Crowns

A crown replaces the part of the tooth that appears above the gum, when a filling is no longer the best option. When a tooth is badly damaged and a lot of tooth substance has been lost, it can be difficult to repair the tooth satisfactorily with a regular filling. Then it may be appropriate to make a crown. A crown looks like a natural tooth.

‍The process

To prepare the tooth for a crown, the dentist must first grind to the tooth. The tooth is sanded a little like a cylinder/cone, and then an imprint is taken or the oral cavity is scanned. This is sent to the dental technician who makes a crown.

After grinding and imprinting/scanning, the tooth must be protected with a temporary crown. Temporary crowns are mostly made of a tooth-colored plastic material that is fixed with a temporary cement on the grinded tooth.

Before cementing the crown (attaching to the prepared tooth), the dentist checks that it fits on the sanded tooth, is in proper contact with neighboring teeth, fits in the bite and that the appearance and color are satisfactory. Sometimes extensive adjustments may be needed and the crown must be sent back to the dental technician, and sometimes it may also be necessary for the dentist to take a new imprint. When the crown is satisfactory, it can be fixed on the tooth using a special type of cement.

If the tooth is already rooted, the dentist checks the density and quality of the root filling. If the rooting is no longer optimal, it should be redone (before putting on the crown) if this is possible.

Materials

There are different crown types and materials, and these have different characteristics in terms of strength and aesthetics. The crowns are made of materials such as solid metal, metal-ceramic (a metal sheath covered with tooth-colored ceramic, i.e. porcelain) or solid frame (porcelain). All of these have different properties, for example, solid metal is stronger than porcelain crowns, while porcelain crowns are aesthetically prettier and material is selected according to location and needs.

Alternative treatment for crown

A more affordable alternative to crown treatment is to build up the tooth with a composite (plastic) filling. This is normally considered a weaker solution, and may result in poorer aesthetics compared to a crown. In some cases, it is not possible to lay a good filling, and then a crown will be the only option to prevent the tooth from being lost.

Pin crown

Sometimes the tooth can be so damaged that there is insufficient attachment for a crown. Then the dentist can lengthen the tooth with a pin and a build-up, a so-called pin cone. In order to put a pin, the tooth must be rooted if it is not already. Part of the rooting mass is removed to make room for the staple. The pin is firmly inserted inside the root and fixed with a special cement.

Staples and build-ups are often made of a metal alloy, but also of composite (plastic), ceramic or fiber.

A tooth that is rooted and has a staple and crown will never be as strong as a fresh tooth. When chewing, the load on the pin can be great and the staple/tooth may crack or have a crack in the root. This often means that the tooth has to be pulled.

Caries

Even if a tooth has a crown, there may be holes (caries) in the transition between the crown edge and the tooth surface when plaque and bacteria get stuck, and often such gaps can be repaired with a filling. If the hole is large and/or inaccessible for repair, it may be necessary to make a new crown. It is therefore important to pay close attention to the cleanliness and have good oral hygiene.

Complications

Abrasion and fracture

A crown can wear down by chewing, and crown materials can also fracture, for example, porcelain can chip off.

Need for root canal

Sometimes there may be a need to root the tooth immediately after it has been sanded because the tissue in the tooth reacts to grinding or the tooth tissue is already inflamed. In this case, the tooth is rooted before a crown is made.

There may also be a need for a root canal later. Then you can try to treat the tooth through the dental crown.

How long does a penny last?

It is desirable that a crown should last for many years. Nevertheless, there are a number of reasons that can shorten the life of a penny. This can be abrasions, breakage of porcelain, caries under the crown edge or other injuries/diseases. In those cases where caries or the porcelain fracture cannot be repaired and affects the functioning of the crown, a new crown may be appropriate.

Cleaning/Hygiene

There may be holes on the tooth along the crown edge, and gum inflammation can occur around crowns. A good cleaning and use of fluoride is therefore a prerequisite for such restorations to last and work for a long time. Regular check-ups with the dentist/dental hygienist are also necessary. They will instruct and advise you on the cleanliness.