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Dean George is the Marketing Specialist and Content Creator for Dental Insurance
Store and its social media channels. He is a regular contributor to Agent Straight Talk, the
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A crowning achievement - dental royalty

Jul 26, 2012

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Has this happened to you? You are chomping on some ice, hard candy or maybe some popcorn and suddenly you realize something is floating around in Chomper Central that shouldn’t be. You know this because it isn’t dissolving and it doesn’t taste as good as what you were eating.

Talk about biting off more than you can chew!

Depending upon the size of the tooth enamel you lost and the amount of decay the remaining tooth has, your dentist (whom you have consulted immediately because you are dental wise from reading this blog) may recommend knighting you into the royal dental family by crowning you with a dental crown.

In preparing for a crown your dentist may take X-rays to study the roots of the tooth needing the crown and the surrounding bone. If your tooth decay looks like downtown Detroit or if there’s a risk of infection or injury to your tooth’s pulp, your dentist may recommend a root canal first.

Before beginning the process of making a crown, your dentist will numb your tooth and the gum tissues surrounding it. (My dentist usually says something like, “You may feel a little pinch” before producing a syringe as long as a ’58 Cadillac.)

After that the dentist will file down the tooth receiving the crown along the chewing surface and the sides to make room for the crown. The space needed for the crown depends upon the type of crown used. There are four types:

  • Metal These are probably the most durable and use gold alloy, other alloys like palladium, or a base-metal alloy like chromium or nickel.

    Pros: Withstand biting and chewing force well, are thin and rarely chip or fracture. Tooth wear to opposing teeth is minimal. Cons: Available in metallic only. Because of this metal crowns are a good choice for out-of-sight molars.

  • Porcelain-fused-to-metal Can be color matched to adjacent teeth unlike metal crowns. With proper equipment may be available in one visit. 

    Pros: Look like normal teeth and is a good choice for front or back teeth. Cons: Wears opposing teeth down more than metal or resin crowns and the porcelain part can chip or break. Also, sometimes the metal underlying the porcelain can look like a dark line, especially at the gum line or further if your gums recede.

  • All-resin These crowns are less expensive than other crown types and look natural.

    Pros: Affordable, expand and contract like natural teeth and are gentle on opposing teeth when you chew. Cons: Wear down over time and more prone to fracture than porcelain-fused-to-metal crowns.

  • All-ceramic or all-porcelain These crowns provide the best natural color match than any other type and may be a good fit (see what I did there) for people with metal allergies.

    Pros: Natural looking and a good choice for front teeth. Cons: Not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns.

    But what if your dentist has to deal with excess space in the ol’ pie hole (due to the amount of decay in the tooth being crowned) rather than space being in short supply? If that’s the case your dentist will use filling material to “build up” the tooth so it can better support the crown. Filling material might be dental amalgam or dental composite.

    After reshaping the tooth your dentist will either use impression paste or putty to make an impression of the tooth receiving the crown. The impressions are sent to a dental lab that manufactures the crowns and returns them to the dentist in one to three weeks. If the crown is porcelain your dentist can also select the shade that most closely matches the neighboring teeth.

    While your crown is being manufactured your tooth will need to be protected and your dentist will outfit you with a temporary crown. Temporary crowns are usually made of acrylic, plastic or a thin shell of metal and are held in place using temporary cement that can be easily removed at your next appointment.

    Some dentists eschew (pun intended) traditional dental impressions and opt for optical impressions with a CAD/CAM milling machine. With this method milling machines are attached to a camera that take a picture impression of your tooth.

    The dentist then uses this impression and the milling machine to design the shape of your crown. The machine fabricates the crown by grinding down a cube of porcelain, or dental ceramic. The advantage to this is that a tooth can be shaped and its crown cemented all in one visit. The whole process of making the crown may take around 30 minutes.

    The disadvantage is most dentists don’t have these expensive machines in their offices and the CAD/CAM machines are limited to making porcelain (ceramic) crowns only. Depending upon your personal needs, your dentist may not recommend this type of crown for your situation.

    Always consult with your dentist for recommendations before undergoing a major dental procedure like getting a crown or a dental implant.

    Thanks for reading Agent Straight-Talk and remember: Everyone smiles in the same language!

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    Copyright 2012, Bloom Insurance Agency, LLC©

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