Dental Crown Indications
Indications for Dental Crowns
Because of their quality and reliability, dental crowns have become very popular for the restoration and treatment of various dental issues. Dental prosthetics restore the outer layer of the teeth and act as the enamel. A dental crown provides an artificial protective cover for the internal components of a tooth, the dentin and the pulp. The crown prevents pain, sensitivity, and damage to the internal structures of a tooth.
Dental crowns also ensure a tooth’s proper function, especially after extensive dental work such as tooth canal treatments, tooth filling, and tooth replacement. The crowns provide a protective cover and provide a chewing surface for the teeth.
Other common reasons for dental crowns are cosmetic purposes. Dental crowns conceal natural tooth discolouration, tooth fillings with different colours, and misshapen or broken teeth.
In summary, the indications for dental crowns are root canal treatments, advanced dental caries or heavily filled tooth, tooth replacement or dental implants, aesthetic restoration, cracked teeth, dental realignment/ rearrangement, and crown replacements.
Dental Crown after a Root Canal Treatment
A root canal is an endodontic treatment that saves teeth by eliminating bacteria in an infected tooth and protecting the remaining tooth from reinfection. Infection, which mainly occurs after intense cavities, causes the pulp in the centre of the tooth structure to become inflamed. Dentists also recommend root canal treatment from teeth broken by trauma that exposes the pulp.
While a root canal saves the natural tooth, it also weakens the tooth structure. Usually, a dentist drills through the tooth to access the pulp before cleaning the tooth and applying a filling. The dentist also removes the decayed enamel and the dentin to prevent further deterioration. Even with filling, the remaining tooth cannot bear the dental forces of chewing.
Crowning a tooth that has undergone a root canal treatment is an effective way to improve function and prevent further damage. Notably, not all teeth treated with a root canal treatment need a crown. Teeth with sufficient tooth structure and less mastication pressure may not require dental crowns—for example, teeth at the front.
A dental crown strengthens and restores the chewing function of a tooth that has undergone a root canal. A dental crown also restores the tooth’s natural shape and aesthetic for patient confidence. Furthermore, crowning also protects the tooth from pressure and damage.
One of the most common indications for dental crowns is the replacement of an old or existing crown. On average, dental crowns last between 10-15 years. However, the longevity of a dental crown depends on several factors.
For instance, periodontal disease around a dental crown is a crucial reason to replace a crown. In most cases, inflammation occurs where the crown meets the gum. An infection could occur due to plaque accumulation, margin discrepancies in dental crown measurements, and an allergic reaction to the material used to make the dental crown.
Besides gum disease, dental caries is another indicator for a dental crown replacement. For example, if an adjacent tooth develops dental caries, it can infect the crowned tooth. In this case, the dentist has to remove the crown, treat the decaying tooth, and install a new crown.
Another reason for crown replacement is the development of cracks on the crown. Some materials used for dental crowns, such as porcelain, are brittle, which means cracks can occur, especially when the pressure is high.
The cracks expose the concealed tooth to infection because bacteria and food particles can penetrate the crack. In addition, if the tooth with a dental crown is sensitive, cold and, hot substances can cause sensitivity.
Sometimes, a dental crown replacement can help fix an aesthetic concern. As the teeth age or discolour, the darkening or stained appearance makes the crown stand out. The crown may often appear whiter or opaque in comparison. Furthermore, while dental crowns are designed to look like teeth, they may discolour over time.
In some cases, the crown may stand out due to a previous error during the dental crown preparation and cementation procedure. Corrective work may happen shortly after cementation of the crown to correct a mistake and ensure patient comfort.
In some cases, a patient may undergo a teeth whitening procedure. The other teeth may turn bright, but the crown may appear dull in contrast, hence the need for a dental crown replacement with a matching colour. Unfortunately, this also means that the patient must undergo whitening procedures in the future to keep the teeth in a consistent shade.
A cracked tooth is a common problem among children and adults. Small cracks may develop on the enamel and expand into the dentin. In most cases, teeth with minor cracks or craze lines function normally. However, if the cracks are extensive, patients may experience pain as they chew. This is called the cracked tooth syndrome.
Generally, teeth with filling and root canal treatments may develop cracks. For example, the molars have around five cusps which form the tooth’s shape and make chewing easier. These cusps can easily break off after extensive tooth treatment, such as a root canal. Other fractures may occur along the edge of the teeth, especially the teeth at the front.
