What alternatives do I have to a dental crown?
If your tooth is able to be restored, you have a few options:
Veneers are restorations that partially cover the visible part of the tooth. Usually these are used on anterior (front) teeth to improve the aesthetics of the tooth or if damage to the tooth is minimal. Examples of this are if the tooth failed to develop properly, is discoloured or there is loss of part of the tooth. The amount of tooth removed is usually a lot less than for a crown or sometimes it may not be necessary to remove any tooth at all.
“Lumineer” is the brand name type of prefabricated veneer. A kind of one size fits all approach and only works if all the anterior (front) teeth are being done together.
Onlays cover the biting surface on posterior (back) teeth and are used when the damage to the tooth from decay or fracture in limited. These don’t usually extend down all sides of the tooth to cover it entirely. These can be made of gold or bonded ceramic material such as E-max.
Crowns vs Extractions
Sometimes teeth are too badly compromised to be crowned and we may decide to extract them.
You then have the option of leaving the space. This has drawbacks which include:
- A missing tooth can be unsightly.
- The space will result in the teeth on either side “drifting” and leaning into the space or rotating, which has consequences
- The opposing tooth (ie the tooth in the same position on the opposite jaw) will move into the space because there is no “opposing” tooth to limit it’s eruption. This is called over-eruption and can cause problems with tooth alignment.
- You may no longer have a tooth to use for chewing.
If you decide to fill the space where the tooth was extracted, you can choose an implant and crown, a bridge or denture.
Dental Implant Crowns
If you have lost a tooth, an implant crown may be a good option. This will replace the lost tooth providing a good aesthetic and functional result. Having an implant is a time-consuming process and considerably more expensive than having a crown placed on an existing tooth.
Implants are dependent on having sufficient bone quantity and in the vicinity of the extracted tooth. Often, patients require bone grafting, or a sinus lift to provide enough bone to place the implant that supports the crown. It can take 6 – 12 months or even longer for the whole process.
It is possible to make a denture with only one tooth on it if a single tooth has been extracted. Often these dentures are called “spoon dentures” because the acrylic base is curved and fits the palate like a spoon. People, especially younger ones, are often averse to wearing dentures of any kind or size. One last point –
dentures need to be cleaned regularly (similar to your teeth).
While a crown is placed on a single tooth, a bridge spans a gap where teeth are missing. It and involves using one or both adjacent teeth as supports. A dental bridge is usually anchored on each side by a crowned tooth and there is a false tooth joined to the crown at each end. The false tooth is called a pontic.
Bridges can span two or more missing teeth and may involve several abutment or support teeth, but there is a limit to the length of the bridge span.
Bridges can often be anchored on implants. Your dentist needs to carefully assess the load on the bridge, forces from chewing or grinding habits; and state of the bone around the support teeth or implants.
The aesthetic requirements of the bridge are also a very important component. Sometimes the teeth on either side of the bridge are not suitable to be crowned. They are either too badly compromised by decay or fracture; there is gum disease which makes the tooth unstable; or the tooth may be in perfect condition and modifying it to support a crown would only damage it.
Crown vs Bonding
Bonding is not an alternative to crowns, it is the method by which a restorative material is held onto the tooth. Sometimes ‘Bonding’ can refer to the use of Composite Resin filling materials that use resin bonding to adhere them to the tooth. However, many of the crown and veneer materials are also adhered to the tooth using bonded resin cements.
Crown vs Filling
Crowns are usually placed to protect the underlying tooth. A crown covers the tooth and helps hold it together. A filling, particularly a very large one, may not be strong enough to serve this function. Fillings “fill in” the missing tooth but they don’t provide a lot of structural support – they become the “weakest link” in the tooth, resulting in more tooth (or tooth plus filling) breaking away or fracturing, compounding the problem.
Dental Crown vs Cap
“Caps” is the name many people call dental crowns. It has that name because a crown fits over the tooth like a cap.
Crowns vs Implants
Dental implants have two parts – the post which holds it secure, and the crown that goes on top.
Crown vs Root Canal
A root canal is a therapeutic treatment to the root of the tooth only. Root canals are the tiny channels inside every one of your teeth, which contain the pulp. This has the nerves and blood vessels which a healthy tooth needs. If your tooth is damaged, bacteria can easily infect your tooth pulp, giving you a very painful toothache.
Root canals usually won’t cause you much pain. In fact the opposite is true: endodontics are designed to relieve the severe pain of your damaged or infected tooth.
Dental crowns are usually placed over the remaining tooth, as often the tooth is structurally weakened as a result of the treatment.