A dental crown has one of the hardest jobs in the body. It has to take chewing force meal after meal, survive grinding, stay sealed against bacteria in a mouth that is always wet, handle ice water one minute and hot coffee the next, be gentle on the teeth it bites against, and still look like a natural tooth. That is why the material a crown is made from, and how precisely it fits, matter so much. At the Timonium office of Dr. Steven W. Haywood, DDS, crowns are made from high-quality porcelain, all-ceramic and tooth-colored, crafted from impressions of your own teeth.
This article looks at everything a crown has to endure, how today’s crown materials measure up, and what you can do to help your crown keep doing its job.
The job description of a dental crown
A crown is a cap that covers a damaged tooth. It restores the tooth’s shape, preserves the structure that remains and protects it from further damage and decay. Here is what that job asks of it.
Take chewing force, day after day
Back teeth grind and crush food many times at every meal. A crown has to spread that force across the tooth underneath without cracking, chipping or loosening. A weak or poorly shaped crown can concentrate stress in one spot and fail there.
Survive grinding and clenching
Many people grind or clench, often during sleep. Grinding and clenching place excessive force on teeth, wearing enamel away and introducing small cracks, and dental work is not exempt. A crown on a grinder’s tooth faces far more stress than chewing alone.
Stay sealed at the edges
The edge where a crown meets the tooth, near the gumline, is its most vulnerable point. If that edge wears or pulls away, bacteria can slip underneath and decay can develop on the tooth beneath the crown. A tight, smooth seal is as important as the strength of the crown itself.
Handle temperature and acid
Cold drinks, hot soup, citrus, soda and wine all bathe a crown. A good crown material doesn’t break down, dissolve or change shape with these swings, and it resists staining.
Be gentle on the opposing teeth
Strength alone isn’t enough. A crown that is rough or that hits too hard can wear down the natural teeth it bites against. That is why crowns are polished and the bite is checked and adjusted.
Look like a tooth
Natural enamel is not flat white. It has subtle color, a little translucence at the edges and texture that catches light. A crown on a visible tooth has to replicate the color and translucence of your natural teeth so it doesn’t stand out.
Be compatible with your body
A crown sits against gum tissue for years. It should not irritate the gums, cause reactions or contain materials you would rather keep out of your body.
How today’s crown materials measure up
No single material is perfect for every tooth. Here is how the common options compare, and what the practice uses.
All-ceramic porcelain
The practice specializes in all-ceramic, tooth-colored crowns made from high-quality porcelain. Porcelain can be shaded and layered to replicate the color and translucence of natural teeth, it resists staining better than resin, and it is well tolerated by gum tissue. Each crown is crafted personally for you from molds and impressions of your natural teeth.
Porcelain fused to zirconia or gold
For bridgework, where one restoration spans a gap and carries extra load, high-grade porcelain or porcelain fused to zirconia or gold is chosen to restore full strength and function. The practice’s bridges are all-ceramic and tooth-colored. See dental bridges.
Gold
Gold has a long history in dentistry and is strong and workable. It is available for inlays, but most patients prefer the more natural look of tooth-colored materials.
Composite resin
Tooth-colored composite is ideal for fillings and bonding, where it is sculpted directly on the tooth. It is not as strong as enamel and can pick up stains, so it is used for smaller repairs rather than as a full crown on a heavily loaded tooth.
Amalgam and other metals
Silver amalgam is a blend of metals held together with mercury. Metal can discolor and age teeth. Dr. Haywood never uses amalgam and is fundamentally opposed to the use of mercury in dental fillings. Read white fillings vs. silver fillings.
Why fit matters as much as material
The finest porcelain will fail if it doesn’t fit. Crowns at the practice are usually completed in two appointments, and much of that time goes into fit.
- Preparing the tooth. Damaged structure and any decay are removed.
- The impression. An impression of the prepared tooth guides the making of your crown. It dictates the crown’s precision, so more than one may be taken.
- The temporary. A temporary crown protects the tooth in between. Its size, shape and color do not resemble the final crown.
- Fit, bond and polish. At the second appointment, the permanent crown is checked for an ideal fit, bonded to the tooth and polished.
- The bite. If you feel you are biting first or harder on the new crown, a simple adjustment keeps the tooth from getting sore.
For more on the two-visit approach, read same-day crowns or two visits?
The tooth underneath still counts
A crown can’t get a cavity, but the tooth under it can, especially at the edge near the gumline. Healthy gums around a crown help keep that edge protected. And not every damaged tooth needs a crown at all: when only part of a tooth is damaged, a bonded onlay can restore strength while keeping more healthy tooth. Crowns are reserved for teeth that are extensively damaged, cracked or root canal treated. See are you an ideal candidate for a dental crown?
If the material itself is a concern, the practice restores teeth with non-toxic, metal-free and biocompatible materials, and avoids nickel and bisphenol plastics as well as mercury.
Helping your crown handle the load
- Clean the edges. Brush twice a day and clean between your teeth daily, paying attention to where the crown meets the gum.
- Protect it from grinding. Ask about a custom bite guard. Every style at the practice is clear, comfortable and made for you.
- Don’t use it as a tool. Avoid chewing ice or hard candy and opening packages with your teeth.
- Go easy on sticky foods. Caramel and taffy can tug on dental work.
- Keep your checkups. A cleaning and exam every six months lets a worn edge be caught early.
- Call if something changes. A crown that moves, a bad taste around one tooth or new sensitivity is worth a call. See loose crown? warning signs before it comes off.
Cost, insurance and financing
Your fee depends on the tooth and the restoration it needs, and it is discussed before treatment. The practice is out of network with all dental insurance companies: you pay at the time of your visit, and the office files the claim on your behalf so your plan can reimburse you for what it covers. Health savings and flex plans are welcome, and financing is available through CareCredit, with no-interest options up to 12 months, and Cherry, with plans from 3 to 24 months. See financing options.
Frequently asked questions
What is the best material for a dental crown?
It depends on the tooth, your bite and your priorities. The practice specializes in all-ceramic, tooth-colored porcelain crowns, which replicate the color and translucence of natural teeth.
Can a crown wear down my other teeth?
A rough surface or a crown that hits too hard can wear the teeth it bites against. Polishing the crown and checking and adjusting your bite help protect them, so call if a new crown feels high.
Can a tooth with a crown still get a cavity?
The crown itself can’t decay, but the tooth underneath can, usually at the edge near the gumline. Daily cleaning and regular checkups protect it.
Are porcelain crowns biocompatible?
Porcelain is well tolerated by gum tissue, and the practice never uses amalgam. If you have sensitivities, raise them at your consultation: restorations here are non-toxic, metal-free and biocompatible.
Protect a damaged tooth in Timonium
If you have a cracked, worn or heavily filled tooth, request an appointment or call (410) 453-9399. The office of Dr. Steven W. Haywood, DDS is at 108 W Timonium Rd, Ste 200, Timonium, MD 21093, serving Timonium, Towson, Hunt Valley and Baltimore. Learn more about dental crowns and all of restorative dentistry.
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Book a visit in Timonium to find out what your damaged tooth needs.
