A dental crown is an artificial restoration that is fitted over the remains of an existing tooth and which has the shape, colour and feel of a natural tooth. They can be made from different types of materials such as porcelain, ceramic or metal and are a great alternative to implants and cosmetic bondings
If one or more of your teeth are weak, damaged, or have a cosmetic problem that spoils the appearance of your smile such as teeth that are uneven, discoloured or misshapen, your dentist may recommend fitting a dental crown to correct the problem.
Dental crowns or simply ‘crowns’ are sometimes referred to as “caps”, because they are in fact placed as a cap covering an existing tooth, or the remaining portion of a tooth that has been chipped, broken, or damaged by decay. Most of the time a tooth has undergone extensive dental work such as root canal treatment and the dentist has recommended a crown as a long term option to restore the tooth.
If your dentist has recommended capping or crowning one or a few of of your teeth or if you are considering having a dental crown fitted for aesthetic reasons, it is a good idea to understand the basics of what crowns are, why and in which situations they are used and if they are the right option for you.
In this article, we will cover everything you need to know, including dental crown costs, the different materials they can be made from, and how they are fitted as well as the situations in which they can be used successfully.
A dental crown is a restorative cap that covers a whole tooth or part of a damaged tooth, to repair its functionality or to improve the cosmetic appearance of a tooth that is otherwise healthy and functional but simply doesn’t look good in regards to its original colour, shape or size.
Many times a tooth that has had extensive treatment due to deep decay and infection such as root canal therapy, a simple filling may not be enough to guarantee the longevity of the tooth after it has been worked on (devitalised). Your dentist may recommend that a full coverage crown be placed soon after the success of your root canal treatment to ensure that what remains of the tooth is protected and you can count on keeping the tooth for much longer that if you left it with only a filling.
The crown is individually made to fit over the tooth or remaining portion of the tooth, and is cemented into place, so that it performs the role of a permanent restoration that feels natural when biting and often, is indistinguishable from the neighbouring teeth.
This is why crowns are also used to mask discoloured, misshaped or gapped and crooked teeth. Placing a crown over unsightly teeth can instantly improve the look of them and give you a better looking smile without having to lose any teeth or have braces should you desire it.
Dental crowns can be made from different types of materials, some of which are designed to mimic the appearance of the natural teeth and others that will not blend in so well, which means that they are usually reserved for teeth that are not visible when the mouth is open. When deciding which type of crown to use on a specific tooth the dentist and patient should discuss the situation and come to an understanding of the best type to use in regards to the aesthetics, cost, functionality and patient preference. The most common types of dental crowns are:
These are natural looking and can be placed in the mouth on the front or even over the back teeth.
There are different variations of Ceramic used and each will depend on the dentists’ expertise and experience as well as the laboratory they use to produce their crowns. Digital scanning has transformed this area of dentistry along with the use of in surgery milling systems like Cerec which are a computerised pressed forms of making crowns as opposed to the firing methods used in a lab by a technician. Porcelain is a form of ceramic which is most commonly used by lab technicians to achieve a natural finish but is not the strongest of the materials so is usually reserved to anterior teeth.
Empress and Emax, Cerec, and Zirconia are highly aesthetic and very strong ceramic materials used to make crowns which allows the most skilled cosmetic dentists to achieve beautiful results both in the front of the mouth as well as with the back teeth without worrying about fracturing like porcelain.
These crowns may contain precious metals like gold, palladium or platinum, or cheaper materials such as steel, nickel chromium or cobalt chromium. These tend to be stronger than basic laboratory made porcelain crowns for posterior teeth, but don’t blend in with the other teeth. With the evolution of materials and techniques the new ceramic crowns are proven to be as strong as a metal crown when used properly on the right patient and situation.
Gold crowns, which give a distinctive appearance if used on visible teeth are a great long term material for wear and tear purposes and many dentists still lean towards this precious metal as their go-to preference for certain cases such as patients who grind and have alot of wear on their teeth, as well as those how might have poor hygiene and not floss in order to keep the margins clean around the restoration which is very important in the case of ceramics. There has, although, been a rise in requests for gold crowns due to celebrities and people in show business who opt to ‘bling’ up their smile by using these gold restorations on front teeth as well as back in order to achieve a certain look or style. It is definitely a personal preference in terms of the look they provide but the longevity of these crowns are definitely a bonus.
These are precious metal crowns with a porcelain overlay, or coating to provide added strength whilst still looking natural. The external part of the crown is in fact porcelain that has been layered and cooked onto the metal base making the basic metal crown much more appealing and tooth like. This crown type does have a more opaque look since the metal needs to be covered or disguised and you tend to get the appearance of a ‘grey’ or metallic margin over time due to possible gum recession. A solid option, usually will be based on the compromise between the patient’s desire to have a natural looking restoration, the cost and the expertise of the dentist.
Fitting a permanent dental crown requires at least two appointments, and the initial visit may involve X-ray slides being taken of the tooth and the underlying root structure, in order to assess the strength of the remaining tooth and its roots. If the tooth is very decayed or if your dentist thinks that damage to the tooth may compromise the tooth pulp, you may need to have a root canal procedure as well, before the crown can be placed. If you are having crowns done purely for cosmetic reasons then you will still have X-rays as well as photos possibly to document the before and after of your treatment.
