Dental Crowns: What are They and Do I Need One?

An article written with Dr. Sherry Tsai

Common Symptoms of Needing a Dental Crown

$Tooth with cavity and fracture needs a dental crown$

Often, patients will look in the mirror at their teeth and see dark shadows around old amalgam fillings, or dark areas at the top of their teeth. Some patients feel discomfort when they bite down, brush, or drink hot/cold drinks. All of these, though not always, can be signs of needing a dental crown. The most common symptoms of tooth issues that crowns can address are:

» Bite pressure pain/discomfort (when chewing)
» Bruxism - wearing down your natural teeth to the point they hurt
» Root exposure from clenching/grinding
» Fractured teeth - old large fillings usually cause this
» Black or dark area around old or leaking mercury/amalgam fillings
» Reoccurring or recurrent decay around old fillings and old crown margins
» Broken or worn-down tooth causing sensitivity
» Sensitivity to sweet, hot, cold, etc.

While not all these situations warrant a new crown, it is best to have Dr. Tsai evaluate the tooth and root structure as soon as you can. Having a crown placed early can avoid further costly treatment such as Root Canal Therapy and Dental Implants.

What are Dental Crowns?

A dental crown is like a tooth-shaped cap or cover customized to fit over a tooth or an implant. It is used to restore a tooth’s shape and size, to improve its appearance, strength and structural integrity, and to enhance its performance.

A crown is cemented in place and fully covers the visible portion of the tooth, encasing it for full protection. Dental crowns are also used to cover Dental Implants or to support a Dental Bridge.

Crowning may be done:
» To cover and protect worn-down teeth
» To protect sensitive teeth
» To support teeth with large fillings
» To protect cracked or weakened teeth from breaking apart
» To restore badly shaped or discolored teeth
» To protect a restored tooth on which root canal has been done
» To hold a dental bridge in place
» To cover a dental implant

How are Dental Crowns Placed?

Crowning takes two visits to the dentist. On the first, your teeth are prepared to receive the crown, an impression of your teeth is taken, and a temporary crown is placed. The second visit is for placing and bonding the permanent crown.
Once Dr. Tsai decided that you need a dental crown, the first step she will take is to prepare the tooth to receive the crown. She will first numb the area with anesthetic and then work on removing the parts of the tooth causing any issue - decayed, misshaped, or discolored parts, etc. While doing this, she will also shape the tooth, without touching the pulp, so that the crown can be placed firmly on it with proper alignment to adjacent teeth.

Dr. Tsai will then take the impression of your teeth, including the prepared tooth, to be able to fabricate a crown that will fit snugly on the prepared tooth. She will also do a careful color-matching to ensure that the new crown matches the rest of your teeth and does not look different. The impression, along with other specific instructions, is then sent to our lab for fabrication, which typically takes about two weeks. Since the prepared tooth cannot be left uncovered for that long, Dr. Tsai will place a temporary crown made of acrylic-based material, which will later be replaced with the permanent one. Apart from being the temporary cover, the temporary crown also serves other important purposes - it allows you to get used to the feel of the new crown and also allows addressing any issue that may crop up.

When the permanent crown is fabricated, the temporary one is removed and replaced with the permanent crown. Dr. Tsai will make necessary adjustments to ensure that the new crown looks, feels, and functions just like your natural tooth, and when Dr. Tsai and you are satisfied with how it looks and feels, the new crown will be permanently fixed in place with special dental cement. The final step is scraping off and cleaning the excess cement around the tooth.

What are Dental Crowns Made of?

Dental crowns are made of various materials - ceramic, porcelain, porcelain fused to metal, all metal (like gold or other alloys), and stainless steel. The choice of material to be used for your crown may depend on various factors - location and function of the tooth, color or shade of the adjacent teeth, your gum condition, whether you have any allergies, and your own preference.

Here at Millbrae Dental Care, the best dental clinic in the San Francisco Bay Area, we generally use all-zirconia crowns. Zirconia is a strong and durable ceramic material, and all-zirconia crowns are even stronger than porcelain crowns with metal base. They also provide a great balance of function and aesthetics. For anterior or front teeth, we usually use a more cosmetic Empress II material which provides translucency or depth effect for a more natural tooth/crown. This makes sure that your smile shows only beautiful, natural-looking teeth to others.

Pros and Cons of Dental Crowns

Like everything else, dental crowns have their pros and cons. Let’s take a look at these.
Pros» There’s no need for removing internally healthy tooth structure
» Well-made crowns are nearly impossible to distinguish from your natural teeth
» Crowns can last a long time, 5-20 years is typical
» Their permanent bonding makes them easy to care for like a natural tooth
» Crowning can be used to solve a wide range of teeth problems

Cons» Though a tooth may not need to be extracted, it has to be ground down and shaped to receive the crown. So, it loses its appearance and functionality
» Some crowns can chip or become loose over time and need to be replaced
» When your gums recede you will see a metal/dark line at the top of your tooth
» The tooth under a crown may still be affected by reoccurring decay or damage

Caring for Dental Crowns

pretty woman smile with nice dental crowns

Dental crowns, especially a crown placed on a natural tooth and not on an implant, can create more problems than you intend for it to solve if not properly cared for. The natural tooth under the crown can still be affected by decay and other problems associated with a natural tooth. To prevent such problems, you have to take great care of your oral hygiene and dental health.

Since crowns are permanently fixed on the teeth, you can take care of them like you would your natural teeth. You should brush your teeth twice a day and floss at least once a day to keep your teeth and gums healthy and clean. You should also strictly follow the twice-yearly professional cleaning routine universally recommended.

How Much do Dental Crowns Cost?

This is a difficult question to answer as there are many situations, materials, areas of the mouth and insurance coverage. A general price range for standard crowns used to repair and cover your back teeth is $950-$1195^*. When you are replacing anterior or front teeth and want a natural look to the teeth, we switch to our aesthetic labs and use material such as Empress II. These crowns or aesthetic veneers rage in price $1,500-$1,850^*. Again, these prices are typical ranges. It is best, if you think you need a crown, veneer, or implant crown, to call Dr. Tsai and have her evaluate and provide a more detailed treatment plan with pricing and payment plan options.

As useful and beneficial as they are, dental crowns may not be the only answer to all teeth problems. If you have any of the symptoms mentioned above, or if you think you need a crown, dental implant, dental bridge or any other treatment, schedule an appointment with Dr. Tsai or give us a call.

Have questions about dental crowns? email or call us:
(650)-583-5880

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^* These are suggested ranges of crowns, bridge units, etc. They are not actual prices are not quotes of our prices. Prices vary with tooth number, location, color, additional procedures needed, aesthetic qualities, etc. Please ask our office for a clinical evaluation and a financial estimate for your situation.

Dr. Sherry Tsai provides Dental Crowns, Family Dentistry, Cosmetic Dentistry, TMJ Pain Relief, and Sleep Apnea treatment in Millbrae, San Bruno, Burlingame, San Mateo and the Bay Area