Different types of dental crowns and alternative treatments
“You need a dental crown” … not words many of us particularly like to hear. We’ll walk you through your options.
Getting a dental crown is a significant investment in your health, to strengthen and preserve the life of your tooth. It’s also a significant financial investment. Unless you’ve had a lot of dental work done previously, you may not be aware that there are several different types of dental crowns available. They come at varying costs depending on the type of dental crown you choose.
But why do you need a dental crown (also known as a tooth cap) at all?
Most of us would prefer to save our teeth rather than get them pulled out! The primary function of a crown is to strengthen, protect, and improve your tooth’s appearance – future proofing it for the years to come.
A dental crown works to strengthen your tooth the same way that a steel ring is used to strengthen a wooden chisel.
The steel ring prevents the wooden handle from splitting when it is constantly hammered down upon. The force applied by your opposing teeth has a similar effect as a hammer onto the wooden chisel.
Tooth pain is a terrible feeling.
So is the thought you may need the tooth extracted, leaving a big gap where your tooth used to be.
When you experience tooth pain it is often the push you need to go to the dentist and get the recommended treatment. What you may not know is, in many cases, even though your tooth needs treatment, there is no immediate pain. This makes it easy to justify putting off the treatment for a later date. However, delaying the procedure is risky. Your tooth may worsen during this time, which could lead to more invasive and expensive treatments in the future such as root canals – or the dreaded tooth extraction.
If you’ve decided to take action and treat your tooth, it is important to understand what options you have. This includes the types of dental crowns and alternative treatments available.
Types of Dental Crowns
When you think of a dental crown, this is the type that most likely comes to mind first.
Traditional laboratory crowns have been around for a long time and generally involve two procedure appointments. This is in addition to your initial assessment where the dentist recommends a dental crown and you agree to get it done.
Lab crown appointment 1
During the first procedure appointment, the dentist will reduce your tooth down quite significantly so the crown can fit over top. You will be asked to bite on a tray filled with a gooey impression material so they can take an impression of your tooth. Then they will fit a temporary crown over your tooth, and book you in for another appointment in a couple of weeks’ time.
During this time a dental laboratory will create a custom-made dental crown, matching your natural tooth anatomy and shade. Temporary crowns are designed to be easily removed by the dentist. They are attached to your tooth with a very weak glue – which often lead to them falling off.
Lab crown appointment 2 – usually two weeks later
When you come back for your second appointment, the dentist will likely have to make some small adjustments to the permanent crown, and then it will be fitted and cemented into place.
Due to the time and labour involved, traditional porcelain or ceramic laboratory crowns often come with quite hefty price tags. They usually cost around $1500 each in New Zealand and Australia.
Types of laboratory dental crowns
Porcelain fused to metal. These crowns benefit from the strength of metal yet are more natural looking due to the porcelain tooth coloured covering. The downside is that sometimes the metal beneath the porcelain can be seen, which creates an unsightly dark line.
All porcelain or ceramic. These look very natural as they are designed to look just like your regular teeth. They are not as long-lasting as metal crowns, so often to increase durability, dentists choose porcelain or ceramic materials that are as hard as possible. The downside of this is that they can cause more wear to opposing teeth than other types of crowns.
Metal and gold crowns. It is generally considered that metal and gold crowns are the strongest type of dental crown, as they are long-lasting and durable. The downside is that it’s not particularly attractive to have a mouth filled with metal. Nowadays there are other far more aesthetically pleasing options available, which has reduced the demand for metal crowns.
Single Appointment Dental Crowns
Gone are the days that you need to book multiple dental appointments to receive a crown. Nowadays, thanks to significant technological advancements, there are several different types of single visit dental crowns on the market. These single visit crowns are increasingly becoming more and more popular among patients and dentists alike.
The OVC3 is a relatively new procedure (around five years old) and is used on molar and premolar teeth.
Although the procedure is new, the trusted hybrid ceramic materials it is made of are not. The main benefits include;
- Non-invasive. It is much more conservative than a laboratory crown. This means that you keep a lot more of your natural tooth.
- Affordable price. The OVC3 usually only costs up to half the price of a laboratory or CAD/CAM crown.
- Realistic. The OVC3 is tooth coloured. It has a natural looking shape that models an ideal anatomical average taken from a large sample of teeth.
- Practical. If you later need a root-canal, the dentist can simply drill through the OVC3, complete the root-canal treatment, and then fix it using composite. A much more affordable option than having to buy a whole new crown!
How does it work?
The OVC3 comes pre-formed in a box. The dentist measures your tooth, then selects the appropriate OVC3 based on your tooth size and the closest shade to your natural tooth colour. In a single appointment (usually only 45 minutes long), the dentist preps your tooth then bonds the OVC3 into place.
CAD/CAM crowns can be used on your front teeth and your molars/premolars. There are several different brands available including CEREC. How it works is a milling machine fabricates the crown onsite and then the dentist cements it to your teeth the same way as a laboratory crown. They are made from different types of ceramic materials that are colour matched to your teeth.
The CAD/CAM crown is fitted to your tooth in a single visit that usually takes several hours including the time to mill the crown. The price is normally quite expensive, similar to a laboratory crown. This is because dentists need to recover their costs from the expensive CAD/CAM milling machinery.
Alternatives to a dental crown
If you really cannot afford the cost of a dental crown there are other cheaper options available to you.
Large composite filling. The advantages of a large filling include that it is cheap, and it is also non-invasive, meaning that your tooth does not need much reduction. The disadvantages include that it is not very durable and your tooth’s cusps are not supported in any way. Most dentists will not offer a guarantee for a filling if a crown is recommended. Although you can get fillings made from composite, which is a tooth coloured material, it is difficult for the dentist to make the anatomy look natural when the filling is really large.
Tooth extraction. The final option is to simply have your tooth extracted. This is generally the cheapest alternative to a dental crown although certainly the least desirable!
The important thing is to choose what is right for you, and your budget.