Dental Crowns

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A dental crown (also known as a cap) is a protective shell which a dentist manufactures and places over damaged teeth to strengthen them.

Why do I need a Crown?

A crown is used in situations where the structural integrity of a tooth has been weakened. This is frequently as a result of extensive decay, the need for a large filling, or accidental damage. Crowns are also used as part of the bridgework process; they are the method by which a bridge can be fixed in place.

Alternatives to Crowns

In some cases, damage to a tooth can be repaired by a cavity filling, but this is only possible when the tooth retains a viable structure. It is likely that the dentist has decided the tooth is beyond this stage if he or she is recommending a crown. The crown offers many advantages over the cavity filling, but one of the principle ones is that the crown is designed and manufactured away from the consulting room. With a filling, the dentist has to create and shape the material directly in the patient's mouth, meaning that they have less control over how the tooth ends up appearing; the crown, on the other hand, is shaped to fit the tooth, jaw and patient's bite perfectly.

Diagnosing the need for a Crown

Your dentist will usually treat a decayed tooth with a filling first (this is known as intracoronal restoration)- he or she will only diagnose the need for a crown if the tooth's structure is so damaged that extracoronal (literally, "outside the tooth") restoration is the only possibility. This will be determined during the initial consultation.

What is involved in fitting a Dental Crown?

Firstly, the dentist prepares the tooth concerned, by shaping it so that the crown can be fitted. This may involve removing some of the outer surface, or building up the core of the tooth with filling material. In cases of serious damage, it may be necessary to insert a post into the tooth so that the crown can rest upon it and remain stable.

After the tooth is prepared, an impression of the patient's teeth is taken, so that the bite can be measured accurately. The colour of the surrounding teeth can also be noted so that the crown can be made to match (in cases where a porcelain crown is being used). The patient then makes a second appointment while the crown is designed by a dental technician- the dentist may provide a temporary crown while the final one is being prepared.

There are many different types of crown available, depending on the location of the tooth or the patient's preference (please note that not all of these choices may be available through the NHS). The following are some of the options:

• Porcelain bonded to precious metal crown.
• All-porcelain crown: made from porcelain alone. Excellent aesthetic results and very suitable for front teeth.
• Porcelain and composite crown: made from a combination of two different materials. Can look the most natural in certain cases.
• Glass crown: made from glass alone. Excellent, natural appearance.
• Precious metal crown: made from gold and palladium. Very strong and hard-wearing but have poor aesthetics (they're visible in your mouth just as amalgam fillings are).

When the crown is manufactured, the dentist will check that the colour matches (if applicable), and set it in place using dental cement.

Cost of Dental Crowns

In Britain, dental work can be carried out through the NHS, or the patient has the option to go for private treatment at a higher expense. In September 2007, fitting a crown on the NHS cost £194, though this is unlikely to include crowns made from some of the more expensive materials. Our figures indicate that the average cost of fitting a crown through private treatment is £391.