Nicholas Ehmann, DDS, BMSc
Ann Ma, DDS, BMSc
Picture yourself in this scenario: You’re sitting in the dental chair, your dentist comes to check your teeth after your cleaning, and they tell you that you would be best served by having crowns put on some of your teeth… What?! You had no pain before, no issues, but they think you should spend thousands of dollars to fix teeth that you didn’t think needed fixing? If this scenario sounds familiar to you, then you’re in the majority.
What is a Crown?
Before we go any further, we should define what exactly is meant by the word “crown”. A crown, sometimes referred to as a “cap”, completely covers the exposed tooth in the oral cavity. I often explain it to kids as a “full suit of armour” or making “Iron Man” out of their tooth, which usually jazzes the heck out of them. There are many different types of crowns, but most of them can be classified into porcelain/ceramic crowns, metal crowns, or a mixture of the two. Bridges are just crowns that are connected by a fake tooth in the middle, to fill the space of a missing tooth.
Why Should I Get a Crown?
There are different reasons why a dentist would suggest a crown. Some of the most common reasons are as follows:
- To protect a tooth from fracturing when it has been heavily restored. This is likely the reason your dentist has suggested a crown in the example I made in the first paragraph. A filling (AKA restoration), while necessary to get rid of decay, doesn’t actually strengthen the tooth. Therefore, over time, the weakened tooth may fracture. The timeline of “when will it fracture” is one of the hardest things to predict in dentistry. Some heavily restored teeth can fracture within years of having the restoration placed. Others can last decades. The more restorations placed in your tooth, and the more times a restoration must be replaced can both increase the chances of fracture. In addition, if your dentist can see small fracture lines (which often show up after some time in heavily restored teeth), you can be sure they’ll recommend a crown before a fracture happens, which would require the tooth to be extracted.
- To protect a tooth that has had a root canal treatment (RCT). We will discuss RCT’s in detail in another blog article. Basically, with no pulp or blood supply, a crown protects a RCT’d tooth from fracturing (which it is 6x as likely without a crown).
- Fixing a fractured tooth, or a tooth with little tooth structure remaining. In these scenarios, a filling would likely just fall out because there is nothing to hold it in place. This situation is complicated because you may need multiple different treatments in order to keep that tooth. Some things that may be required are: crown lengthening, root canal treatment and a post-and-core buildup. THEN you can place the crown. This is one of the most heroic efforts we can do to try and save a tooth. The costs add up, and it’s unlikely that the tooth will be savable if it needs to be fixed again. In other words, don’t let your tooth fracture or decay enough to get to this point. Pre-emptive crowning is worth it!
- Cosmetic reasons. Crowning is an option when your tooth is heavily restored or stained, and you want to make it look like a beautiful tooth again.
The Bottom Line
There are other reasons why one might want to crown a tooth, but those described above are likely to be the most common. In this day and age, dentists and their treatment decisions are scrutinized more than ever, so your dentist should be able to explain to you why they suggest any treatment. If you don’t understand or have concerns about any treatment, not just crowns, please tell your dentist! And if you don’t get a satisfactory answer, you’re always more than welcome to get a second opinion, as some dentists are better at explaining than others. We’re human too, and communication can be difficult, but if you have a good dentist, they should try to take the time to address any and all of your concerns.
We would also love to answer questions straight from you! If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at ask@orbishealth.ca with your feedback. We’d love to hear from you.
RESOURCES:
- McCracken, M., Louis, D., Litaker, M., Minyé, H., Mungia, R., Gordan, V., Marshall, D. and Gilbert, G. (2016). Treatment recommendations for single-unit crowns. The Journal of the American Dental Association, 147(11), pp.882-890.
- Lynch, C., Hale, R., Chestnutt, I. and Wilson, N. (2018). Reasons for placement and replacement of crowns in general dental practice. BDJ, 225(3), pp.229-234.