At the first appointment, your dentist will discuss the options for the material your crown is made of, and together, you will decide upon the best choice. It will depend if the crown if towards the front or one of the teeth in the back, as this will dictate how visible it might be to others as well as how strong it needs to be to support your chewing power and of course total cost will then help you make your choice supported by the advice from your dentist. To begin preparing the tooth, a local anaesthetic may be used if the procedure would otherwise be painful, but this is not always necessary particularly if you have had a root canal treatment prior.
The tooth is prepared by removing any damage or decay, and filing down the outer surfaces in order to allow the crown to fit comfortably and securely.
If only a small portion of the original tooth remains, your dentist may also use a filling material at this point to build and shape the base of the tooth so that it can hold the crown. A thimble shape is created and depending on the type of crown you have and your dentist have chosen the preparation will be reflect the requirements for the fit of that specific type of crown on your tooth.
Once your dentist is satisfied with the preparation work, they will take impressions of your teeth using either putty and moulds, or in some cases, digital scans. These impressions take in not only the tooth in question itself, but the surrounding teeth and gums and those on the opposite biting surface, to ensure that the new crown is a good fit and will allow you to bite normally.
The impressions are sent off to a dental laboratory, which casts models of your teeth and uses them to fabricate the crown specifically to fit your tooth. This usually takes a couple of weeks, and so means that you cannot have your new permanent crown placed the same day. If a in surgery milled cerec crown is prepared you may even be able to have the whole procedure completed on the same day as the impressions or digital scan need not be sent to an external lab.
In the meantime, your dentist may use a temporary crown to protect your underlying tooth or to cover an unsightly tooth in the meantime, which is usually made of an acrylic or resin material, and affixed to the tooth with a special temporary dental cement. This temporary tooth should hold up well for the time between your two appointments, but does not take the place of a proper permanent crown. This could mean that you may experience some sensitivity during this time if the teeth prepared do not have root canal treatment and a vital pulp. Your dentist can advise you should you not be able to cope with the sensitivity.
When your permanent crown has been fabricated and returned to your dentist, you will need to go in for your second appointment to have it fitted. Your dentist will remove the temporary crown (if used) and check that the permanent crown fits properly and that you are happy with its appearance and fit.
The new crown will then be fitted, and again, your dentist may use a local anaesthetic to do this. Your dentist will prepare the surface of your natural tooth by lightly etching it to improve adhesion, and then permanent dental cement will be used to secure the crown in place.
Having your tooth prepared for a crown and the fitting itself may be slightly uncomfortable, but your dentist will use a local anaesthetic if there is a possibility that the procedure will be painful, to allow you to remain comfortable. Should you have an in- surgery Cerec ceramic crown, you may not require a temporary stage and have the new crown fit on the same visit.
Immediately after your new crown has been fitted, it is important that you avoid eating until the local anaesthetic has fully worn off to avoid accidentally biting the inside of your mouth.
For the first 24 hours after treatment, your dentist will probably advise you to steer clear of hard, crunchy or very chewy or sticky foods, to give the crown’s cement the chance to set fully.
While the crown itself will not decay, the joint between the crown material and the surface of the natural tooth, and the gums themselves, are just as vulnerable to decay as your other teeth-so it is important to take good care of your teeth after a crown has been fitted, brushing and flossing thoroughly and scheduling regular dental check-ups and hygiene visits.
Your crown will essentially function as a normal tooth after the initial 24 hours have worn off, and you can eat normally-but it is wise to avoid very sticky foods, biting down hard on nuts or crusty bread, or chewing tough foods on your crowned tooth, to reduce the risk of breaking or loosening it.
Dental crowns are designed to be permanent, but it is important to watch out for signs of problems such as chipping, damaging, or loosening of the crown-as well as keeping an eye on the gum line to watch for potential signs of decay that can compromise the underlying tooth, or the integrity of the crown.
Dental crowns are offered under the remit of NHS dental services if your dentist determines that a crown is the best choice for you, and are classed as a Band 3 course of treatment. The price of a dental crown on the NHS is £244.30 at the time of writing.
However, NHS dental treatment only makes provision for the placement of a crown if this is a necessity, and not an elective or cosmetic procedure intended to simply improve the appearance of your teeth. The type of crown offered is also limited as a silver or porcelain bonded on metal will be the basic crowns with anything else requiring you to pay a difference.
Dental crowns can of course be fitted by private dentists too, and the ultimate tooth crown cost can vary depending on the work involved, the material your crown is made from, and the charging structure for the procedure at your private clinic of choice.
A privately fitted dental crown costs from around £400 upwards for a simple metal crown, and rises exponentially for more challenging and complicated procedures, or if using more costly materials for the construction of the crown itself. Cerec and other ceramic crowns will be in the price range of £600-£800. Most clinics provide payment options facilitating the purchase of crowns and can be discussed at the time of your treatment plan proposal.
Like any other type of dental treatment, understanding the basic idea of what materials are available and techniques for your needs is important and you should always discuss your options with your dentist thoroughly so you can indeed make the right choice. Whether it be to protect a recently fractured or tooth with tooth canal treatment or to achieve a more pleasing tooth colour or shape, a dental crown could be the answer to restoring your smile.
If you are looking for a dentist that specialises in dental crowns in your local area to help you achieve the perfect smile, look no further. Smileo has over 2,000 private dentists in the UK, all performing a range of dental treatments such as crowns, dental fillings, teeth bonding, dental implants, and dental veneers, teeth whitening or laser gum contouring.
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