Crowns

The purpose of a crown is to replace the structure, function and/or esthetics of damaged or defective teeth. Crowns are all-ceramic, highly esthetic restorations that fully cover and protect a tooth, and often its nerve, from future damage.

To prepare a tooth for a crown, the visible portion is reduced in all dimensions (360°) by 1-1.5mm. All damaged tooth structure (including decay, fractures and old fillings) is removed.

Tooth structure that needs to be replaced, to aid in the retention of the crown, is called the "buildup."
Sometimes, fractures decay and old restorations extend under the gum line.

In this case, a laser is required to remove the gum tissue so that healthy tooth structure can be exposed and prepped. This process is called a "gingivectomy."

Scheduling

Crown appointments are almost always scheduled in pairs. The first appointment is for "prep", while the second is to "seat" the crown.

The prep appointment for a single crown will generally be 60-90 minutes with each additional tooth be prepped adding about 20 minutes. Seat appointments are usually scheduled for 30-40 minutes, with each additional crown adding about 20 minutes.

Patients will normally be numbed with an injection of local anesthetic at both appointments for their comfort. Two or three injections are often needed with normal effects ranging from 2-12 hours post injection.

Sensitivity

One possible result from the process of removing the bacteria associated with decay and/or fractures from teeth is sensitivity after the procedure.

After a period of months this sensitivity tends to subside or resolve completely. In cases where a tooth is still "sensitive" and the crown is fine, the sensitivity is derived from nerve damage caused by the process of removing bacteria and/or bad tooth structure that was present prior to the procedure.

In cases where the sensitivity is more than a patient would like to deal with, we recommend devitalizing the tooth by removal of the nerve.

A root canal removes the nerves from teeth which can eliminate discomfort and sensitivity almost immediately.

Aftercare

It is okay to eat and drink, but keep in mind that sensation to biting forces and temperature is impaired. Please be careful.

Almost all discomfort associated with dental procedures postoperatively is due to the injection/s and/or trauma to the gum, and not the actual procedure to the tooth itself.

Swelling, bruising and generalized discomfort at the injection site as a result of soft tissue trauma are common for up to 10 days. The discomfort may radiate and spread. Most patients feel little or no discomfort by the following day.

It a gingivectomy is needed, the gum tissue around the crown can be sore tor 7-10 days.
For comfort, it is strongly recommended that all patients who are not contraindicated use 600-800mg of ibuprofen (Advil®, Motrin® , etc.) every 8 hours for as long as 5 days following crown appointments. It is best to take the first dose of ibuprofen before the anesthetic wears off.

Peridex™ antibiotic rinse should be used for 5 days before and after both appointments if multiple teeth are crowned.