The All-Things Dental Blog

Crowns Top Questions

Posted on Feb 22, 2016

Interviewer: Why do I need a crown? Can I just get a filling?

Interviewee: When we talk about crowns and crowns versus fillings, you have to think about the structure of the tooth. Most of the time if I'm recommending that you have a crown, it's because we need to protect the tooth. A crown sometimes called a cap covers the entire tooth, and we have other videos to show exactly what a crown looks like. But if your filling gets really, really, really big you’ve had filled, then you’ve had it filled again, every time you have that tooth filled, then there's less and less tooth. And if I made a giant filling, you go to eat something and the tooth would just break. Fillings are not meant to support teeth in order for chewing. They're meant to be inside of the tooth. So when you have a filling that has overtaken the tooth and even white fillings, silver fillings, it doesn’t make a difference. If there's more filling then there is tooth, natural tooth, then we need to cover it with a crown to protect it. the crowns that we do in our office are zirconia, they're very strong, that and not only are they strong but they look great. When you look on the inside of the crown, on the outside, it's white but it's stronger than the porcelain-fused-to-metal crowns that we used to do and even the gold crowns. So that’s what it is used for, not a filling because if it's too big, we need to crown it.

Interviewer: I had a root canal a long time ago, why do I still need to crown the tooth?

Interviewee: When you have a root canal, you're basically cleaning out the inside of the tooth. And in cleaning also the inside of the tooth, there is no longer the body's nourishment of blood and the nerve inside. That takes the pain away however it also makes the tooth brittle. And when the tooth is brittle, it is more inclined to cracking and breaking. Now, that may happen in a day, that may happen years later but it will break. The majority of implants that I do are for people who had a root canal but never got the tooth crowned. I always ask my patients, I said, "Well, you had the root canal, did the dentist say that you needed a crown and you never got the crown?" "Oh, the tooth stopped hurting and it didn’t bother me. And then one day, they're biting on the simplest of things." Most of the time it's oatmeal or a piece of bread and the tooth just simply just cracks in two. And usually when the tooth cracks in two, there's nothing that we can do about it anymore. We have to pull it, we have to start talking about implants and other things to replace the tooth. So once you have that nerve taken out of the tooth and the tooth becomes brittle, you must protect it with a crown. And when you cover up that tooth, then you can chew anything you like. But if you don’t cover up that tooth, even though you're pain free, structurally, the tooth is not strong enough. I once heard this analogy which I thought was wonderful. If you had a tree that had a branch attached to it, it's still getting water and moisture and everything like that. But if you detach that tree from the branch, it gets brittle. It breaks easy. And that’s the same thing with the tooth. If that tooth does not cover it with something, it's going to break.

Interviewer: What is a crown made out of?

Interviewee: Most people when they think what crown is made out of, they say porcelain. Now, over the years, crown materials have changed. We used to do gold which gold is still really good. We say that it's very bio compatible. Meaning the body likes it a lot but cold is not very cosmetic. If you're going to get a gold crown, usually we put it in the back. We don’t want you looking like a pirate or anything in the front. Then there's also porcelain-fused-to-metal crowns. Porcelain-fused-to-metal crowns means that you're going to have metal underneath and on top, they lay a porcelain to make it look better. Now, those sorts of crowns, they have a lot of different issues that come and they're kind of falling out of favor in dentistry, meaning that people are moving a little bit more away from them. The next kind of crown that we have is the zirconia crown or a bruxir crown. Those are becoming very popular in dentistry because they're very strong. They're made of one piece, not two pieces stuck together. And they're called bruxir crowns because that means people who clench or grind their teeth, they're less inclined to break them. So, and they also have the best of the cosmetic world because they look like white on the inside and they look like white on the outside. Now, mostly in our office use zirconia crowns. There are other times that we use the kind of crowns, maybe veneers in other situations. But mostly if we're talking about a back tooth, we're talking about doing some sort of zirconia or bruxir crown.

Interviewer: How long do crowns last?

Interviewee: Crowns really have a two component reason of how they last. Of course, it depends on how good the crown was to begin with. And it also has to do with maintenance. You need to take care of that crown as if it is your own natural truth. That means brushing, that means flossing, that means visiting the dentist to make sure that it stays clean around the crown. Of course, a crown should last. I mean, I have people who've had crowns for 40 years and I've had crowns for one year. I've seen people with crowns for one year and they go bad. There's so many different factors that go into how long a crown lasts. If you ask your insurance company, they’ll say five years, but that’s not the case. That shouldn’t be the case. Your crown should last very long but you got to take care of it. You need to clean around or you need to keep it clean. Crowns can get cavities around them. They're very difficult to detect in x-ray so you want to make sure that you're taking caring of it. just because you have a crown doesn’t mean you just kind of throw your hands up and saying nothing will ever happen to that tooth. That’s a little different for implants though. Implants cannot get cavities but that’s a whole different story altogether but you got to maintain that crown and it can last you 10, 20, 30 years depending on the maintenance.

Interviewer: How many times do I have to come for my crown?

Interviewee: The crown procedure is done in two visits. The first visit is the preparation visit. That means that we're going to prepare the tooth for the crown, take out any cavity or any decay that’s underneath whether that’s on a silver filling or white filling, if it was an old crown that we needed to clean up. After we prepare the tooth, we take a mold of the tooth, we send that off to the laboratory and the laboratory is going to create our crown. So the second visit, you would come back in about two weeks and on that two-week visit, you're going to come, no anesthesia necessary. We take off your temporary crown, we try on your permanent crown, we make sure everything is right, margins are closed. Everything is good with it. We take x-rays to verify and then we put cement onto the crown. So that takes two visits.

[Audio Ends]

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Hi, I’m Dr Tamisha Denis a Dentist here in South Florida. Looks like you’ve found my blog. This is where I write about Patient related stuff about Dentistry.

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