Quicker and Stronger
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Some of us have more crowns than the queen of England. Unfortunately, they don’t glitter grandly on our perfectly coifed heads. Instead, they’re embedded in our mouths, hopefully unseen by the casual observer, but saving our ability to bite and chew.
“A crown is needed when there is not adequate tooth structure to support a filling, inlay or onlay,” explains Dr. Steve Dedrickson, a dentist with Sevens Dental Group in Clayton. “A crown completely covers the outer portion of the tooth and protects it from external stress.”
Dedrickson uses a traditional approach to placing crowns. First, an impression of the damaged tooth is taken to create a model. Trained technicians at a dental laboratory use the model to fabricate the crown, which will look and feel like the original tooth. A temporary crown is placed until the permanent crown is completed.
“A crown will last for several years,” Dedrickson says. However, crowns require proper care to ensure their longevity. “There are problems that can develop with the tooth underneath the crown,” he warns. “A tooth with a crown can still develop a cavity, and if that occurs, the crown will need to be replaced.” Therefore, it’s important to floss around the crown to keep it clean and reduce the chances of decay. Dedrickson also recommends semi-annual dental check-ups and cleanings to help ensure the health of crowns, natural teeth and gums.
There are a variety of materials used to create dental crowns. Typically, a crown is made of metal, porcelain fused to metal, resin or ceramic. Crowns may be sensitive to temperatures, and they may chip or become loose over time.
Dr. Ethan Schuman of Schuman Center Dental Aesthetics in Creve Coeur uses a different approach to crowns. CEREC (Chairside Esthetic Restoration Ceramics) allows a crown to be made and placed in a single visit. Only about 2 percent of dentists use CEREC technology, Schuman says, although he began offering the procedure about six years ago. Schuman says the advantages of CEREC include the time saved and the fact that a CEREC crown is bonded to the natural tooth, resulting in more strength and support than traditional crowns.
“First, we prepare the damaged tooth by painting a thin layer of reflective powder directly on the tooth’s surface,” he says. “Using a special camera, we then take a picture of the tooth. There’s no need to take a messy impression and send it to the lab. We work from this photo, which is actually a pin-sharp optical impression of the tooth.”
While the patient waits for about 10 minutes, a ceramic block that matches the natural tooth color is milled by a high-speed diamond bur to the specifications indicated by the optical impression. The resulting crown is perfectly shaped and bonded to the tooth with strong adhesive. “CEREC crowns conduct heat and expand or contract just like natural tooth enamel,” Schuman says. “Because they’re so accurately made and placed, they don’t tend to get decay underneath.”
Whether made in a laboratory or created using CEREC technology, dental crowns allow for a natural look and feel when the original tooth is beyond repair. The queen herself would be impressed.
