Crowns

A crown is a type of restoration that replaces the entire visible structure of a damaged tooth. You may be familiar with these as “caps,” but they’re the same thing. Crowns may become necessary either when a tooth is too damaged to receive a filling, when a large filling fails, or in other circumstances.

What is a crown?
Sometimes the portion of a tooth that is visible above the gum line becomes too badly damaged and can’t be saved, but the roots beneath the gums may still be healthy and strong. If this is the case, then Dr. Ertl will cement a crown on the old tooth. The crown will completely cover what is left of the existing tooth, and we will size and shape it just like the original healthy tooth. Different materials can be used to fabricate crowns, and the circumstances unique to each patient will determine which material Dr. Ertl recommends for your situation.

Why would I need a crown?
Crowns are used when: a tooth is too damaged for a filling, a tooth is badly cracked or broken, or a tooth has become badly worn down. Crowns are a good solution because Dr. Ertl can save the healthy structure of the existing tooth and the healthy roots. An alternative to a crown is to have the damaged tooth extracted, or to receive an implant

Why use a crown instead of a filling?

Fillings are used when there is a small amount of decay on an otherwise healthy tooth. But sometimes a tooth has so much damage to its structure that it can no longer hold a filling safely (in other words, placing a filling would require removing so much tooth structure that even with a filling in place, it would be vulnerable to breaking or fracturing). If a large percentage of the tooth is damaged, then the entire visible surface of the tooth above the gumline can be replaced with a crown.

Why use a crown instead of pulling the tooth?
As oral health care providers, we will always advocate for services that allow you to keep as much of your natural tooth structure as possible. The roots of your teeth are firmly planted in your gumline, and your teeth affect the way your face looks. A crown rebuilds the tooth to its original size and shape, saving as much of the healthy tooth and root as possible. If your damaged tooth were removed, you will have a gap that can: cause an improper bite, cause your teeth to migrate (change position), and change the appearance of your face. Receiving a crown preserves the spacing between your remaining teeth, and retains your proper bite.

What are the types of dental crowns?
Crowns are classified by the materials by which they are composed. There are typically three types available, and Dr. Ertl will explain which materials are best for you based upon your unique circumstances.

Gold Crowns

Gold is extremely malleable and provides an excellent fit between the crown and the existing tooth. Gold requires minimal preparation of the existing tooth, and keeps more of the original tooth structure than is possible with other methods. Gold crowns will not chip; and since they are softer than porcelain crowns, they are not as likely to cause wear on your other teeth. The downside of gold may be aesthetic, because it will contrast obviously with your natural teeth This is less of an issue for crowns placed in the back of the mouth.

All Porcelain or All Ceramic Crowns

These crowns are often used for front teeth because their greatest advantage is a very natural appearance. Porcelain can be shaped to perfectly match the shape and color of your surrounding teeth, making the crown nearly identical to your other teeth. However, this type of crown requires considerable preparation, leaves less of the existing tooth, and it is often challenging for the dentist to get as tight a fit as they can with a gold crown. Their beautiful appearance makes them a popular choice.

Porcelain-over-Metal Crowns
This popular crown type provides an excellent combination of aesthetics and durability. The porcelain is color matched to your existing teeth and fused to a metal base. The metal base provides exceptional strength and durability, making these types of crowns less likely to break. However, the metal center also means this type of crown will never match the translucency of a natural tooth or an all porcelain crown; and, over time, a thin dark line can develop where it meets the gum.

What is the procedure for placing a crown?

If the tooth is extremely damaged, Dr. Ertl may first recommend root canal therapy. Otherwise, he will prepare the tooth by filing it down enough to fit the crown over it. (This then becomes the base to which Dr. Ertl cements your finished crown.) He will take impressions of the prepared tooth and the surrounding teeth which the lab will use as a model for the new crown. Since the lab typically takes two weeks to prepare the permanent crown, he will provide a temporary crown until the permanent one is ready. On a second visit, the temporary crown is removed, and the permanent crown is cemented in place.

How long do crowns last?

Crowns are considered permanent dental restorations, but they do not last forever. With proper hygiene a crown can last between ten to fifteen years, but they can also last much longer.

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