Dental Crowns – The Ultimate Guide

A dental crown, also known as a dental cap is placed over a tooth to cover the tooth to improve its appearance by restoring its shape and size to strengthen it. It is a very popular dental restoration technique that can be applied either on a dental implant or the patient’s natural tooth. The dental crown completely encircles the tooth, protecting it from further damage or decay. In this article, we have gathered all the essentials about dental crowns to help you get a general idea of this popular dental treatment.

Who Are the Candidates of Dental Crowns?

There are two main types of candidates for restoration procedures using a dental crown:

1. Patients with Large Cavities

Patients with very large cavities often require root canal treatment, if the tooth’s pulp becomes infected. Once the root canal treatment is performed, the tooth can be safely capped with a dental crown. If left untreated, the tooth will most likely require extraction and a dental implant.

2. Patients Requiring Dental Implants

Most patients turn to dental implants when other treatment options have failed and the tooth needs to be extracted. Having a dental implant straight away after the tooth has been extracted is usually recommended, to prevent any bone loss in the area. Most crowns can be placed around 2-3 months after the dental implant procedure.

Apart from those 2 main groups of patients, ones who have poorly aligned teeth, severely discolored teeth, and destabilized front teeth are also the ideal candidates for the dental crown procedure.

READ: Dental Implants: Types, Pain, Cost

What Is the Procedure of Dental Crowns Like?

Most dental crown procedures require two separate appointments with the dentist, the only difference being that all-porcelain crowns can be placed in only one appointment.
When the patient’s tooth is used as a base for the crown, the dentist will begin by thoroughly cleaning it and removing any decayed parts from the tooth’s structure. Once that’s done, an impression of the tooth is taken – this impression will be used by a dental technician to create the dental crown. During the second appointment with the dentist, the final touches are done. After necessary adjustments have been completed, the crown is cemented with permanent cement or dental glue.

What Are the Types of Dental Crowns?

There are many types of dental crowns available. In restorative dentistry, patients get to choose between many types of materials and techniques. Each material has its advantages and disadvantages though, so it’s a good idea to do a bit of research and check some before and after pictures by type before visiting the dentist.

1. All-Porcelain Crowns

As the name suggests, all-porcelain dental crowns are made out of porcelain.

Advantages of All-Porcelain Crowns

• They Look Natural
Porcelain crowns perfectly imitate the patient’s natural tooth, including the enamel. This means that it reflects light the same way as a normal tooth would.

• They Are Aesthetically Pleasing
All-porcelain dental crowns fit smoothly and match your teeth' color perfectly, making them an excellent choice for restoring visible teeth such as the front teeth.

• They Are Non-Allergic
Porcelain is a biocompatible material, meaning there’s no risk of developing an allergic reaction from the dental crown. It may be more suitable for people with metal allergies. Gum irritation from all-porcelain dental crowns is also impossible.

• You Can Have the Crown Placed in Just One Visit
All-porcelain crowns don’t require multiple visits to the dentist – they can be done in one appointment, and it takes around 30 minutes to place the crown and cement it in place.

• They’re A Bit More Expensive
All-porcelain crowns are generally a bit more expensive than other types of crowns. If patients want to treat a more hidden tooth, it might be a good idea to opt for another type of crown.

• They May Be More Fragile
Generally speaking, porcelain is praised for its aesthetics, not its durability. All-porcelain crowns are less durable than porcelain fused to metal crowns, and they can withstand less pressure. This is one of the reasons why all porcelain crowns are usually applied to the front teeth and not the molars. These crowns also have a higher risk of cracking or chipping. Patients with all-porcelain crowns on their front teeth may need to avoid contact sports or very hard foods.

• Your Teeth Can Be More Sensitive
Porcelain as the material tends to expand or shrink when subjected to hot or cold temperatures. This means that you can experience hypersensitivity and discomfort when having very hot or very cold foods. Through expansion and shrinkage, cracks may also appear in your tooth, even with the crown applied.

• More Prep-Work Is Needed
Before a crown can be placed properly, the patient’s natural tooth needs to be reduced. All-porcelain crowns tend to require more tooth reduction than other materials. This is because porcelain is not as durable as other materials and, as such, the crown itself needs to be bigger.

2. Porcelain Fused to Metal Dental Crowns

Also called PFMs, this type of crown is made up of a metal shell over which a veneer is fused. The metal provides the crown with durability while the porcelain from the veneer helps the crown maintain a natural look.

Advantages of Porcelain Fused to Metal Dental Crowns

• Improved Durability
The metal component of PFMs provides these types of crowns with excellent durability and reliability, even when subjected to high amounts of pressure. Most porcelain fused to metal crowns lasts for many years before needing to be replaced.

