More About Crowns

Indications for Crowns Include:

  • Large Filling – When a filling occupies more than 50% of your tooth, there is a point when there is just not enough tooth structure to support the filling. To avoid the filling from cracking your tooth when you bite on it, a crown is placed over the tooth to protect it. The crown is a standard way to keep the tooth structurally sound and avoids unforeseen extractions.
  • Cracked Tooth Syndrome (CTS) – A tooth may exhibit pain upon biting, and this can be a sign of an internal fracture, usually due to a previously placed metal filling that expands and contracts with temperature changes. The only way to prevent the tooth from flexing is to place a crown to hold it together.
  • Root Canal - After root canal therapy, teeth tend to become brittle and are more apt to fracture. These teeth need to be protected by a crown.
  • Bridges - When you are missing a tooth or several teeth, it is important to replace these teeth and this can be done by a removable partial denture or more favorably by a fixed bridge. A fixed bridge is cemented onto anchor teeth located on either side of the space. The bridge typically has a porcelain cover and looks very realistic.
  • Esthetics – Crowns can be used to perform a cosmetic makeover/smile makeover and provide patients an amazing new smile that greatly improves the quality of their life.

A Brief History

Crowns are not new. They have been used since the 1700’s as an obvious benefit to saving teeth from serious fractures. Originally, Full Gold Crowns (FGC), made of yellow gold, were used to restore back teeth only. Porcelain-fused-to-metal (PFM) crowns, developed in the 1800’s, offered better cosmetic results which have improved steadily.

All Porcelain Crowns

Today, All Porcelain Crowns (APC) represents state-of-the-art technology allowing the most beautiful smile makeovers imaginable. All Porcelain Crowns are now made of revolutionary high-tech porcelains. The color of the porcelain and the color of the cement can both be selected to achieve the desired shade for our patients. Further, all porcelain crowns allow light to pass through the porcelain just like your natural teeth, a phenomenon called “translucency.” At Fountain View Dentistry, the choice of Empress II, Captek, or LAVA crowns (to name a few) allow us to deliver the Hollywood smiles for our patients that brings them from other states and even other countries.

CROWN PROCEDURE SUMMARY:
Fabricating 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. While wearing the temporary crown for two to three weeks, the lab will fabricate your final crown. At your next visit, the temporary crown is removed and the final crown is fitted and cemented into place.

CROWNS PROCEDURE IN DETAIL:

A. X-ray of tooth
B. Computer anesthesia (local)
C. Prepare tooth for crown
D. Retraction cord
E. Impression
F. Temporary crown
G. Lab fabricates final crown (two to three weeks)
H. Final crown cemented onto tooth

First Appointment
The first visit begins with an X-ray of your tooth to ensure a healthy status and a review of your diagnosis and treatment needs. Next, we administer a computerized local anesthetic around the tooth. 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.

Once you are numb, Dr. Harden will conservatively prepare or shape your tooth in a very specific way in order to maximize the retention and esthetics of your new crown. After the tooth is fully prepared, we place a thin piece of retraction cord around your tooth that allows space for the upcoming impression material to reach the crown margin. The impression cord is removed after several minutes and an impression (mold) of your tooth is made using a modern comfortable tray and a material that is very pleasant to the patient.

Following the impression (mold), we will place a temporary (transitional) crown over your tooth, which will remain on your tooth for two to three weeks while the lab fabricates your final crown. These plastic (acrylic) restorations are placed on teeth to protect them from sensitivity and to maintain them in their correct three-dimensional position during the transitional period. The temporary cement used to hold on your temporary crown is designed to allow easy removal of the temporary at your next scheduled visit.

Instructions about your temporary crown:

  • Sometimes, a temporary crown may come off your tooth as a result of the temporary cement. If this should occur, please place the temporary crown back on your tooth promptly, using a drop of Vaseline™ in the temporary crown to hold the temporary crown in place until you can schedule an appointment. Once again, REPLACING THE TEMPORARY CROWN PROMPTLY IS VERY IMPORTANT! It only takes a short time for teeth to move if the temporary crown 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 our Woodstock dental office. If your temporary crown feels loose, we advise you keep it out of your mouth at night to avoid swallowing it. In either case, we will be happy to recement it for you.
     
  • Home care is extremely important while your temporary crown is in place. The health of your gum tissue and the success of your final crown depend upon it. PLEASE be sure and brush around your temporary and gums every day. Be careful using floss, tooth picks, and irrigation devices because they may cause your temporary crown to come off. Use common sense. Also, try to chew your food on the opposite side of your temporary crown. Remember, brush your temporary and gums every day!

If you 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 us.

Second Appointment
Your second appointment is a relatively short visit. First, we will ask you how your tooth felt while in the temporary. This is important information. If the tooth had deep decay, a deep filling, or a fracture and felt sensitive while in the temporary crown, we may decide to seat your final crown using temporary cement (rather than final cement) to evaluate it further.

If your tooth felt fine while in your temporary, which is almost always the case, your temporary crown is gently removed, and the temporary cement is cleaned from your tooth. We evaluate the esthetics with you to ensure you like the color, shape, and look of your new crown (front tooth or back tooth). Next, we fit the crown so it functions and feels like a natural tooth. An X-ray is taken to ensure the lab fabricated your crown with a perfect fit. If all of these factors are acceptable to you and to us, the crown is cemented on your tooth using final cement. Your tooth may feel mildly sensitive to cold temperatures for a few weeks. This is not uncommon. However, if the sensitivity is significant and does not subside, or if the bite feels uncomfortable, we recommend you contact us. Further adjustments to the crown may be necessary.

We hope that this brief description provides you insight to crown procedures and answers any questions you may have had. Fountain View Dentistry takes great pride in delivering the finest health care possible utilizing patient-friendly technology, amazing staff that always exceed your expectations, and doctors that take time to explain treatment and make you feel comfortable. “Come to the Dentist and Relax”! If you have any questions regarding a crown procedure or any other procedure, please contact us at (770) 926-0000.
 

New Patients Always Welcome. To experience distinctly different dental care, call today and reserve your appointment with Dr. Harden and our wonderful staff. Fountain View Dentistry serves the Woodstock, Acworth, Canton, Kennesaw, and Marietta communities with general dentistry and cosmetic dentistry for all ages.

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