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Health story the dentist who changed my life

Health Story: The Dentist Who Changed My Life

After a long history of unpleasant experiences, Jonathan finally found the right dentist. Read his story.
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Dental Crowns

By

Megan Freedman

What is a dental crown procedure?

A dental crown is a fixed device that covers a damaged tooth or a dental implant with a tooth-shaped cap. Placing a dental crown is an outpatient procedure that restores the strength and function of a tooth and the appearance of your smile. The procedure involves taking a mold of a tooth that has been filed down to make a customized crown to fit the tooth. The crown is attached with permanent cement. 

Placing a dental crown, also called a cap, is generally considered safe, but there are risks and potential complications. It is only one method used to repair damaged teeth. Discuss all of your treatment options with your dentist to understand which options are right for you.  

Types of dental crowns

The types of crown that your dentist may use include:

  • Ceramic crowns are made of porcelain blended with other materials. Ceramic crowns are tooth-colored and generally not as durable as metal crowns. Metal crowns can be made of copper, gold, and other metals.

  • Metal crowns are often used on back teeth because of the metal’s strength and durability.

  • Porcelain-fused-to-metal crowns are made of metal with tooth-colored porcelain laid over it. They are typically stronger than ceramic crowns, but the metal may become visible near the gums over time.

Other procedures that may be performed

You may need a root canal procedure if damage, decay or infection is deep enough to affect the pulp inside your tooth. The pulp contains nerves, blood vessels and other tissues.

A root canal involves drilling into the tooth and removing the pulp. Your dentist cleans the root canal and fills it with a permanent inert material. Then the tooth is filled and covered with a temporary material until the crown is ready.

Why is a dental crown procedure performed? 

Your dentist may recommend a dental crown to treat or repair the following:

  • Cracked or chipped teeth that cannot be repaired using less complex procedures. Sometimes, a severely damaged tooth will lead to an infection and need root canal treatment to save the tooth before placing a crown.

  • Dental implants that may be covered by a dental crown

  • Misshapen or discolored teeth that would look or function better with a dental crown

  • Missing teeth that are replaced with a bridge. Dentists may use a dental crown to support a dental bridge

  • Tooth decay (cavities, dental caries) that occur when bacteria in your mouth produce an acid that damages the teeth. Dentists often repair minor to moderate decay with a dental filling, but severe or deep decay may require a dental crown to save the function and appearance of the tooth.

Sometimes, a severely decayed tooth will need a root canal treatment to save the tooth before placing a crown.  

Who performs a dental crown procedure?

The following dental providers perform dental crown procedures:

  • General dentists prevent, diagnose and treat diseases and conditions of the teeth, gums, mouth, and associated structures of the jaw and face.

  • Pediatric dentists specialize in caring for the dental needs of children and teens.

  • Prosthodontists specialize in restoring damaged teeth with crowns, bridges and other devices.

How is a dental crown procedure performed?

Your dental crown procedure will be performed in a dental office or clinic. Sometimes a root canal is needed before placement of a dental crown. You may need a root canal procedure if damage, decay or infection is deep enough to affect the pulp inside your tooth. The pulp contains nerves, blood vessels and other tissues.

A root canal involves drilling into the tooth and removing the pulp. Your dentist cleans the root canal and fills it with a permanent inert material. Then the tooth is filled and covered with a temporary material until the crown is ready.

A dental crown procedure generally includes these steps:

  1. You will sit in a reclining position in the dentist chair and wear a clear shield over your eyes. The shield can protect your eyes from spraying liquids and dental instruments.

  2. Your dentist will inject a local anesthetic into the gums near your tooth. The anesthetic prevents you from feeling pain during the procedure. Your dentist may apply a painless topical anesthetic to partially numb the gums before the injection.

  3. Your dentist will reshape your tooth so that the crown can fit snugly over it. To do this, he or she may fill any hollowed-out areas of your tooth with a filling material. The dentist will also file down certain parts of your tooth.

  4. Your dentist will make a mold (impression) of your tooth and the teeth around it with a type of putty. Your dentist uses the impression of your teeth to make a customized crown that fits correctly.

  5. Some dentists have equipment to make crowns in their offices. In this case, your dentist will make and place your crown during the same visit. Your dentist will use cement that permanently attaches the crown to your tooth.

  6. Some dentists send dental impressions to a lab that makes crowns. In this case, your dentist will place a temporary crown on your tooth until your permanent crown is ready. Your dentist will use cement that lasts for a few weeks or months.

  7. You will return to the dentist’s office in a few weeks. Your dentist will remove the temporary crown.

  8. Your dentist will examine and test the crown for proper fit. This may involve grinding the crown to ensure a proper bite.

  9. Your dentist will place your permanent crown with permanent cement.

  10. You may need to return for painless adjustments of the crown to ensure a comfortable bite.

Will I feel pain?

