Dental Crowns: Types, Procedure & Care

So, your Dentist has recommended a crown for one of your teeth. You might find yourself asking as a result:

What are dental crowns?
How are they made? and;
What options are available to you?

This guide will attempt to outline everything you might need to know about dental crowns to help you make informed decisions about your dental care.

HIGHGATE HILL DENTAL – Crowns: What are they, what’s involved and what types are there.

At Highgate Hill Dental Centre, we want to ensure that our patients have healthy strong and stable teeth. Due to various circumstances your tooth might become vulnerable to infection and/or further damage and may require more complex restorative work to return it to former glory. This restorative process involves crowning your vulnerable tooth and may be recommended to you by your Dentist. No, this doesn’t mean they your tooth will have a coronation ceremony. It does mean however that a more protective and bespoke helmet be fashioned for the vulnerable tooth.

An image of a dental crown being put on a tooth.

What are dental crowns?

Crown treatments are elective procedures that are performed to restore and protect significantly damaged and vulnerable teeth from decay, infection, and chewing forces. They are typically recommended when fillings in heavily restored start to fail, a tooth has undergone root canal therapy, or a tooth has cracked.

Crowns, as an object, are fabricated based off a mould of your own tooth. They are then fitted on top of the vulnerable tooth to essentially cap or “crown” the tooth. This crown or shell can absorb more of the chewing forces than the weaker tooth that the crown is now protecting. The goal of this process increases the lifespan of that tooth.

Additionally, the crown is fitted exactly to “your” tooth to create a strong seal that significantly reduced the chances of decay and subsequent infection. Crown’s also have the additional benefit of providing a level of cosmetic enhancement to the tooth depending on the material that is chosen to repair it.

What’s involved for you?

Visit 1: Duration (1h 30min) |The below is a very general overview of the process|

Step 1: First impressions and shade selection.

At the start of your crown procedure, your dentist will take an initial impression of the tooth that is being crowned. After which they will choose a shade for your new tooth and then provide you with local anaesthetic to numb that tooth and/or general area of your mouth.

Dental tools needed to create an initial impression of the tooth that is being crowned

Visit 2: Duration (30mins) |

Step 1: Temporary crown removal

Firstly, the temporary crowned tooth will be anaesthetised to ensure that this process is comfortable. Once the tooth is numb, the temporary crown is removed.

Step 2: Preparation and cementing

The tooth is then cleaned to remove excess temporary cement that might hinder the bond between your new crown and the tooth. Your new crown is then fitted without cement on top of your tooth to check the fit and your bite. Once your Dentist is happy with the fit, your crown is secured with a cement of your Dentist’s choosing on top of your tooth.

Step 3: Final adjustments

The Dentist will check your bite again and may make minor adjustments if they deem necessary.

How to prepare for your crown appointment?

To prepare yourself for this appointment we often suggest eating beforehand. We also recommend bringing some headphones so that you can listen to your favourite songs, podcasts or audiobooks during the procedure.

An image showing green ticks next to an icon of plate with fork and a spoon, and an icon of headphones.

How to care for your Dental crown

To ensure the longevity of your crown it is essential that you treat it like a regular tooth. That means maintaining your habit of brushing twice a day with a fluorite toothpaste and soft toothbrush and flossing regularly. It is also important that you regularly attend dental check-ups and cleanings as this can extend the lifespan of you crowns through early detection and intervention.

What types of dental crowns are there?

FULL GOLD CROWN

An image showing a golden tooth crown on a red pillow being held by a hand at the front of a royal building with royal guards playing musical instruments

Metallic crowns are one of the oldest types of dental crowns dating back to before 700 BC. Modern full gold crowns are typically made of metal alloys that include gold, but also mixed with nickel-chromium, or palladium.

Advantages	Disadvantages
The most biocompatible.	Gold/ metallic crowns are more expensive than alternative crown options due to the increased material cost.
More resistant to wear and tear	Gold/metallic restorations will not blend into your smile and are more noticeable than alternatives
Able to withstand high levels of pressure and force. This makes them particularly useful for restoring back teeth, where the force of chewing and grinding is greater.
Requiring less tooth structure to be removed to accommodate the crown. Since more tooth can be preserved they are usually recommended for those who have previously undergone extensive dental work already.

CERAMIC CROWN

An image of a ceramic tooth crown on a red pillow in front of a historical building

All-ceramic crowns are made for high quality ceramic materials which make them durable as well as aesthetically pleasing due to their resemblance to natural teeth. The ability to fashion a crown that mimics natural teeth more closely means that it is a more suitable selection for more visible teeth.

Advantages	Disadvantages
The highest aesthetics and most natural-looking restoration. It is frequently used for a front tooth restoration	However more prone to chipping or cracking if subjected to excessive force or pressure as the material is more brittle.
It is less likely to cause sensitivity due to temperature changes unlike metallic crowns.	More of the natural tooth may need to be removed to accommodate the crown which may weaken the underlying tooth.

PORCELAIN FUSED METAL CROWN

An image of a porcelain fused tooth crown on a red pillow in front of a historical building

Porcelain Fused Metal crowns (PFMs), combine the best qualities of metal and porcelain. The core of the crown is made of a durable metal (gold alloy or other biocompatible dental meta0s), while the external shell is covered with porcelain that mimics that natural appearance of a tooth.

Advantages	Disadvantages
The metal substructure of PFM crowns provides strength and durability,	The porcelain can delaminate from the metal over time.
The porcelain overlay provides a natural-looking and aesthetically pleasing appearance.	Wear on the opposing teeth over time, due to the hardness of the porcelain.
They are used in either front or back restorations because they combine durability with good cosmetic appearance	The metal substructure may be visible at the gumline, particularly if the gums recede

ZIRCONIA CROWNS

An image of a zirconia tooth crown on a red pillow in front of a historical building

Zirconia crowns are known for their high strength, biocompatibility, and resistance to wear and tear. It has a natural toothlike aesthetic, who’s aesthetics are only second to the eMax crowns.

Advantages	Disadvantages
Zirconia as one of the strongest materials used in dentistry which makes these crowns highly resistant to chipping and, cracking.	Less natural translucency than a ceramic crown which may affect the overall natural appearance of the crown.
Zirconia crowns can be colour-matched to the patient’s natural teeth, providing a highly aesthetic and natural-looking restoration.	More expensive than PFM crowns.
Less tooth structure is removed than a PFM crown however more tooth structure needs to be removed than a gold crown. This can be a consideration for the dentist assessing whether enough tooth structure is present for further work.
Zirconia is wear resistant which protects the crown and the opposing teeth from unnecessary damage.

Understanding Dental Crowns: A Key to Long-Term Tooth Protection