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By Dr. Rob Gausmann, DDS  – Printed March 17, 2014

Q. My dentist says I need a crown. What is this and why do I need it?

A.  Although hearing this statement may bring about thoughts of royalty, palaces, and the finer aspects of life, this is not likely what the dentist is suggesting. Keeping teeth healthy and strong is the top priority in dentistry.  Oftentimes, a dentist will recommend a crown to achieve this priority.

A crown, often referred to as a cap, is a dental appliance that covers the entire visible portion of a tooth. The basic purpose of a crown is to keep a compromised tooth from fracturing or breaking apart. By covering the entire surface, no individual parts of the tooth are exposed. This essentially prevents the tooth from fracturing. If a tooth does fracture, it could cause a patient discomfort ranging from sensitivity to pain. In extreme cases it may require removal of the tooth.  Examples of compromised teeth include:

Teeth with large fillings or large cavities

Fillings are placed in teeth to replace damaged tooth structure caused by cavities. Sometimes these fillings are large and make up more than 50% of the tooth. Small fillings can develop cavities around them and require removal and replacement, therefore creating a large filling. Once teeth have large fillings they become more susceptible to fracture.

Teeth with fractures or broken pieces

Teeth can break for multiple reasons. Trauma can cause fractures, biting into hard objects, or even grinding and clenching can cause teeth to break. The most common part of a tooth to break is the cusp or “pointy” part. Once this breaks, it can cause the previously mentioned discomfort. A large filling is typically not the best treatment because the tooth will likely be more susceptible to fracture.

Teeth that have had the nerve removed (after a root canal)

Teeth that have had endodontic therapy (a root canal) are more susceptible to fracture.  Often teeth require a root canal because they are already compromised from a large cavity, previous fracture, etc…  In addition to the reason for the root canal, a portion of the tooth must be removed during the root canal process. This leaves a large portion of the tooth unsupported and more susceptible to fractures.

These are three of the more common reasons why a dentist may recommend a crown.  Other reasons exist such as cosmetic purposes, making a tooth taller or shorter, or making a tooth more stable for the attachment of a dental appliance - such as a partial denture. 

Crowns are custom fabricated for each individual tooth and can be made from several materials. Crowns may consist of all metal, metal with tooth colored porcelain, or all glass. Each of these crown types have advantages and disadvantages. The dentist can help determine which type of crown is best, based on the location and other characteristics of the tooth needing the crown.

Crowns may be more expensive than a large filling or removing the tooth, however, a crown is a much better treatment option when considering the longevity of the tooth. It should be considered as an investment to preserve overall dental health.

Dr. Rob Gausmann, DDS  – Gausmann Family Dental

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