The What, Why, and How of Crowns

A crown or cap, tooth cap, or porcelain jacket, is a type of dental restoration that fully cups over that portion of a tooth or dental implant that lies at and above the gum line. Once placed, it in effect becomes the tooth’s outer surface. In comparison, a dental filling just fills in or repairs a portion of a tooth. Crowns are permanently cemented in to place. The tooth-crown unit that results functions and is cared for just like a natural tooth.

There are several reasons why a dental crown might be made for a tooth. Dentists routinely use them to repair and strengthen damaged teeth and improve tooth appearance, including color, shape and even apparent alignment. While some other treatment alternatives do exist, no other kind of dental restoration provides the exact same set of benefits and advantages as a crown.

Crowns can be constructed using:

  • Porcelain or other types of dental ceramic
  • Metal, precious, semi-precious, or non-precious dental alloy
  • A combination of dental ceramic and metal alloy (porcelain fused to metal crowns)

Why would you need a dental crown?
A dentist might recommend capping a tooth for a variety of reasons but most tend to fall within one or more of the following categories:

  • Restoring or making changes with a tooth’s shape
  • Reinforcing a structurally compromised tooth
  • Improving a tooth’s appearance

In some instances, a dentist’s recommendation to place a cap is based solely on their judgment, as opposed to clear-cut clinical signs. Adding in the fact that they can be quite costly, creates the situation where finances may influence the diagnosis given. Just as not placing a crown when one is needed has associated risks, performing the process of crown placement opens the door for potential complications too. For this reason, this procedure should not be performed without reasonable justification. Let your dentist explain to you why they feel it is required. You may not fully understand all of their arguments, but they should at least make some sense.

Applications for Placing Crowns
Since a cemented crown becomes its tooth’s new outer surface, it is not hard to imagine how placing one can be used to rebuild or improve a tooth’s shape. Caps are routinely used as a solution for worn, chipped, or broken teeth, or those that are misshapen due to a developmental anomaly. Beyond just restoring a tooth’s shape, a crown can provide a reinforcing and strengthening effect too. Because a dental crown encases the entire visible portion of a tooth, porcelain crowns can be used to enhance or idealize the cosmetic appearance of teeth.

It is an advantage to have a crown placed as opposed to a dental filling, mostly due to the way that it is constructed. Crowns are fabricated in a dental laboratory by a dental technician that uses copies (or impressions) of your teeth. In comparison, dental fillings are built during your dental appointment, within the confines of your mouth. This difference in how they are made means that a dental laboratory technician gets the opportunity to simulate and examine aspects of your bite and jaw movements from a variety of angles, and then sculpt your dental crown so it has the ideal shape. With a dental filling, the dentist has far less control over the restoration’s final contours because it is often difficult for them to visualize, evaluate, or access the tooth they are working on.

As a general rule, a crown shouldn’t be placed solely to improve the appearance of a tooth if there is an alternative procedure that could just as well achieve the same end result. This is because during the crowning procedure, large portions of the tooth are trimmed away. If a more conservative dental procedure can equally improve a tooth’s appearance, such as porcelain veneer, dental bonding, or even just teeth whitening, then it is usually best to consider that treatment option first.

This leaves you with a lot to think about if you are considering having a crown placed. Reaching out to your local orthodontist is the best thing to do if you are looking for further advice, and if you have questions, direct them at us! We are happy to help however we can.