Family/Cosmetic & Implant Dentistry

Types of Crowns

Aren't all crowns alike?  Shouldn't I just shop around to find the best price and go there?
- The old saying, "You get what you pay for..." and "If it sounds too good to be true, it is..." are applicable here.  Among other things, the cost to do a crown is based on the skill level of the practitioner, the quality of his/her equipment/technology, and the quality of the materials used.  In essence, crowning or replacing a tooth is replacing a part of your body.  As such, care and consideration of these factors are very important.  Please consider:
  • SKILL  - The skill level and experience of the dentist is paramount.  Bad dentistry can lead to future problems.  Does this dentist stay abreast of the latest dental technologies/techniques and use only the best materials?
    • POORLY SHAPED CROWNS - can cause food traps that then lead to further decay and gum inflammation or gum disease.  Poorly shaped crowns can also alter your bite limiting your chewing ability and/or causing you to bite unevenly, thereby adding undo pressure to surrounding teeth and overtime, damaging them. 
    • POORLY FITTED CROWNS or crowns with open margins (where the crown edge meets the natural tooth) allow bacteria to seep underneath causing further decay, which can then lead to bigger problems.
  • MATERIALS - The materials chosen can make a huge difference in the longevity, durability and appearance of your crown.  Lesser quality materials means your crown may not last.  See below...
  • TRUST - Finding someone you trust is also key.  Is this dentist overly aggressive with their treatment planning?  Could you get by with a filling or partial crown/onlay instead?  Do they take the time to show you what they see by using intra-oral camera photos and high definition digital x-rays?  Do they explain the reason why the dentistry is necessary?  Do they back up their work and support preventive care?
Understanding the Difference Between Various Dental Crown MaterialsFor individuals with chipped, broken, severely discolored or decayed teeth, dental crowns may be a good option for restoring smiles.  Dental crowns are essentially caps that are sized and shaped to resemble a natural tooth.  They are placed over an existing tooth, which is filed down to hold the dental crown in place, or a crown can also be secured in place with a dental implant.

If you are considering having one or more dental crowns fitted as part of a dental treatment program, then understanding the difference between various materials used to manufacture dental crowns can make it easier for you to determine which type of crown material is right for you. 

Here are a few dental crown options to consider:
  • All Porcelain or All Ceramic –These dental crown materials offer the most natural look in your mouth, since they can be made to look just like real teeth.  For those people who are allergic to metal, or who prefer not to have metal crowns, all porcelain or all ceramic crowns are an excellent option.  However, there are differences in materials used.  
Note:  We use the CEREC Cad Cam same day crown system utilizing the best all porcelain materials available and eliminating the need for return visits and temporaries.  The new zirconium porcelain material make it a perfect choice for all teeth.  See:  CEREC
      • Very strong and durable.
      • Aesthetically pleasing.  Most natural looking.
      • IMPORTANT - No metal means the dentist is able to see through the crown in x-rays.
      • Excellent choice for patients with metal allergies.
      • Not all materials for all porcelain/ceramic crowns are alike and not all dentists are able to offer this option.  Quality of material used is key to durability and aesthetic success.
  • Porcelain Fused To Metal – To reap the benefits of the strength provided by metal dental crowns without the aesthetic drawbacks, another good option is a dental crown that has porcelain fused to the metal.  This provides a metal base for strength, but the exterior surface is porcelain, allowing it to more naturally blend in with your other teeth.
PROS -   
      • Long lasting and durable.
      • Aesthetically pleasing if the metal margin doesn't show through.
      • Because of the porcelain on the crown, this option is not quite as durable as a metal only dental crown, but it is still long-lasting and durable.
      • The metal margin beneath the porcelain shows through as a dark shadow or line at the edge, making the teeth not quite as “natural” looking as all porcelain or all ceramic crowns.
      • Many patients with metal allergies are not candidates for metal crowns.
      • Some patients are opposed to metal in the mouths.
      • IMPORTANT - Dentists can not see through a metal restoration in an x-ray (whether it is a crown/bridge or filling), thereby inhibiting his/her ability to diagnose or determine if there is a problem underneath.  However, they can still see the root of the tooth so an x-ray is still needed.
      • The quality of metals used in the crown can differ greatly and should be carefully considered.  
  • Metal – Metal dental crowns are among the strongest options, although their major disadvantage is their aesthetics.  The material used to create these types of dental crowns is a metal alloy.  The metal alloy can be a number of materials.
  • Long lasting and durable.  
  • Metal is clearly visible and not aesthetically pleasing.
  • Many patients with metal allergies are not candidates for metal crowns.
  • Some patients are opposed to metal in their mouths.
  • Some patients experience hot/cold sensitivity with metal crowns.
  • IMPORTANT - Dentists can not see through a metal restoration (whether it is a crown/bridge or filling) in a x-ray thereby inhibiting his/her ability to diagnose.  However, they can still see the root of the tooth so an x-ray is still needed.
  • The quality of metals used in the crown can differ greatly and should be carefully considered.
  • Resin – These are typically the least expensive option when it comes to selecting a dental crown material, but they come with the strong disadvantage that resin can wear down more quickly than other material types.  Resin dental crowns look good in your mouth, but will need to be replaced more quickly than other types.
BESIDES MATERIALS, THE SKILL LEVEL AND EXPERIENCE OF THE DENTIST IS ALSO KEY TO THE SUCCESS OF THE RESTORATION.  If you are considering dental crowns for restorative or cosmetic dental purposes, it is best to discuss your options.  We will help you choose the dental crown material that best fits your needs.

This patient came to us with several metal crowns and fillings.  See how in this x-ray, the metal looks like a white blob?  Metal makes it more difficult to detect decay lying underneath.

For this patient, we created an all porcelain CEREC crown on her lower tooth.  Notice the difference between this new crown and her old metal fillings on the upper teeth?  We can see through the CEREC crown giving a clearer view of what is happening underneath.