I'm a Princess, Of Course I need a Crown...

Of Course I Need A Crown, I’m a Princess…

            In the old days, dentists learned a lot of jokes from their patients. Or their barbers. Today, however, we tend to get our humor from emails, Facebook tags and internet memes. Or, when in person, smartphone pictures.

            Technology has even changed the way we share laughs.

            There are several internet memes and pictures floating around regarding dental caps or crowns. The punchline usually being something to the effect; “Of course I need a crown…I’m a princess aren’t I?”

            As a tribute to this humor, let us examine who, what, and why one might need a dental crown. Whether you are royalty or not, crowns are a very common recommendation.

            There are quite a few things that can weaken teeth and prompt the necessity of what we dentists call a full coverage restoration. Full coverage is just a fancy way of saying that a tooth needs help splinting itself together while talking and chewing. Cavities, old fillings, traumatic fractures, root canals, and cracks are the most common reasons that teeth should be crowned.  There are also situations where front teeth can be capped for cosmetic reasons, such as poor alignment, bite problems, severe wear, trauma, and deep, dark staining.

            There are three main types of material that crowns can be made of. They are gold, porcelain, and a combination of the two called porcelain fused to metal. Cosmetically, porcelain is the closest match to natural teeth that we have. Porcelain can be layered in different shades and highly characterized to match almost anyone’s natural tooth color. Gold (alloy) crowns are extremely durable and conservative, but suffer cosmetically when we smile or laugh. Porcelain fused to metal crowns were a traditional favorite, offering the strength of gold and almost as good esthetics as all-porcelain caps. Today, the advancement of digital dentistry and improvements in materials allow for most crowns to be made of some type of porcelain that looks just like a tooth.

            Earning a crown is usually a two visit process.  At the first visit, the tooth is cleaned up and all of the old cavities, cracks,and fillings are removed. Any voids are restored with a new filling material, called a core buildup. Some type of model (analog or digital) is recorded of the shaped tooth. A tooth colored temporary is then placed on the tooth to protect it until the dental lab returns the finished crown.  At the second office visit, the temporary is gently removed and the tooth is cleaned and desensitized. The crown is placed with a biocompatible cement that helps to prevent future cavities.

            The most important part of any dental work that we do actually takes place away from the office. Maintenance. The great part about a crown is that it feels, chews, and acts just like a normal tooth. In practical terms, that also means that it can get a cavity like a normal tooth. There are not metal or porcelain eating bacteria in your mouth. The crown can get a cavity on the natural tooth structure where the crown and tooth come together. That’s why it is very important to floss around existing crowns. Rinsing with fluoride also helps to keep the crown to tooth junction strong.

            Until next week, keep smiling.

-Please send comments to Drs. Parrish at www.ParrishDental.com.