Every day at the dental office I either make or break a person’s day when providing the results of regular dental check-ups.
One of the frequent conversations that results in a look of despair on someone’s face is the dreaded words: “The tooth needs a crown.”
A full-coverage crown is an important tool in our toolbox to provide long-term structural survival for a tooth. The procedure and fundamental reason of a dental crown is often misunderstood.
Dental decay is very common, and the resulting removal and fill of the diseased portion of the tooth always results in a less structurally stable tooth. (Think a pot hole in the road.) The smaller the amount of decay (pothole), the smaller the filling (asphalt patch). Small holes and small patches work well and last many years. Large holes, breaks or cracks when filled with filling material leave the tooth structurally unstable and prone to catastrophic breaks in the future. It is our job as dentist to let you, as patients, know when a tooth is ready for a crown.
Indications that we look for are the amount of natural tooth that has been removed and is now filling material, additional decay, cracks, symptoms (biting pain, cold sensitivity), history of breaking teeth, biting forces, esthetics and many other factors.
The goal of a crown is to protect the tooth from further breakdown, restore the contours and biting (or smiling) function. This is accomplished by “capping” the entire tooth. If you think of a tooth as a peanut M&M, we are restoring the candy shell. If you were to try to squeeze and break a M&M in your fingers, it would be very difficult. Once that candy shell is compromised it becomes much easier to crush it. In this analogy the peanut inside the candy represents the pulp (nerve) of the tooth. It is our goal to protect that nerve, because if cracks or decay get to it, it means root canals, extractions, pain, $$$.
The crown procedure is accomplished by circumferentially removing about 1 mm of tooth in every dimension and replacing it with a new, strong outer layer. That outer layer can be made of different materials based upon the needs of the particular tooth. We offer three materials—gold (the most durable) or two porcelains (super strong but less beauty or weaker but incredibly beautiful). These crowns can be fabricated either in our office for a one-time visit or in the case of the gold and super strength porcelains, at the dental lab.
The crown is an important tool in our dental tool box. It allows for a long-term restoration of a tooth which has been structurally compromised by the very difficult environment that a tooth lives in. Waiting past the advised time for a crown increases the risk of catastrophic breakdown of a tooth.
While attending a dental coronation ceremony is never how anyone wants to spend their time, it will result in a long-term restoration of wearing teeth. If you look in the mirror and see large, old silver fillings with some dark crack lines propagating down the sides of the tooth, it may be time for you to become a dental king or queen with a new crown.
(Dr. Gregory Furdek of Kiel and New Holstein Family Dental is part of the Tri-County News’ Preferred Business program.)