Do I Really Need a Crown?

If you’ve been asking the question: “Do I Really Need a Crown?”, you have probably talked to a few friends, a couple of dentists, researched online, and are still left with as many questions as when you started, maybe even more.

So let’s take a look at a few things which should give you more clarity to understand whether you need a dental crown or not.

First, You Need Diagnostic Check-up

You can’t decide if you need a dental crown or not before having your mouth checked by your dentist. This initial exam is essential. It will determine the condition of your teeth, gums and bone. It will also determine if you have cavities, a weak tooth or any infection going on in your mouth.

Only after this comprehensive exam (which in the most comprehensive cases includes oral cancer screening as recommended by the ADA) can your doctor determine if you need a special treatment involving a crown.

Reasons Why You Would Need a Dental Crown

There are many reasons why you could need a crown. Here are the three main reasons:

– A dental crown can help make a weak tooth stronger in the event the original tooth was fractured or highly decayed.

– A dental crown can also be used for aesthetics reasons. If your teeth look uneven in shape and color, for example, you may decide to get a crown to make your smile look nicer.

– A previous restoration chipped, fell off or is falling and you need to replace it with something more permanent such as a dental crown.

Basically, You Will Probably Need a Dental Crown in Case you Have:

• a very weak tooth
• a cracked tooth
• a dental implant (or a root canal treatment) that needs to be capped with a crown
• uneven or discolored teeth (and you want to improve aesthetics)
• to hold a dental bridge

How Do I Know What Type of Crown I Need ?

There are many different types of crowns. These types differ in material, cost and uses. Here are some of the main type of dental crowns are:

Gold crowns

Mainly used for back restorations due to their gold color. Because they are made of copper and other metals, these caps are very strong and long lasting. However, today they are not very much used in modern dentistry.

All Porcelain Crowns

One of the most popular choices in modern dentistry. Entirely made of porcelain, these crowns provide the best and most natural look.  Also, as no metal is used, they  are toxic-free.

Porcelain Fused-to-Metal Crowns (PFM)

Porcelain fused-to-metal (PFM) crowns, as the name goes, are a mixture of porcelain and metal. Because of their metal structure they provide strength and durability. Because of their porcelain material they provide good aesthetics.

Zirconia Crowns

A relatively new kind of crown that combines the strength of metal with the aesthetics of porcelain crowns.  Because zirconia can be cut and shaped at the same dental office they can be done and custom made in less time.  They are biocompatible because they are metal free crowns, not likely to cause allergic reactions.

 E- MAX: Finally the Lithium Disilicate Crowns

A type of all-ceramic crown made of lithium disilicate. Their light, thin material provides great aesthetics and durability. Your tooth will look perfectly natural.

 Now, How Do I Know The Type Of Crown That Best Suits my Needs?

That is something you need to discuss with your doctor. You will probably get different choices according to:

-The place where the crown will be placed

-Your needs and wants

-Your budget, and your insurance coverage.

Dental Crowns Procedure

Depending on the condition of the teeth, procedures may be different. Simple procedures for a fractured tooth (but with a healthy bone and root) will definitely take less time than procedures for teeth that need bone grafting or a dental implant, for example.

But in general, a crown procedure will require some basic steps:

• Your dentist will prepare and shape your tooth (or teeth).
• X-rays may be needed (under your consent) to check up your roots and bone. An intraoral camera will possibly be used to take pictures of your teeth.
• This preparation may involve different treatments such as removing cavities, bone grafting, placing an implant or just shaping your tooth with the drill.
• Your dentist will then take impressions.
•  Finally, you will get a temporary crown placed, until your permanent cap is custom-made in a dental lab.

Typically it can take about two weeks to have your definite crown made at a dental lab.

On the next office visit (or visits) your dentist will:

• cement the crown.
• carry out a final checkup to confirm your crown has a perfect fit.
• If your dentist is a highly specialized doctor he or she will check that your bite is aligned, that your mouth functions are correct, and you feel absolutely comfortable with your new tooth.

Alternatives To Getting a Dental Cap

Nine times out of ten, when a dentist recommends a cap it is because you need it.

However, in cases where other options can work without running the risk of losing your tooth there are alternatives to getting a crown.

Below are a few options to avoid the time and costs associated with a lab custom fabricated restoration.

1. Porcelain Onlays: Porcelain onlays are a safer approach, preserving more of your natural tooth structure, which in the end leads to a healthier mouth. The porcelain onlay is bonded to your natural tooth’s enamel, helping it avoid fracture, while preserving most of the enamel. Only 2% of dentists in the US perform this procedure regularly, according to a recent study of the ADA. This procedure requires a high level of skills and takes more work and time, but when performed by the right dentist, it can be a great alternative to getting a dental crown.

2. Phasing Treatment: In some instances, you can put a filling instead of a crown. Although a crown would be the optimal solution, putting a filling could buy you time until you get a more definitive treatment.

3. Using Provisional Crowns: In some occasions, your dentist will be able to use an in-office fabricated crown, also known as a provisional crown. The provisional  crown can be bonded to the tooth and buy the patient time until he or she can afford a more definitive treatment. The downside to provisional crowns is that they are only temporary. On average, a provisional crown will last 3-9 months. Keeping a temporary crown too long can result in the patient losing the tooth.

4. In-office lab Indirect Resin Crowns: even though very few dentists use this approach, in office lab indirect resin crowns are a good short term alternative to a crown. An indirect resin crown is made out of resin (instead of porcelain). The indirect resin cap is made in the office by the doctor, and finished on the same day. Although this method is performed only by a few doctors, it can save you time and money in the short term.

Main Take-Away

If you decide to have a dental crown done, choose a dentist that has good credentials, and above all, that he or she is a good restorative dentist. Prosthodontists, for example, are  highly trained dentists who have taken three or four year of further studies. They can provide restorative treatments in the most skilled and professional way.

A highly trained dentist such as a prosthodontist will not only care about the appearance of the tooth, but most importantly, the functional aspects of the crown as well as the bite or occlusion.

These factors are part of what determines the longevity of a cap and can make the difference between a crown that will last as little as 2 years or as long as 20 or 30 years.

If you’ve been asking the question: “Do I Really Need a Crown?”, you have probably talked to a few friends, a couple of dentists, researched online, and are still left with as many questions as when you started, maybe even more.