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Crowns

Treatment Overview

A crown(often called a cap) fits over and replaces the entire part of a decayed tooth above the gum line. It encases the tooth and becomes the tooth's new outer surface.

You may need two or more visits to your dentist to repair a severely decayed tooth with a crown.

Crowns may be made of porcelain or a metal base covered with a thin layer of ceramic that matches your teeth and looks like a normal, healthy tooth. Crowns for the teeth in the back of the mouth may be made of gold.

During your first visit, your dentist will take out the decay and make an impression of your teeth to create a mold used for making the crown. Your dentist will:

  • Numb your teeth, gums, tongue, and surrounding skin. Your dentist will first put a substance that feels like jelly directly on the area to start the numbing process, and then inject an anesthetic to complete it. Some dentists will give you nitrous oxide gas (laughing gas) to reduce your pain and help you relax.
  • Sometimes use a small sheet of rubber on a metal frame (rubber dam) to target the decayed tooth and stop liquid and tooth chips from entering the mouth and throat.
  • Drill out all the decay.
  • Take an impression of the decayed tooth. The mold will allow a technician to make a crown that perfectly matches the drilled tooth.
  • Cover the tooth with a temporary crown until your permanent crown is ready. Some methods do not require a temporary crown.

If you need a second visit, your dentist will:

  • Remove the temporary crown.
  • Cement the permanent crown to the damaged tooth.
  • Have you bite on a piece of carbon paper. This shows how well the crown is positioned. Your dentist may need to reshape and polish the crown.

What To Expect

Your lips and gums may remain numb for a few hours until the anesthetic wears off. To avoid injuring your mouth, be careful not to chew on your numb lip or cheek.

Why It Is Done

A crown is used to:

  • Treat teeth that have broken or decayed so much that your dentist cannot fix them with a filling.
  • Cover a tooth that is so severely damaged that most of the top part had to be removed.
  • Repair a defective filling.
  • Improve how a tooth looks.

Dentists sometimes use crowns after root canal treatment to seal the tooth and prevent it from breaking.

How Well It Works

A crown will work just like a healthy tooth.

Crowns sometimes come loose or wear out over time. So you may need to get a crown cemented again or replaced.

Risks

If tooth decay is right next to the pulp, the pulp may not be strong enough to make healthy dentin, which surrounds and protects the pulp. If this happens, your dentist or endodontist may have to remove the pulp, or an oral surgeon may have to remove the tooth root.

If you have certain heart problems, your dentist may prescribe antibiotics before a dental procedure. Some procedures can cause bacteria in the mouth to enter the bloodstream and cause infections in other parts of the body. The antibiotics lower your risk of getting an infection in your heart called endocarditis. For more information, see People Who Need Antibiotics to Prevent Endocarditis and Procedures That May Require Antibiotics to Prevent Endocarditis.

What To Think About

If the decay is near the pulp, your dentist may need to do a root canal before placing a crown. If the tooth cannot be fixed, it may need to be taken out (extracted). Then a bridge or implant can be placed. If the pulp dies after you get a crown, you will need a root canal to remove the dead pulp.

Credits

ByHealthwise Staff
Primary Medical ReviewerAdam Husney, MD - Family Medicine
Martin J. Gabica, MD - Family Medicine
Arden G. Christen, DDS, MSD, MA, FACD - Dentistry

Current as ofMarch 28, 2018


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