• They Look Good
Like the all-porcelain crowns, porcelain-fused-to-metal crowns look most like normal teeth, apart from a small dark line where the metal and porcelain components meet.
This line usually goes unnoticed, when a less visible tooth is capped.

• PFMs Are More Affordable
Generally speaking, porcelain fused to metal crowns is less expensive than all-porcelain crowns.

Disadvantages of Porcelain Fused to Metal Dental Crowns

• The dark line where the metal and porcelain components meet can be a problem in some cases, especially when the front teeth are treated. For patients suffering from gum recession, this issue is even more visible. If a back tooth is restored, it shouldn’t be a problem either way.

• PFM Crowns Require Quite A Bit of Tooth Reduction
To be able to place the crown properly, the dentist will have to reduce some of the patient’s teeth. With PFM crowns, it’s less than with all-porcelain crowns but more than with zirconia crowns.

Despite some disadvantages, PFMs have been accepted as the gold standard for the repair of damaged teeth.

3. Zirconia Dental Crowns

Zirconia is a very durable ceramic dental material that has been in use for many years now. Zirconia is usually used for full ceramic restoration procedures. It is satisfied with esthetic requirements as well as fulfills functional requirements.

Advantages of Zirconia Dental Crowns

• High Durability
Zirconia crowns are extremely durable and more than capable of withstanding the pressures of biting and chewing. These crowns also resist better to high temperatures, and they don’t expand or shrink as much as all-porcelain crowns do. Zirconia crowns are stronger than PFMs and all-porcelain crowns, meaning they can be used for the front teeth as well as the molars.

• Zirconia Crowns Look Natural
Zirconia crowns are very similar to the patient’s natural teeth, and minor touches can be performed easily to better camouflage the crown.

• They Are Biocompatible
Zirconia crowns have the same benefits as all-porcelain crowns. Being biocompatible, they won’t cause an allergic reaction.

• They Require Less Tooth Reduction
Zirconia crowns require less tooth reduction before applying them to the patient’s tooth. This means that the risk of complications is also reduced.

Zirconia is the strongest crown; it can resist wear and tear. If you protect and take care of it well, it can forever stay in your mouth.

Complications of Dental Crowns Are Rare, But They Do Exist

Dental crowns are one of the safest dental restoration procedures in the world, but the risk of developing complications still exists, even if it’s to a low degree. Patients can develop allergic reactions to the materials used for the dental crown. This is very uncommon, but it can happen. All porcelain crowns and zirconia crowns are biocompatible, so the risk of developing an allergic reaction is close to zero. Other complications are related to the preparation process of the dental crown. If the dentist removes too much of the tooth’s structure, the tooth’s nerve may be damaged. If too little material is removed or the crown is not properly sealed, an infection can occur. In some cases, discomfort or sensitivity may also occur after the procedure. Sensitivity may develop against heat and cold if the tooth that has been crowned still has a nerve in it.

The Recovery Period of Dental Crowns Is Not Restrictive at All

There is no restrictive recovery period required for dental crowns. You can resume your daily activities just after the procedure is done. There are no dietary requirements either. There is no need to worry about harming the crowned teeth. Nothing can affect its strength if it is properly placed and cemented.

You Won’t Notice Your Dental Crown After A While

Having a dental crown is far from a burden. People won’t know the difference between your natural teeth and your crown. The materials used can mimic your natural teeth, so it doesn’t matter if you have a crown for the front teeth or the back teeth; nobody will be able to tell the difference.

Dental Crowns Cost May Vary from Country to Country

The cost of dental crowns is generally quite affordable, but prices do vary from country to country and depend on the materials used. Dental clinics in Turkey offer porcelain fused to metal dental crowns for as cheap as €180, while clinics in the USA may charge between €750 and €1,200 for the same procedure.

READ: How Much Does a Dental Crown Cost?

Dental Crowns Last A Great Deal Of Time

Dentists generally suggest 5-15 years of usage as an average for crowns. Although they have not been designed to last a lifetime, they can last several decades if they are maintained well. Good oral hygiene and a well-aligned bite will help their longevity.

Alternatives Are Available

If a dental crown is too expensive or not worth the hassle, patients may opt for different dental treatments such as dental bridges or inlays/onlays. It’s best to check with your dentist regarding which treatment type is more appropriate but generally speaking, dental bridges need to be replaced every 5 years or so, and the prep work is quite extensive.

READ: Best Dental Implants in Turkey – Real Savings

By Kubilay Aydeger - Medically reviewed by Dt. Musa Kaya, on Mar 30, 2024