the dentist will begin by reshaping the tooth so that there is room for the crown to fit completely over the tooth. Sometimes, a "build-up" is also done on the tooth in order to make sure that the middle of the tooth is strong and healthy. The crown ultimately will act like a suit of armor over the tooth and, once it has been finished, it will return the tooth to its ideal size and shape. Once the tooth has been shaped, the dentist or assistant will get the tooth ready for an impression. They will place a piece of string (retraction cord) or a putty between the tooth and the surrounding gum so that the gum tissue is pushed away from the tooth and the tooth will stand out very distinctly in the impression. After a few minutes, this material will be removed and an impression will be taken of the tooth being worked on as well as all of the neighboring teeth. Finally, a temporary crown will be made and placed on your tooth to protect it while the permanent crown is being made.

Between the first and second appointments, the impression is then sent to a dental laboratory where they will make a model of all the teeth. Then, the laboratory will make a customized crown to fit your tooth. The crown can be all-metal (a yellow or white gold, very durable), all-porcelain (tooth-colored, very esthetic), or a combination of both metal and porcelain (esthetic and durable). Once completed, the dental laboratory will return the finished custom crown back to your dentist.

At the second appointment, the temporary crown will be removed and the permanent will be placed on the tooth and adjusted. Once it has been determined that the crown fits good, feels good, and looks good, it is cemented into place. This appointment usually does not require any anesthetic. The final crown is permanent and is not meant to come off. Normal brushing and flossing afterwards will help make sure that the crown will last a long time.