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Caps and Crowns

A crown fits over the entire top of the tooth. A crown is needed when a filling just will not work. A crown may be made of gold, porcelain fused to gold or non-precious metal, white porcelain, or indirect composite. Dr. Gaba recommends using non-metal crowns in most case. The specific material will be chosen based on strength, biocompatibility, and aesthetics.

There are many situations that may call for a crown:

Large decay

If a tooth has decay so deep and large that a filling will not stay, or if the tooth structure is weakened, a crown may also be placed on the tooth to save it.

Large old fillings

When large old fillings break down, or get decay around them, they usually need to be crowned. It is important to crown a tooth that has been structurally weakened to prevent a cracked or broken tooth. Once a tooth breaks, it may not be possible to save it.

Cracked tooth

When a tooth is cracked, a filling will not seal the crack. A crown has to be placed over the tooth to hold it and the crack together. If a crown is not placed on the tooth, the tooth will become sensitive to chewing pressure, or will eventually break. It is important to crown a cracked tooth before it breaks, because in some cases a broken tooth cannot be crowned and must be extracted.

Broken/Fractured tooth

Sometimes a tooth that has broken is too weak to hold a filling. A crown will hold the tooth together and prevent it from breaking again.

This patient chose not to have the cracked tooth above crowned, and it later fractured. This tooth had to be extracted because it cracked all the way to the root.

Sensitive teeth

Teeth that are very sensitive, either from a lot of “wear,” or from receded gums, sometimes require crowns to seal and protect the teeth from hot and cold sensitivity. Although Dr. Gaba may recommend composite restorations combine with homeopathic remedies as an initial treatment plan.

In cosmetic dentistry, crowns (sometimes called “caps”) are rarely used since the advent of veneers, but in some cases a crown may be necessary for a particular tooth. A tooth with a bad fracture or a large filling may be a candidate for a crown instead of a veneer.

 

Before: This tooth has a large filling as shown. A crown is needed on this tooth, instead of a veneer, because there aren’t enough natural teeth left to support a veneer. A crown will cover and protect the tooth, but will look the same as a veneer.

After: The top teeth now have veneers, except the one with the large filling, which has a crown.

Enamel Safeguard Rating (Crowns or remaking crowns): 5 to 0- rating base also on the damage during initial preparation of the tooth. Once the enamel is re prepared for another crown, even more tooth structure must be removed.

The first criterion that one should choose in choosing a procedure to improve the appearance of the tooth is one which does the least damage to the tooth for the greatest improvement.