Crowns are dental restorations otherwise known as "caps" which are
coverings that fit over teeth. Crowns may be necessary because of broken
down old fillings, fractured, chipped or sensitive teeth. Crowns are
also used to improve the appearance of natural teeth that are malformed,
malpositioned or discolored.
Crowns are made of natural looking porcelain and are made to improve
your overall smile or to blend in with your own teeth. Sometimes an
underlying metal shell is used under the porcelain if additional
strength is needed.
Some of the indications for a crown are:
A previously filled tooth where there now exists more filling
than tooth. The existing tooth structure becomes weakened and can no
longer support the filling.
Root canal - After root canal, teeth tend to become brittle and
are more apt to fracture. These teeth need to be protected by a
crown.
Bridges - When missing teeth are replaced with a bridge, the
adjacent teeth require crowns in order to support the replacement
teeth.
Crowns strengthen and protect the remaining tooth structure and can
improve the appearance of your teeth. Crowns can be made from different
materials which include the full porcelain crown, the porcelain
fused-to-metal crown and the all-metal crown. You and your dentist will
decide which type is appropriate, depending upon the strength
requirements and esthetic concerns of the tooth involved.
Fitting a crown requires at least two appointments. During your first
visit, the tooth is prepared for the crown, an impression or mold is
made of the tooth, and a temporary crown is placed over the prepared
tooth. At the subsequent visit, the temporary crown is removed and the
final crown is fitted and adjusted and cemented into place.
First Appointment
The first visit begins by giving you a local anesthetic. Depending upon
the type of local anesthetic used, you can expect to be numb for one to
four hours. If your anesthesia should last longer, do not be concerned.
Not everyone reacts to medication in the same manner. One word of
caution: While you are numb, please be careful not to bite your lip or
tongue. A soft diet or no meal at all while you are numb is probably a
good idea. If your child has been the patient, please watch them
carefully to be sure they do not play with their tongue or lip while it
is numb.
Once you are numb, your dentist will prepare your tooth in a very
specific way in order to maximize the retention and esthetics of your
new porcelain to metal crown. After the tooth is fully prepared, we
proceeded with the impression stage. We used a thin piece of retraction
cord that is placed around your tooth in order to get the impression
material under the gum where the crown ends. Please rest assured that
this small piece of cord was removed prior to the end of today's visit.
Should you experience any discomfort you can take a mild analgesic
(Tylenol™, Advil™, Anacin™, etc.) as long as there is no medical
contraindication based upon your medical history. Typically, you can
take anything you would normally take for a headache. If the discomfort
persists, please call your dentist.
Once the impression stage is completed , your dentist or his assistant
will place a temporary (transitional ) crown (or bridge if multiple
teeth were involved) on your tooth. These plastic (acrylic) restorations
are placed on teeth to protect them and the gum tissues between dental
visits. The temporary cementing medium used is designed to allow the
easy removal of the temporary at your next scheduled visit.
There are a couple of additional facts you should know about regarding
the care of your temporary crown:
Home care is extremely important while your temporary crown is in place.
The health of your gum tissue and the success of your final treatment
restoration depends upon it. PLEASE do not be afraid to clean your teeth
between visits. With a minimal amount of home care, you should be able
to maintain the continued health of your teeth and gum tissue during the
time required to fabricate your new crown.
Sometimes, even with meticulous care, temporary crowns or bridges may
become loose between visits. If this should occur, please place the
temporary crown or bridge back on your tooth immediately. Putting a drop
of Vaseline™ in the temporary crown or bridge will very often increase
the retention and hold the temporary in place until you can schedule an
appointment. Once again, REPLACING THE TEMPORARY CROWN IMMEDIATELY IS
VERY IMPORTANT! It only takes a short time for teeth to move if the
temporary is not put back into its proper position. This could affect
the final restoration significantly and may necessitate new impressions
and a great deal of time. If you cannot replace the temporary crown
yourself, put it in a safe place and call the office. We will be happy
to recement it for you at the earliest possible moment.
Second Appointment
At that time, the temporary crown is removed and any temporary cement is
cleaned from the prepared tooth. Your dentist will fit the final crown,
check for accuracy, adjust for any bite discrepancies and evaluate the
esthetics. If all of these factors are acceptable, the crown is cemented
to your tooth. It is not unusual for the new crown to be mildly
sensitive to cold temperatures for a few weeks. However, if the
sensitivity is severe, does not subside, or if the bite feels
uncomfortable, contact your dentist. Further adjustments to the crown
may be necessary.
We hope that this brief instruction sheet will answer most of your
questions regarding crowns. Following these simple guidelines will help
provide you with the finest in dental care. If you have any questions
regarding this or any other procedure, please feel free to contact us!
