Do you need a crown?

Are you aware of all the different options?

A dental crown is a tooth-shaped "cap" that is placed over a tooth -- covering the tooth to restore its shape and size, strength, and/or to improve its appearance.

Currently our crowns vary in cost from €500 to €800
The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line. 

Why Is a Dental Crown Needed?

1. To protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth
2. To restore an already broken tooth or a tooth that has been severely worn down
3. To cover and support a tooth with a large filling when there isn't a lot of tooth left
4. To hold a dental bridge in place
5. To cover misshapened or severely discolored teeth
6. To cover a dental implant

What Types of Crowns Are Available?

Permanent crowns can be made from all metal, porcelain-fused-to-metal, all resin, or all ceramic.

1. Metals used in crowns include gold alloy, other alloys (for example, palladium) or a base-metal alloy (for example, nickel or chromium). Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum. Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, metal crowns rarely chip or break. The metallic colour is the main drawback. Metal crowns are a good choice for out-of-sight molars.
2. Porcelain-fused-to-metal dental crowns can be colour matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown's porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown's porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth.
3. All-resin dental crowns are less expensive than other crown types. However, they wear down over time and are more prone to fractures than porcelain-fused-to-metal crowns.
4. All-ceramic or all-porcelain dental crowns provide the best natural colour match than any other crown type and may be more suitable for people with metal allergies. However, they are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.

What Steps Are Involved in Preparing a Tooth for a Crown?

Preparing a tooth for a crown usually requires two visits to the dentist, the first step involves examining and preparing the tooth, the second visit involves placement of the permanent crown.

1. First Visit: Examining and preparing the tooth. At the first visit in preparation for a crown, your dentist may take a few X-rays to check the roots of the tooth receiving the crown and surrounding bone. If the tooth has extensive decay or if there is a risk of infection or injury to the tooth's pulp, a root canal treatment may first be performed.
   Before the process of making your crown is begun, your dentist will anesthetize (numb) your tooth and the gum tissue around the tooth. Next, the tooth receiving the crown is filed down along the chewing surface and sides to make room for the crown. The amount removed depends on the type of crown used (for instance, all-metal crowns are thinner, requiring less tooth structure removal than all-porcelain or porcelain-fused-to-metal ones). If, on the other hand, a large area of the tooth is missing (due to decay or damage), your dentist will use filling material to "build up" the tooth to support the crown.
   
   After reshaping the tooth, your dentist will use impression paste or putty to make an impression of the tooth to receive the crown. Impressions of the teeth above and below the tooth to receive the dental crown will also be made to make sure that the crown will not affect your bite. The impressions are sent to a dental laboratory where the crown will be manufactured. The crown is usually returned to your dentist's office in 2 to 3 weeks. If your crown is made of porcelain, your dentist will also select the shade that most closely matches the colour of the neighbouring teeth. During this first office visit your dentist will make a temporary crown to cover and protect the prepared tooth while the crown is being made. Temporary crowns usually are made of acrylic and are held in place using a temporary cement.
2. Second Visit: Receiving the permanent dental crown. At your second visit, your dentist will remove your temporary crown and check the fit and colour of the permanent crown. If everything is acceptable, a local anaesthetic will be used to numb the tooth and the new crown is permanently cemented in place.

How is the cost of the crown determined?

There are many factors to costing a crown

1. Surgery time and Prepartion materials used
2. Postage/Delivery to/from the Laboratory
3. Manufacturing materials in the Laboratory

The surgery time, preparation materials and delivery costs are the same for every type of crown. Discussing different types of crown and choosing a less expensive option can reduce the cost of the crown.

1. An all ceramic crown is made using cad cam technology and is very technique sensitive. As such it is the most expensive of the porcelain crowns. The aesthetics of these crowns are the best but they are more fragile than those bonded to metal
2. A full gold crown can be made from different types of gold and cost will be fully determined by the cost of alloy at that time. Currently the cost of gold is high so these crowns can be quite expensive.These crown are less aesthetic than a porcelain crown but involve less tooth structure being removed and are less prone to fracture
3. A porcelain bonded to metal crown can use three types of metal. There are varying costs for the different metals. The choices are in order of cost non precious metal, precious metal and bio gold. There are aestetic considerations with these choices and it would depend on which tooth was being crowned

The best policy is discuss the options with the dentist and decide together which best suits your needs and your finances.