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Dental Crowns: What Are They, Procedure And Cost

{ News - Nothing but the tooth }

Sept 2020
26th
26th of September 2020

Dental crowns are one of the most common dental procedures but many people are not aware what a crown is exactly. To be very simple, a crown is a new tooth surface that sits over your existing tooth to protect it.
 

When is a dental crown needed?

This is a really good question. A dental crown is needed when the underlying tooth is heavily broken down and a routine filling will not be sufficient. There is a choice to be made between having a filling and a crown and we will provide the best advice as to which will be suitable. Now, in many cases, there is the choice of a transition from a large filling to a crown later on. This decision may be made due to financial reasons or to assess if the pulp (nerve) is still alive over a period of time for example. If the tooth is already root filled, then a crown is certainly required especially for back teeth.

When a tooth has a root filling, it becomes quite brittle and is liable to crack. We see this regularly and unfortunately this may mean that the tooth needs to be removed. If a crown had been placed, this would have been avoided.

Other reasons why a crown would be needed would be for occlusal (bite) purposes. If your bite needs to be altered then often your tooth/ teeth will need a new surface to ensure the contacts of your bite are correct.
 

Dental crown procedure

The procedure for a dental crown involves reducing the size of the tooth down by re shaping it. In the past, this would have involved cutting the tooth down quite a lot so that there was plenty of space for the crown. However, modern day dentistry and advanced techniques mean that we can provide a beautiful crown with minimal reduction. In some case, we only need to reduce the tooth by 0.7-1.0mm.

In terms of appointments, we usually need 2 visits. On the first visit, the tooth will be shaped carefully and digital scans taken using our amazing Trios 3 Shape intra oral scanner. No more impressions! The scanner allows us to view the preparation, check that there is enough space, check there are no undercuts and measure the shade (colour) of the adjacent teeth. It is an amazing piece of technology.

After the preparation, we will place a temporary crown that is made from acrylic or an acrylic composite hybrid material. This is usually left for 2 weeks which gives the laboratory enough time to fabricate the crown.

During the temporary crown phase, we will advise you to keep the area clean and often we will recommend using chlorhexidine mouthwash (Corsodyl) to keep the gum healthy. This would only be for a short time as Corsodyl can stain teeth a dark brown colour!

At the next visit, we will remove the temporary crown, clean the underlying tooth and check the fitting. Once we are 100% happy (both of us) the crown can be cemented into place. Sometimes, we will advise using a soft cement so that the crown can be removed if required. Reasons for this may be to allow the gum around the tooth to heal or to check the bite if this is being altered.

For the first few days, the new crown will feel a little strange as the surface is different to your previous tooth and will take some time to get used to. It is important to eat a soft diet for 48 hours and not to drink or eat anything too hot or cold that could affect the cement setting. After this time, think of the crown as your natural tooth and keep it clean!
 

Same day crown

Sometimes, you may wish to have the crown placed on the same day or 24 hours later. If so, we can help! With advanced notice, we will arrange for the preparation to be in the morning and the fitting appointment a few hours later or the next day. There is a small laboratory surcharge for this as they will prioritise your work over everything else that day.
 

Dental crown cost

At Progressive Dentistry, our crown fees start at £765 for a standard crown. £995 for a premium crown (high aesthetics) and £1350 for a fully customised crown (ultimate aesthetics for a front tooth).

Please visit our fees page for latest prices.

For a free video consultation on dental crowns please book via our online booking system.


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E Max Crowns

Our case of the month for April was one involving E Max crowns by Ivoclar, which is our opinion, give the best aesthetic results. In the past, tooth coloured dental crowns had a layer of metal underneath for strength with the ceramic bonded on the outside. Now these could look perfectly acceptable but there were issues. Having two layers means that more of the underlying tooth has to be cut down to accommodate the material. For any of you that has read any of our posts knows that we believe in minimally invasive dentistry, cutting away more tooth than necessary just does not sit right with us. Another issue with metal ceramic crowns is that the metal layer may become visible over time as the gums recede which gives that classic grey line around the tooth. Not very desirable. One of the main advantages of ceramic crowns is that there is no metal underneath and this grey line will never be an issue. 

The aesthetic qualities of E max crowns are second to none. Our case shows that the crowns can be fully customised with translucency at the edges, varying shades, light reflection and opaque areas to name a few. The skill of the dental technician plays a huge role here and we work with some excellent laboratories know for excellence. 

For our case, Ceramic Studios in Kensington made the wonderful E max crowns fully which were fully customised.
 


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If you have a dental crown, this article is for you. In the old days of dentistry, there were only a few types of crown. Namely: 

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At Progressive Dentistry, we aim to use metal free crowns wherever possible. There are a number of metal free crowns now available which have certain indications for the area required. For example,
 

Zirconia Crowns

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We pride ourselves on being progressive and leading the way in modern cosmetic dentistry. In the old days, cosmetic dentistry was more about being invasive and cutting healthy tooth enamel for multiple veneers or crowns. Due to the advances in technology and materials this has all changed. These days, if a tooth does need a veneer or crown, then we will match this tooth with the other teeth as best as possible. This way, the adjacent teeth do not need to be harmed in anyway. Here is a classic example. Our patient required a front tooth crown. After some tooth whitening, a new crown was made in all ceramic. Just look at the result:
 


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Crown Replacement For 2 Front Teeth

Our next case involved two front teeth which had two crowns. The patient was unhappy with the colour, shape and overall appearance of them. The main request was to provide a natural replacement. Front teeth are the first point of eye contact and as such extremely important in cosmetic dentistry. A number of factors must be assessed before treatment can begin and this starts with thorough planning. Initially, study models were prescribed and a diagnostic wax up. This is to enable the patient to see the anticipated final shape and contour of the crowns and compare them with the current situation. The wax up will also be used as the template for the final crowns and for the temporary crowns. The following photographs show how we dramatically improved the situation with cosmetic dentistry.