Nobody really enjoys going to the dentist. So, if you’ve just been told that you have to undergo a dental crown procedure that will require multiple visits over several months, nobody could blame you for feeling a little bit nervous.
Well, don’t worry. Getting a crown does involve repeated visits to the dentist, but most of them will be short and painless. In order to reassure you, we’ll use this blog to outline the procedure and explain what, exactly, is involved.
What is a Dental Crown?
Your dentist will recommend a dental crown if you have a tooth that is visibly damaged by decay or chipping, but whose root is still viable. A crown is basically a cap that is fitted over the damaged tooth to protect it.
Caps can be made out of materials such as porcelain, gold, metal alloys, acrylic, and ceramic. They are modeled on the tooth to be capped and shaded to match the rest of your teeth (unless you choose gold or metal alloys, of course). This means the cap is indistinguishable from your natural teeth. Here is what you should expect when getting a tooth crown:
Step 1: Numbing the Tooth
The first step in the procedure is to numb the tooth using a local anesthetic. Once the tooth is numb, the dentist and their assistant can start to take impressions and prepare the tooth for the crown.
Step 2: From Chair to Lab
In order for your crown to fit properly and look natural, the dentist needs to send a model of your whole mouth to the dental laboratory that will manufacture it. To make this model, an impression of your teeth is taken. A horseshoe-shaped rubber tray that will fit over your teeth is filled with an impressionable material like alginate. This is then pressed firmly onto your teeth, creating an impression, which is then filled with a modeling material.
Once this has hardened, the dentist will have a perfect model of your mouth to send to the lab. A smaller impression of just the tooth that needs to be crowned will also be made at this time. This will be used later to provide you with a temporary crown.
Step 3: Finding Exact Shade
The dentist will then record the exact shade of your teeth using a shade guide. This is important if the crown is to be unnoticeable.
Step 4: Preparing the Tooth
This is where the process gets a little uncomfortable. In order for the crown to fit properly, the damaged tooth beneath it needs to be reduced. The crown itself is a model of your tooth with a hollow inside which fits over the core of the tooth that is left after it has been reduced. The crown needs to fit tightly and securely to seal off the core and prevent bacteria from entering.
To prepare the tooth, the dentist needs to remove the exact amounts of the tooth and any old filling material. It is quite common to discover new areas of decay during this step of the process. If this is the case, the dentist will clean out all the decayed material and fill the core with a composite material. If you had a root canal treatment this will also require a composite core.
Once any repair work has been taken care of, the dentist will continue to remove material from the tooth. This is taken from the top, biting surface, and the sides of the tooth, leaving a little shelf or margin around the core for the cap to sit on.
This is the most important step in the procedure and it also takes the most time to complete.
Step 5: Impression of the Prepared Core
Once step four is completed, an impression of the prepared core will be needed. This will be used to model the inside cavity of the crown, ensuring it fits like the proverbial glove. Even the slightest inaccuracy can result in an ill-fitting crown, so follow the dentist’s instructions to the letter.
First of all, the dental assistant will apply a polyvinyl siloxane material around the tooth. The impression tray is filled with a corresponding material and placed over the prepared tooth. You will then be asked to bite down on this so it is pushed down on the core, creating an exact impression. You’ll have to concentrate hard here as you should maintain the bite for at least 5 mins as the material dries without the slightest movement of your teeth.
When the material sets, the dentist will remove the tray from your mouth and inspect the impression for any flaws or air bubbles. Sometimes this step has to be repeated multiple times before a satisfactory impression is made.
Step 6: Temporary Crown
While your permanent crown is being prepared in the dental laboratory, your tooth still needs some protection. This is why you’ll have a temporary crown fitted until the permanent one is ready.
The dentist or their assistant will fill the small impression of your tooth that they made earlier with acrylic resin and place it over your tooth. Once this has set, usually two to three minutes, the mold will be removed from your mouth. The dentist will shape the temporary crown and smooth any rough edges. Then they will fix it in position with temporary glue.
A temporary grown is very important to maintaining your tooth’s health prior to permanent capping. Most of the enamel has been removed from your tooth during the preparation stage. This leaves the dentin exposed, making the tooth hypersensitive to temperature and any pressure that might be put on it. The temporary crown protects the dentin and prevents infection while you are waiting for your permanent crown bearable.
It also holds the core in place and prevents shifting. If the core shifts, the crown will not fit properly. This is why you absolutely must follow your dentist’s instructions for wearing a temporary crown. And if it becomes loose, you should go to your dentist immediately to have it glued back in place.
Step 7: Cementing the Permanent Crown
Once the dental laboratory has completed the permanent crown, usually a week to ten days after your initial visit, it will have to be fitted. This dental crown procedure will begin with numbing the tooth and surrounding area. Although it is already prepared, your tooth will need to be thoroughly cleaned before the crown is fitted.
The dentist will remove the temporary crown, clean all traces of glue from your tooth and dry it. The dentist will then place the crown over the core, checking the fit and making any adjustments necessary to ensure that it is right.
Once they are satisfied that the fit is right, the crown will be cemented into place. After 10 mins, when the cement has set, your bite will be checked and any excess material removed. And that’s it. Now, as long as you follow your dentist’s instructions, you have a perfect smile again, and no more pain or sensitivity to worry about. We hope you found this blog helpful, but if you need more information, contact us at Doral Sedation Dentistry and we’ll be happy to help.