Caps & Crowns

Similar to a house that is built on a foundation of sand, a tooth that is extensively restored with fillings can crumble and wash away. This is why many dentists suggest placing a crown or "cap" on teeth that have very large fillings.

A crown is indicated when there is little tooth structure left or the remaining tooth is weakened, and it is likely that a tooth will fracture during normal chewing. If a tooth fractures, the only option may be to pull the tooth or have a root canal.

Crowns can also be fabricated to make the front teeth look more attractive or to achieve better chewing function in an individual with worn-down teeth.

Crowns may be fabricated out of various materials. Certain materials work better in different situations. However, the patient usually has the choice of gold, resin, porcelain or a mixture of the materials.

A dentist usually will need about two or three appointments before the patient can leave the office with the brand-new crown.

The first appointment is usually to examine the tooth and determine the type of crown to be placed.

After that, the dentist will actually drill around the tooth so the crown will fit perfectly over the remaining tooth structure. Once the dentist is satisfied with the drilling part, he or she will take an impression with a material that is about the same consistency as mashed potatoes. The dental lab will use this impression of the tooth to help make the final crown.

The patient may have to wait several weeks before the finished crown returns from the lab. During this time the patient will have a temporary crown glued on. This crown is weaker than the lab-fabricated one and should not stay on for more than a few months.

Finally, after the dental lab has fabricated the final crown, the dentist will use a very strong cement to glue the crown to the tooth.

Once the final crown is cemented on, the tooth or teeth have been given the chance to resist fracture for a very long time. However, the tooth still may break down if any decay gets under the crown or there is enough force during biting to dislodge or crack the crown.

Children may actually get a different type of crown that does not have to be made in the lab. These teeth do not fit the same way as the adult crowns. This is because the crown will go on the baby teeth that will fall out in a few years. It is important to put crowns on baby teeth with large cavities because the teeth could break, which could cause pain or movement. The latter could require the patient to have braces later in life.

Crowns are an important part of patient care in dentistry. Many patients avoid having crowns and wait until a tooth breaks to ask for one. This usually makes treatment more difficult and less successful. If your dentist suggests a crown should be placed, it would be a good idea to follow his or her advice so you may avoid a broken tooth.