by Jeffrey Gross, DDS, FAGD of The Healthy Smile
This question is another one that I hear when we need to replace a crown. However, before we get to find out why a crown requires replacement, let’s take a few moments to review what a crown is and discuss some of the details surrounding it.
A crown is part of a field in dentistry called restorative. There are many components to this field, but they all have one thing in common: their purpose. The goal of restorative dentistry is to go backward in time and reset the status of the mouth. Restorative dentistry fixes and repairs damage in the mouth. The damage that I am referring to could involve a simple cavity or be as complicated as teeth on multiple implants. Function and appearance are the keywords in this type of dentistry. The ability to chew and demonstrate an attractive smile is essential to all of us.
Bacteria create cavities which in turn destroy and break down tooth structure. Fillings are the easiest and fastest way to repair a destroyed tooth. If the tooth destruction is extensive, a filling cannot do the job. Large fillings push the limit of the physical properties of the filling material.
When I was in school, learning about the makeup of dental materials was incredibly dull. However, when I started to practice and learned more, I discovered how my decisions on choosing the suitable material for the job would make the difference between success and failure.
What does a dentist do if a potential filling is too large? First, the practitioner makes a choice and moves to a different solution for the problem. One of the best and most predictable directions in which to move is a dental crown. The crown process involves a digital or physical copy of the tooth. We make the crown outside of the mouth to whatever shape will harmonize with the adjacent teeth and allow the proper function to occur.
After a dentist verifies the crown’s fit and color matching accuracy, setting it into place is the next step. A particular type of glue, or as we call it, “cement”, attaches the crown to the tooth. The glue creates a firm seal between the crown and the tooth. When a crown is attached correctly, it becomes part of the mouth’s entire smile and chewing apparatus.
Materials that we use to make crowns are exceedingly strong, and breakage is not an issue. The weak link in the chain is the glue. Besides holding the crown firmly in place, the glue seals off the tooth from the outside environment. Acids in our saliva and bacteria search and look for openings on teeth in which to do damage. After years of function in the mouth, the glue starts to break down. The breakdown of the glue creates an entrance for a cavity to form under a crown.
The cavity is typically in one part of the crown while the rest is firmly attached. Therefore, the only way for the dentist to fix the cavity is to remove and replace the crown. Typically removal involves destroying or splitting the crown to get it off the tooth. The destruction of the crown is the main reason why dentists cannot reuse a crown.
One key to making a crown last for many years is a good fit and excellent dental glue. Never skimp on these two steps. As I like to say, not all crowns are created equally.
If you need a new crown or replacement, call us at 440-892-1810 and we can discuss your future. I look forward to meeting you.
Jeffrey Gross, DDS, FAGD is an Ohio licensed general dentist and is on the staff of Case Western Reserve School of Dental Medicine.
The Healthy Smile • 27239 Wolf Road, Bay Village, OH 44140 • 440-892-1810 • www.jeffreygrossdds.com