CROWNS

Crowns are dental restorations otherwise known as "caps" which
are coverings that fit over teeth. Crowns may be necessary because
of broken down old fillings, fractured, chipped or sensitive teeth.
Crowns are also used to improve the appearance of natural teeth
that are malformed, malpositioned or discolored.

Crowns are made of natural looking porcelain and are made to
improve your overall smile or to blend in with your own teeth.
Sometimes an underlying metal shell is used under the porcelain if
additional strength is needed.

Some of the indications for a crown are:

A previously filled tooth where there now exists more filling
than tooth. The existing tooth structure becomes weakened
and can no longer support the filling.

Extensive damage by decay.

Discolorations and compromised esthetics.

Fractures

Root canal - After root canal, teeth tend to become brittle and
are more apt to fracture. These teeth need to be protected
by a crown.

Bridges - When missing teeth are replaced with a bridge, the
adjacent teeth require crowns in order to support the
replacement teeth.

Crowns strengthen and protect the remaining tooth structure and
can improve the appearance of your teeth. Crowns can be made
from different materials which include the full porcelain crown, the
porcelain fused-to-metal crown and the all-metal crown. You and
your dentist will decide which type is appropriate, depending upon
the strength requirements and esthetic concerns of the tooth
involved.

Fitting a crown requires at least two appointments. During your first
visit, the tooth is prepared for the crown, an impression or mold is
made of the tooth, and a temporary crown is placed over the
prepared tooth. At the subsequent visit, the temporary crown is
removed and the final crown is fitted and adjusted and cemented
into place.

First Appointment

The first visit begins by giving you a local anesthetic. Depending
upon the type of local anesthetic used, you can expect to be numb
for one to four hours. If your anesthesia should last longer, do not
be concerned. Not everyone reacts to medication in the same
manner. One word of caution : While you are numb, please be
careful not to bite your lip or tongue. A soft diet or no meal at all
while you are numb is probably a good idea. If your child has been
the patient, please watch them carefully to be sure they do not play
with their tongue or lip while it is numb.

Once you are numb, your dentist will prepare your tooth in a very
specific way in order to maximize the retention and esthetics of
your new porcelain to metal crown. After the tooth is fully
prepared, we proceeded with the impression stage. We used a thin
piece of retraction cord which is placed around your tooth in order
to get the impression material under the gum where the crown ends.
Please rest assured that this small piece of cord was removed prior
to the end of today's visit.

Should you experience any discomfort you can take a mild
analgesic (Tylenol™, Advil™, Anacin™, etc.) as long as there is
no medical contraindication based upon your medical history.
Typically, you can take anything you would normally take for a
headache. If the discomfort persists, please call your dentist.

Once the impression stage is completed , your dentist or his
assistant will place a temporary (transitional ) crown (or bridge if
multiple teeth were involved) on your tooth. These plastic (acrylic)
restorations are placed on teeth to protect them and the gum tissues
between dental visits. The temporary cementing medium used is
designed to allow the easy removal of the temporary at your next
scheduled visit.

There are a couple of additional facts you should know about
regarding the care of your temporary crown:

Home care is extremely important while your temporary
crown is in place. The health of your gum tissue and the
success of your final treatment restoration depends upon it.
PLEASE do not be afraid to clean your teeth between
visits. With a minimal amount of home care, you should be
able to maintain the continued health of your teeth and gum
tissue during the time required to fabricate your new crown.

Sometimes, even with meticulous care, temporary crowns
or bridges may become loose between visits. If this should
occur, please place the temporary crown or bridge back
on your tooth immediately. Putting a drop of Vaseline™ in
the temporary crown or bridge will very often increase the
retention and hold the temporary in place until you can
schedule an appointment. Once again, REPLACING THE
TEMPORARY CROWN IMMEDIATELY IS VERY
IMPORTANT ! It only takes a short time for teeth to
move if the temporary is not put back into its proper
position. This could affect the final restoration significantly
and may necessitate new impressions and a great deal of
time. If you can not replace the temporary crown yourself,
put it in a safe place and call the office. We will be happy
to recement it for you at the earliest possible moment.

Second Appointment

At that time, the temporary crown is removed and any temporary
cement is cleaned from the prepared tooth. Your dentist will fit the
final crown, check for accuracy, adjust for any bite discrepancies
and evaluate the esthetics. If all of these factors are acceptable, the
crown is cemented to your tooth. It is not unusual for the new
crown to be mildly sensitive to cold temperatures for a few weeks.
However, if the sensitivity is severe, does not subside, or if the bite
feels uncomfortable, contact your dentist. Further adjustments to
the crown may be necessary.

We hope that this brief instruction sheet will answer most of your
questions regarding crowns. Following these simple guidelines will
help provide you with the finest in dental care. If you have any
questions regarding this or any other procedure, please contact
your dentist.

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