When restoring a tooth with filling material is no longer an option, a crown will usually be required. Crowns reinforce the tooth structure to ensure prevention of further damage which can cause an individual to lose his or her tooth altogether. Crowns are typically needed when decay has damaged a significant portion of the tooth, or when a large portion of the tooth has been worn down or broken due to trauma, grinding or clenching. Crowns can be comprised of different materials including metal (usually gold), porcelain fused to metal or just porcelain. Porcelain fused to metal crowns and porcelain crowns provide better aesthetics than metal crowns as they can be matched closely to your natural tooth color. One difference, however, is that porcelain fused to metal crowns have a slightly noticeable metal sub-structure (a dark line which will appear near the gum line over time).
Having a crown completed involves two separate appointments spaced approximately two week apart. The first appointment is for the crown preparation. Local anesthetic will be provided to make you more comfortable during the appointment. Preparation of the tooth will then be completed by removing a large portion of the outside tooth structure by filing each of the tooth’s surfaces down making room for the crown to be placed over top. An impression of the reduced tooth will then be taken and sent to a dental laboratory where the permanent crown will be fabricated. The dentist will make a temporary crown for you to wear for the two weeks prior to the cementation appointment. This temporary crown is made in the dental office. It is important that the temporary crown be worn during this period to prevent the adjacent teeth from shifting. This can happen because the prepared tooth is now significantly smaller meaning it no longer reaches adjacent teeth to hold them perfectly in place.
The second appointment is for the crown cementation. This appointment will be slightly shorter and less invasive than the first therefore you will not require freezing. The temporary crown will be removed and replaced with the permanent crown. The dentist will check the fit and shape of the crown and will verify your bite to make sure it is level with opposing teeth. After all this has been completed, the crown will be cemented in place. The crown is secure once it has been cemented meaning you will be able to function as you normally would immediately following your departure from the dental office.