You will typically need two or more visits to your dentist to repair a severely decayed tooth with a crown.
Crowns may be made of porcelain or a metal base covered with a thin layer of ceramic that matches your teeth and looks like a normal, healthy tooth. Crowns for the teeth in the back of the mouth may be made of gold.
During your first visit, your dentist will take out the decay and make an impression of your teeth to create a mold used for making the crown. Your dentist will:
- Numb your teeth, gums, tongue, and surrounding skin. Your dentist will first put a substance that feels like jelly directly on the area to start the numbing process, and then inject an anesthetic to complete it. Many dentists will give you nitrous oxide gas (laughing gas) to reduce your pain and help you relax.
- Sometimes use a small sheet of rubber on a metal frame (rubber dam) to target the decayed tooth and stop liquid and tooth chips from entering the mouth and throat.
- Drill out all the decay.
- Take an impression of the decayed tooth. The mold will allow a technician to make a crown that perfectly matches the drilled tooth.
- Cover the tooth with a temporary crown until your permanent crown is ready.
See pictures of a tooth and tooth decay.
During your second visit, your dentist will:
- Numb your teeth and gums as before.
- Remove the temporary crown.
- Cement the permanent crown to the damaged tooth.
- Have you bite on a piece of carbon paper. This shows how well the crown is positioned. If necessary, your dentist will reshape and polish the crown.
What To Expect After Treatment
Your lips and gums may remain numb for a few hours until the anesthetic wears off. Avoid chewing on your numb lip or cheek to avoid injuring your mouth.
Why It Is Done
A crown is used to:
- Treat teeth that have broken or decayed so much that your dentist cannot fix them with a filling.
- Cover a tooth that is so severely damaged that most of the top part had to be removed.
- Repair a defective filling.
- Improve how a tooth looks.
Dentists sometimes use crowns after root canal treatment to seal the tooth and prevent it from breaking.
How Well It Works
A crown will work just like a healthy tooth.
Crowns sometimes come loose over time, and you may need to get them cemented again or replaced.
If tooth decay is right next to the pulp, the pulp may not be strong enough to make healthy dentin, which surrounds and protects the pulp. If this happens, your dentist or endodontist may have to remove the pulp, or an oral surgeon may have to remove the tooth root.
Some dental work can cause bacteria in the mouth to enter the bloodstream and cause infections in other parts of the body. People who have a difficult time fighting off infections may need to take antibiotics before and after dental surgery. Such people include those who have artificial heart valves or were born with heart defects.
What To Think About
If the decay is near the pulp and your dentist thinks the pulp might die, he or she might suggest taking out the tooth (extraction) and using a bridge or implant. If the pulp dies after you get a crown, you will need a root canal to remove the dead pulp.