What is a dental crown? Do I need a crown on my back molar?
Molars are the large teeth in the back of the mouth. These teeth have a greater surface area for chewing and breaking-up food particles to prepare for swallowing. These teeth were designed to withstand the greatest chewing forces in the mouth. Even though these teeth are strong, molars can develop dental decay and can fracture if the tooth is weakened by a large filling (Figure 1) or when biting into a hard piece of food.
In the image above, you can see the large silver filling that has replaced a portion of the tooth. You can see the very thin enamel cusps on the inside surface of this tooth. This inside wall is weak and if the patient chews a hard piece of food, these inside cusps will fracture.
To prevent fracture, a dental crown in Downtown Los Angeles is recommended to cover and protect the tooth. A crown is a covering or “cap” that encases the tooth. Also, If a molar tooth has been root canal treated, a crown is definitely recommended. The reason is that root canal treatments “hollow-out” in inside of a tooth and this leaves the tooth more susceptible to fracture.
The following steps are needed to prepare a tooth for a crown:
First Appointment
-
Anesthetic is administered to numb the area
-
A natural tooth shade is selected to match the surrounding teeth (Figure 2)
-
Old fillings and decay are removed from tooth
-
The tooth is carefully shaped so that a crown can fit over and cover the tooth
-
An impression of the tooth is made and sent to the lab for fabrication of the final crown
-
A temporary crown is made for the tooth until the final crown is permanently cemented
Second Appointment
-
Anesthetic is administered to numb the area
-
The temporary crown is removed and the permanent crown is tried-on by your prosthodontist in Downtown Los Angeles.
-
Adjustments are made to make sure that the bite is even and the contacts between the teeth are tight
-
The crown is then permanently cemented to the tooth (Figure 3)
Are dental crowns made from different materials?
Yes! Crowns used to be made exclusively from gold or from porcelain-fused-to-metal. Gold is an excellent dental material because it will not break and therefore lasts a very long time. The problem is that many patients object to the color of gold to restore their teeth. Porcelain-fused-to-metal crowns use porcelain to cover the metal and are therefore more tooth-like in appearance. The problem with these crowns is that the porcelain can chip from the metal. When this happens, the crown may need to be replaced by your dentist in Downtown Los Angeles..
The most current dental material to use for molar crowns is called monolithic zirconia (shown above). This material is custom designed for each case on a computer (CAD). This information is then sent to a milling machine for manufacturing (CAM). The benefit of monolithic zirconia is that this material is very strong (even with a narrow thickness), appears toothlike and will not chip. Patients appreciate the natural appearance of this material and the shade can be customized to match the surrounding teeth.
About the Author
Dr. Adam Geach earned his DMD degree from the Harvard School of Dental Medicine and completed residency training in Prosthodontics from the University of Connecticut School of Dental Medicine. As a prosthodontist, he specializes in dental esthetics, implants, and reconstructive dentistry. Approximately 2% of dentists are Prosthodontists. If you have any questions, please contact him
