Top 10 Questions about Crowns

Dental crowns are one of the most common procedures performed in the dental office. Also called caps, crowns are necessary to restore broken, weakened, or decayed teeth back to normal function.

Despite being very common, patients still have many questions about dental crowns. According to Google, here are the top 10 questions asked about dental crowns.

Are crowns painful?

Sometimes.

The degree of discomfort associated with a dental crown usually depends on the reason the crown is necessary. The nerve inside the tooth is irritated and inflamed by large cavities and cracks. When a crown is done to remedy these types of problems, the nerve will remain irritated for a short time during the post-op period.

Your dentist should address any lingering pain or discomfort from a dental crown (lasting longer than 2 weeks). Normal post-op pain will dissipate slowly on its own over about 2 weeks. Pain that persists or worsens after the crown placement is not normal and needs evaluation by your dentist.

The most common cause of post-op pain from a dental crown is a bad bite. The way the teeth come together is very important. When an upper and lower tooth meet in an improper bite, the nerve inside the tooth becomes irritated. This irritation is reversible. A bad bite creates sensitivity to cold and tenderness on chewing. When the bite is off, the dentist can adjust the crown to correct the problem.

Another common cause of post-op pain from a dental crown is irreversible inflammation of the nerve. The initial injury to the tooth (either decay or a crack) may have caused irreversible damage to the nerve. In this case, a crown alone will not treat the tooth. The damaged nerve requires removal with a root canal treatment.

Are crowns necessary?

In certain cases, yes.

When, for any reason, a tooth does not have enough intact enamel to support normal function, a crown is necessary to restore it for long-term use.

Some of these reasons include:

  • Large cavities – A tooth with decay that caused large holes in the tooth, especially on the outer walls of the tooth, is too weak for normal chewing. This situation requires a crown to enable a return to normal chewing.
  • Cracked teeth – A healthy tooth is completely covered by enamel. The way enamel develops on a forming tooth is in a solid sheet, like one continuous piece of glass. Once a crack develops, the enamel becomes weak and is no longer protecting and preserving the tooth during chewing forces. A crown replaces the enamel and creates a new, solid protective coating for the tooth.
  • Root canals – A tooth that has had a root canal is weak. Root canals remove the nerve and blood vessels from the hollow core of the tooth. This means the tooth no longer has a source of hydration. It quickly becomes dry and brittle. A tooth that has had a root canal is much more likely to break. A crown covers the tooth to prevent cracking or breaking.

Are crowns permanent?

Yes.

In general, a crown is the final restoration of a tooth. It restores the tooth to full function after decay, fracture, or a root canal.

This does not mean that once a tooth has a crown, it will never require future dental work. A crown requires maintenance, just like your teeth. A tooth with a crown can get a cavity. A tooth with a crown can get periodontal disease.

A crown made correctly by the dentist and maintained properly by the patient can last forever.

Are crowns covered by insurance?

Yes.

Almost all dental insurance plans provide some coverage for dental crowns. The amount of coverage varies by plan. The most common benefit is 50% of the cost of the crown. The patient must pay the other half of the crown fee.

Some insurance plans require a waiting period on major dentistry, and a crown is major dental work. If your plan has a waiting period, you will not receive benefits on a crown until after the waiting period has passed.

Many insurance companies also require some type of proof that a crown is necessary to restore a tooth. This “proof” typically includes an x-ray, a photo, and a short explanation by your dentist.

Are crowns considered cosmetic?

No.

Crowns are a necessity. In many cases, they produce a more cosmetic result than the original tooth. This is just an added bonus. As discussed above, a crown restores a weak or broken down tooth back to normal function. This means a crown is a functional restoration, not a cosmetic restoration.

Crowns sometimes make cosmetic changes to a tooth or teeth. This is not their primary function, though.

Are crowns supposed to fall off?

No.

Once a crown is cemented onto a tooth, it is not supposed to fall off.

There are several reasons crowns fall off.

  1. Cavities – A cavity at the edge of a crown (called the margin) causes a break in the seal between the dental cement and the tooth. A crown with a cavity under it will fall off.
  2. Saliva contamination during fitting – During the final cementation of a crown, the tooth must be kept dry. If saliva gets into the crown or on the tooth, the seal of the cement loses strength.  This makes a crown likely to fall off.
  3. A very short tooth – Our very back teeth are the shortest in height. Preparing a tooth for a crown requires lowering it. You can imagine that lowering an already short tooth makes it even shorter. Crowns that rest on very short teeth have a greater tendency to fall off. This is because there is less tooth structure for the crown to hold onto.

Can crowns be repaired?

No.

The most common types of crowns contain porcelain. Porcelain is a type of glass. It is very strong, but also very brittle. Porcelain is only capable of being replaced or repaired by heating it to 1400°F in an oven. Obviously, this cannot take place inside your mouth. Broken porcelain requires removal and replacement of the crown.

Can crowns decay?

Yes.

It is possible for cavities to develop at the edge (margin) of a crown.  As with cavities on natural teeth, plaque and bacteria can accumulate and cause cavities.

There are two important steps to ensure your crown does not decay: 1) Your dentist must properly fit the crown to your tooth.  2) You must keep it clean.

Do crowns look natural?

Yes.

There are many cosmetic dental materials available today to make crowns look as natural as possible. With metal-free crowns, we are able to recreate the color, translucency and shape of a natural tooth as closely as possible.

To guarantee the most cosmetic result with your crown, make sure to communicate to your dentist the goals you have for a beautiful smile.

How are crowns fitted?

The process of fitting (or delivering) a final crown to your tooth is a simple one. We remove the temporary crown and clean the tooth surface. The final crown is placed onto the tooth, and an x-ray is taken.

The x-rays shows the way the crown fits against the sides of the tooth. The dentist confirms that the x-ray shows a good fit and makes any necessary adjustments to the flossing areas and the bite until the crown feels perfectly comfortable.

The tooth is dried to remove any saliva contamination, and the crown is placed on the tooth with dental cement. Once the cement has set, we clean the excess and recheck for the proper fit.

Do you need a crown?

Call us today to schedule a consultation with one of our skilled doctors. They will explain the process in detail and answer any other questions you have about crowns.