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As we age, many of us find ourselves with teeth that are no longer structurally sound. Root canals, lost fillings, decay below a filling, chipping and cracking of the enamel are all things that can lead to large scale defects in a tooth’s surface. When the entire surface of the tooth is a problem, but the root system is intact, a crown might be just what the dentist orders.
Grinding your teeth, an improper bite, age, fillings and tooth decay can all be contributing factors in the wearing down, cracking or breakage of your teeth. Dental crowns cover the entire visible surface of your affected tooth and add strength, durability and tooth stability.
Expect to pay more for porcelain crowns because they are usually more time-consuming than gold crowns. Porcelain, porcelain over metal and gold crowns average between $600. to $3100. each in total cost.
The new reinforced resin or bonded all-porcelain type costs more than other types, require more skill from your dentist and the lab, and may exceed your insurance plan coverage for crowns.
Generally speaking, the price of dental crowns increases with the number of in-office treatments required by the patient. Dental insurance does not typically cover all the costs of the dental crown procedure.
Your cosmetic dentist will make an impression of the tooth and a dental laboratory will create the crown. You will typically leave the office with a temporary crown to wear while the permanent crown is being made – this takes about two weeks. The permanent crown is then cemented onto your tooth. Typically, only two visits are required for this part of the procedure. Often, a preliminary restoration of your tooth may be needed before a crown can be placed. To stabilize your tooth, a filling must first be put in place prior to placing a crown due to the loss of original tooth structure. dental crowns usually last ten to fifteen years.
Be sure to discuss with your cosmetic dentist that the cement color used for your permanent crown will be the same as used for your temporary crown. A try in paste is used for this purpose. The color of the cement does affect the overall color of a porcelain crown, so this needs to be discussed long before your temporary crown is placed.
In some cases your cosmetic dentist may choose to use a Flipper instead of a temporary crown. A Flipper is a false tooth to temporarily take the place of a missing tooth before the permanent crown is placed. A Flipper can be attached via either a wire or a plastic piece that fits in the roof of your mouth. Flippers are meant to be a temporary solution while awaiting the permanent crown.
There are basically three types of crowns, those made of gold, ceramic crowns and ceramic-veneered gold crowns. Gold and metal-ceramic crowns are extremely durable and are normally used in molars, where the forces from chewing and grinding are most prevalent. Ceramic crowns are used primarily for front teeth, since they can best resemble the natural tooth color.
The new reinforced resin or bonded all-porcelain type of crown has the nicest appearance. This crown can be made from pure ceramic or a new reinforced composite resin, and is almost indistinguishable from natural teeth. The new bonding technology involved provides an exceptional bond to your tooth. It is metal-free, and thus satisfies the needs of patients with metal sensitivities. When correcting your back teeth with bonding, the cosmetic dentist will perform a tooth colored onlay. This type of procedure is used to correct only those parts of the tooth that are in need. This is a metal-free procedure.
Gold crowns are appropriate when appearance is not a priority to you. The gold metal is extremely workable making gold crowns a more precise fit than any other type. While there exists a slight possibility of chipping with porcelain crowns, gold crowns provide no such possibility.
For a very natural appearance, porcelain fused to metal crowns are the answer. However, they have a metal substructure and require an opaque below the porcelain. This can make the translucency of natural teeth difficult to replicate. Occasionally a darker line will be visible at the edge of the crown, near to your gum when it recedes with age.
Types of Porcelain
There are basically two types of porcelain you’re likely to hear and read about most – the felspathic and pressed ceramic porcelains. The felspathic type is the original method that has been around for 20 years. A Ceramist in a dental lab bakes porcelain onto tin foil and then heats it in an oven. The Ceramist is able to create tints and opaques inside the porcelain to give the natural look we seek.
Pressed ceramic is created from a single ingot. The single ingot is milled in one piece to create the desired shape. The stains and opaques are applied only to the surface of the porcelain to give a natural look.
Expect to pay more for porcelain crowns because they are usually more time-consuming than gold crowns. Porcelain, porcelain over metal and gold crowns average between $600 to $3100 each in total cost.
The new reinforced resin or bonded all-porcelain type costs more than other types, require more skill from your dentist and the lab, and may exceed your insurance plan coverage for crowns.
Generally speaking, the price of dental crowns increases with the number of in-office treatments required by the patient. Dental insurance does not typically cover all the costs of the dental crown procedure.
Dental crowns in general add a good deal of strength to weakened or worn teeth. Depending on your habits and the condition of your gums, there can be some drawbacks. Your cosmetic dentist will advise which is best for you given many factors, including how important appearance is to you. The following are the advantages and disadvantages of the most common crown types.
Advantage: The preparation of a tooth for a gold crown is the simplest and least complicated preparation as there is minimal tooth structure removal with as much as possible of the healthy tooth structure remaining untouched. While porcelain is hard by comparison, it may cause wear on opposing teeth over the years where gold is not as likely to do so. Gold is also easier to fit to the area where the tooth and crown meet for a better fit. Gold is also a healthier environment for the gum tissue.
Disadvantage: The biggest disadvantage to gold crowns is the cosmetic aspect, unless it is being used in the back of your mouth.
Advantage: Porcelain crowns or new reinforced resin are considered to be the most aesthetically pleasing, as it is so easily matched in color to the surrounding teeth.
Disadvantage: The thickness of the porcelain required for pleasing aesthetics also requires that more tooth structure needs to be removed. It is more difficult for your cosmetic dentist to get an ideal fit where your gum meets the crown. Gingival inflammation appears to be more common with porcelain crowns than gold crowns. All-porcelain crowns require a higher skill level from your dentist and lab.
Advantage: Porcelain fused-to-metal crowns have a very natural appearance.
Disadvantage: They have a metal substructure and require an opaque below the porcelain. This can make the translucency of natural teeth difficult to replicate. Occasionally a darker line will be visible at the edge of the crown, near to your gum when it recedes with age.
When considering crowns a common question is how white the crowns should be. Usually, the answer is to whiten your natural teeth to either the level of whiteness you want or to the brightest they can be. Your cosmetic dentist will then have the crowns made to that color. Teeth are of course not monochromatic, so typically more than one color is used to create a very natural look. This color variation is critical in avoiding fake or artificial looking teeth. It is the internal contrast of colors that help create vitality. The internal play of light on the porcelain in the restoration helps to create this vitality. Surface texture is also very important, and helps to break up light reflections and make the crown look more natural.
There is no one standard system in the dental field to measure and determine tooth color. The most often heard about, however, is the Vita shade guide. This guide divides tooth color into four basic shade ranges:
In the A range there are five levels of darkness. Ranges B, C and D, each have four levels.
Not all of your teeth are the same natural color. Usually your eye teeth tend to be darker than the others, your front teeth are typically the whitest, and molars tend to be a shade between the two. The goal for everyone is to achieve their individual optimum whiteness while still looking natural.
Most dentists will show you a shade chart (like the above mentioned Vita Shade Guide) for you to pick from. Keep in mind, with a good cosmetic dentist this is merely a starting point. Other considerations when determining the color of crowns for each patient are your complexion, hair color, the color of your natural teeth and even your eye color.
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