Your comfort and relaxation is important to you and your care team. You may feel brief sharp pinches when your dentist injects your gums with local anesthetic. Ask your dentist if your gums can be partially numbed with a painless topical anesthetic before the injections. 

You may also feel pressure as your dentist prepares your tooth to receive a crown. Take a few long, deep breaths to help yourself relax. Tell your dentist if any discomfort does not pass quickly.

What are the risks and potential complications of a dental crown?  

Complications of a dental crown are uncommon, but any dental procedure involves risks and the potential complications. Complications may become serious in some cases. Complications can develop during the procedure or your recovery.

Risks and potential complications of a dental crown include:

  • Allergic reaction to the crown

  • Anesthetic complications, such as allergic reaction and nerve or blood vessel injury

  • Chipped or loosened crown

  • Infection in the tooth

  • Injury to the mouth

  • Loss of crown if it falls out

  • Sensitivity to heat and cold in the affected tooth

Reducing your risk of complications

You can reduce the risk of certain complications by:

  • Following activity, dietary and lifestyle restrictions and recommendations before your crown procedure and during recovery

  • Informing your dentist if you are nursing or if there is any possibility that you may be pregnant

  • Notifying your dentist immediately of any concerns after the procedure such as pain, fever, and difficulty chewing

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies, especially metal allergies if your dentist is using metal crown material

How do I prepare for my dental crown procedure? 

You are an important member of your own dental care team. The steps you take before your procedure can improve your comfort and outcome. 

You can prepare for a dental crown by:

  • Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Taking or stopping medications exactly as directed.

  • Telling your dentist if there is any possibility of pregnancy

Questions to ask your dentist

Having a dental crown procedure can be stressful. It is common for patients to forget some of their questions during a dentist’s office visit. You may also think of other questions after your appointment. Contact your dentist with concerns and questions before your procedure and between appointments.

It is also a good idea to bring a list of questions to your appointment. Questions can include:

  • How long will the procedure take? When will I go home?

  • What are my options for types of crown materials?

  • What restrictions will I have after the procedure? When can I expect to return to eating, work, and other activities?

  • What medications will I need before and after the procedure? 

  • How will you treat my pain?

  • How do I clean and care for my crown?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after my dental crown procedure?

Knowing what to expect can help you get back to your everyday life as soon as possible.

How will I feel after the dental crown procedure?

Your mouth, gums and tongue may feel numb for a few hours after your dental crown procedure. This is because the local anesthetic will take time to wear off. 

You may also feel some tenderness and your tooth may be more sensitive than usual to cold and heat for a few days or weeks after your procedure. Tell your dentist if these symptoms worsen or continue longer than a couple weeks because they can be a sign of a complication.

When can I go home?

You will probably go home and resume most of your normal activities immediately after a dental crown procedure. Your dentist may tell you to wait to eat and drink until after your anesthetic has worn off and you can feel your mouth and tongue again. This will help prevent you from accidentally biting your mouth or tongue. 

When should I call my dentist?

You should keep your follow-up appointments after a dental crown procedure. Call your dentist if you have any concerns between appointments. Call your dentist right away or seek immediate medical care if you have:

  • Bleeding

  • Breathing problems such as shortness of breath, difficulty breathing, labored breathing, or wheezing

  • Fever

  • Pain in your gums or teeth

How might a dental crown affect my everyday life?

A dental crown can help prevent the loss or extraction of a severely damaged or diseased tooth. It will also help protect your tooth from further damage. A dental crown can help you feel better about your tooth’s appearance. 

A dental crown requires daily care just like a normal tooth. A crowned tooth can still develop decay so you should continue to brush and floss your teeth every day. Visit your dentist for regular cleanings and X-rays to ensure that your crown still fits well. Your dentist will also check that the tooth underneath the crown is still free of decay.

Crowns experience wear and tear and eventually need replacement, generally after five to 15 years. Ask your dentist how long your dental crown should last. 

Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 11, 2016

© 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Cavities. Mouth Healthy by the American Dental Association. http://www.mouthhealthy.org/en/az-topics/c/cavities.aspx.
  2. Crowns. Colgate Oral Health and Dental Resource Center. http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Checkups-a....
  3. Crowns. Mouth Healthy by the American Dental Association. http://www.mouthhealthy.org/en/az-topics/c/Crowns.aspx.
  4. Dental Crowns. The Cleveland Clinic. http://my.clevelandclinic.org/services/cosmetic_dentistry/hic_dental_crowns.aspx.
  5. Tell Me More About Dental Crowns. Colgate Oral Health and Dental Resource Center. http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Checkups-a....
  6. What are Dental Crowns and Tooth Bridges? Colgate Oral Health and Dental Resource Center. http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Checkups-a....

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