Dental crowns on cracked teeth protect the underlying layers- the dentin and the pulp- from sensitivity. The crown prevents pain that occurs when a person bites down on the crack. Dentists may also install dental crowns for patients with healthy cracked front teeth to restore the appearance and smile.
If the cracked tooth has a cavity, dental caries, or is at risk of developing a disease, a dentist may first perform a root canal and cavity treatment. Once the tooth is safe, the dentist places a dental crown. Generally, if a crack develops below the gum line down into the root, extraction may be necessary.
Advanced Dental Caries
Dental caries, which causes cavities and sensitivity in teeth, is a common dental issue. Usually, when detected early enough, a dentist can remove the decayed tissue and prevent further infection. However, the extensive dental work on the tooth weakens the tooth.
A dental crown strengthens the tooth for chewing and also prevents pain from pressure and sensitivity. Crowns also protect the filling inside the tooth. The healthy part of the tooth remains concealed inside the dental crown.
Occlusal Derangement and Tooth Replacement
When a tooth is removed, and the space remains unoccupied for an extended period, shifting occurs. The teeth adjacent to the missing tooth often move forward to occupy the space. Upper and lower teeth can also move up and down. The movement also causes a shift in the jawline and the facial structure.
Teeth shifting further interferes with chewing because the stresses are not evenly distributed in the mouth. Patients may find themselves chewing on one side, which causes mastication pressure on one side of the mouth. Over long periods, the intense pressure causes problems such as tooth fracture and gum problems.
Tooth replacement or dental implants is an excellent solution for missing teeth. Dental implants act as artificial tooth roots to restore the bone and facial structure. There are tooth replacements for single and multiple teeth. Generally, an abutment is installed in the empty socket, and then a dental crown goes to the top to enable chewing and restore a natural appearance.
In some cases, a dental bridge or a series of dental crowns is used to replace missing teeth adjacent to each other. For example, an implant is installed in the first and third empty socket for three adjacent missing teeth. A dental bridge is then attached over the abutments to protect the implants and restore proper chewing and appearance.
The most extensive teeth replacement procedures replace an entire jawline. In this case, the dentist installs several dental implants across the jaw. Then, a dental bridge (a row of dental crowns) is installed over the implants to cover the abutments, restore chewing, aesthetic and function of the teeth, and maintain the facial structure. Contact us for more information
The shape, colour, and alignment of teeth affect the overall appearance of an individual. Dental crowns are useful for treating cosmetic issues. For instance, if a tooth has had extensive root canal treatment, a dentist may use a crown to cover the gaps, tooth discolouration, and tooth filling.
Crowns are also valuable for correcting alignment issues, especially in tooth length and bite at the front. For instance, dental crowns can be used to correct worn-out edges, especially in the front teeth. The teeth may be worn from food and beverages, the hard bristles of a toothbrush, or bruxism. Dental crowns preserve the teeth’ edges from further deterioration and restore the patient’s appearance.
Since dental crowns have material options, a patient can also have a dental crown to enjoy the appearance of metal alloys or gold crowns. Instead of aligning the tooth appearance, metallic dental crowns stand out as a style element.
However, before selecting dental crowns for aesthetic improvements, dentists may consider other treatments such as bleaching and veneering (see dental veneers). The recommended solution may also depend on dental disease. Routine dental check-ups and clean is essential to prevent dental caries under the dental crown.
Dental Crowns for Children
Paediatric dentists use stainless steel crowns to restore baby teeth. Stainless steel crowns are available in a range of sizes to fit most primary molars. Preformed stainless steel crowns for primary molars have been used since the 1950s. Since then these crowns have improved in duplicating the anatomy of the primary molar, they are easier to fit and they need less clinical time to be placed.
Primary teeth have different characteristics compared to permanent teeth. Amalgam and composite fillings commonly used in permanent teeth do not last as long in the primary dentition and stainless steel crowns have proven to last longer and prevent multiple restorations on the same tooth. Studies have shown stainless steel success rate is over 90% and are the restoration of choice for most paediatric patients.
According to Brisbane Kids Dentist Dr Soha Sharif, They are indicated for children with a high risk of caries, early childhood caries, children with special needs, medically comprised children, teeth with developmental defects or anomalies, infra-occluded teeth, cracked teeth, teeth with more than two surface caries, following kids root canal treatment, children with severe wear on their teeth.