A crown, also known as a “cap,” restores a badly decayed or broken down tooth to its natural shape and function, and in the case of porcelain or ceramic crowns, it can also restore the natural look and color of the tooth. A porcelain crown can also go on top of an implant to replace a missing tooth.
The most commonly used type of crown is called a PFM (it stands for Porcelain Fused to Metal). A PFM has an inner layer of metal that varies in its content of gold (base metal for low, semiprecious for medium and high noble for high gold content), with an outer layer of porcelain that chemically bonds to the metal, making it both durable and esthetic. On a scale from 1 to 10 in esthetics, you can expect most PFMs to fall right in the middle. They are a good balance between durability, strength, and esthetics.
Another popular type of crown as of late is the all-ceramic crown or porcelain crown. These restorations, while being metal-free, provide an excellent alternative to crowns containing metal for those discerning patients that expect the best cosmetic result possible. Dental technology has advanced at a rapid pace in the last few years, making metal-free restorations available not only for front teeth but also for the more demanding needs of posterior teeth where the most stress is placed on teeth.
Another not so popular but very effective type of crown is the all-metal crown, classified as well on a varying degree of gold content. While not very esthetic, the gold crown is still the standard to which all other crowns are compared due to its longevity, strength, and biocompatibility.
The choice of the crown should be made together with the dentist. Factors such as remaining tooth structure, type of bite, available space, esthetic requirements, cost, and even allergies may help narrow the options for treatment. In the end, you should choose the type of crown that best fits your personal needs. What may be suitable for one person may not necessarily be the best for another.
The cost of a crown varies greatly depending on the choice of material and whether there’s a specific cosmetic requirement. You can expect the cost of a single tooth crown to be in the range of $800-1500. Additional procedures may be needed depending on the conditions found during clinical treatment (i.e., buildup). The doctor will advise you whether these other procedures should be expected and the cost they carry with them.
The short answer is no. You will be numb during the whole procedure, so pain is a non-issue. Only a mild initial discomfort can be expected during the numbing procedure as the tip of the needle pinches the gum, and that’s about it! After the numbness goes away (usually after an hour or so), some discomfort can be expected as the tooth adjusts to changes in temperature, as well as some tenderness around the gum, but this shouldn’t last more than 24-48 hours.
After anesthetizing (numbing) the area, the cavity or fractured tooth is cleaned out, and the tooth is reduced on all surfaces so that the crown can fit over it. A putty impression or mold is made of the prepared tooth and sent to the lab for the crown fabrication. This can take up to 2-3 weeks, and that is why a temporary acrylic crown is fabricated and temporarily fitted on the tooth to wear during this time. On your second visit, the temporary crown is removed, and the permanent one is cemented on the tooth.
Two visits are necessary to complete a crown. Your first visit would be the lengthiest one, as this is when most of the work takes place. This visit should last about an hour. Your second visit for the permanent placement of the crown once it’s returned from the lab usually takes place about two weeks later and lasts between 10-20 minutes.
Porcelain crowns have been serving patients successfully for many years. The choice of material may affect the longevity of your crowns, but when given proper care and maintenance, crowns can be expected to serve functionally for about 15-20 years. However, even though a crown may still be completely functional (that is there’s no caries, no sensitivity, protects the tooth and fully functions when chewing), the aesthetic appearance may have deteriorated over the years. As it so happens when we age, gums recede, and crowns may lose their luster some ten years or so after their placement.