Dental Crowns in Kitchener: A Definitive Guide

Dr. Kyle Hornby

I have been providing Dental Crowns in Kitchener for almost a decade. Dental Crowns are a routine service provided by Family Dentists. While patients have a great understanding of what a dental filling is and what it does, the topic of dental crowns is far less familiar.

Patients often ask, "how is the crown better than a filling?".

After nearly 10 years of providing Dental Crowns in Kitchener and fielding all types of great questions about them, I decided to put together a really comprehensive and in-depth guide on the subject of Crowns. From what they are to why you need one, from what their made of to how much they cost, this is the definitive guide on Dental Crowns.

So, let's jump into all things Dental Crowns. I'll start with some basic information under a variety of headings and I'll then end the article with some Frequently Asked Questions regarding crowns.

And, as always, if you have any questions for me just e-mail me at info@enamelrepublic.com and I'll get right back to you.

Dental Crowns in Kitchener: What Dental Crowns Do

As a dental patient, you should always want to know how treatment will benefit you. That is, will it provide you with value? So, how can a Dental Crown provide value for you? What does a Crown Do?

Simply, a Crown protects and strengthens weak teeth to prevent a fracture that your Kitchener Dentist cannot repair. If you have a weak tooth and don't want to lose it, you put a crown over it.

When would a tooth be so weak that it would need protection from a Dental Crown?

  1. Following Root Canal Treatment. Root canal treatment allows your Dentist to eliminate severe pain or infection in a single tooth. After the root canal treatment, your tooth loses its moisture source and becomes more brittle and fracture-prone.
  2. Following Loss of a Large Piece of Tooth. Ever break off an entire corner or half of your tooth? It happens. Depending on the size of the broken piece, your tooth may no longer be strong enough to tolerate regular function (chewing).
  3. Following Structural Damage Due to Tooth Grinding ("Bruxism"). Some people grind their teeth at night. This can cause slow but persistent wear on teeth over time. Tooth grinding and clenching can also cause cracking and splitting. Sometimes, teeth split in a way such that your Kitchener-Waterloo Dentist cannot repair it.

It's important to note that Dental Crowns can be used cosmetically to improve tooth appearance, shade and alignment.

Dental Crowns in Kitchener: How Dental Crowns Work

Dental crowns are basically helmets. A dental crown protects and reinforces your tooth, preventing future fracture. Can't you just repair a fracture? Not all the time. Unfortunately, teeth can split in such a way that your Family Dentist cannot fix it. This means you cannot repair or salvage the broken tooth and it will require dental extraction.

When you chew food and grind your teeth, the Dental Crown channels heavy forces along the outer surface of your tooth. It prevents you from introducing a new crack or making an existing crack worse. The dental crown is essentially a thick and robust shell that fits over your tooth. It keeps everything together!

At this point you may be wondering how your Family Dentist installs the crown...

Well, your Kitchener-Waterloo Dentist prepares your tooth for a dental crown and then bonds the crown to your tooth at the insert or delivery appointment. Dental crowns are not removable. Most patients often forget which teeth are crowned because there is no special maintenance for dental crowns.

For more specifics about the Dental Crown procedure, read on!

Dental Crowns in Kitchener: The Dental Crown Procedure

Pursuing a Dental Crown in Kitchener? Here's a quick breakdown of the treatment process: First, your Kitchener-Waterloo Dentist prepares your tooth by removing any decay or weaker areas. During this preparation, the Dentist shapes your tooth so that the crown can fit properly over top of it.  This preparation involves removing 1-2mm from the outside or perimeter of your tooth.

Your Kitchener Dentist then takes a highly accurate impression to capture the shape of the tooth. Next, they place a temporary crown on your tooth to protect it until your crown delivery appointment, 1-2 weeks later. 

At your crown delivery appointment, your Dentist removes the temporary crown, and seats the permanent crown for a “try-in”. The try-in allows your Dentist to ensure that:

  • Your bite feels even and natural       
  • Your new crown fits your tooth precisely
  • You approve of the appearance of your dental crown

If the crown fits precisely, your Kitchener Dentist bonds it to your tooth. Your Dentist will recommend that you avoid hard and sticky foods around the crown for 48 hours. You should also avoid flossing for 36-48 hours. This reduces the chance that you loosen the crown as cement continues to set.

Dental Crowns in Kitchener: Types of Dental Crowns (Dental Crown Composition)

Dental crowns can be made from a wide range of materials. These materials differ in esthetics, strength, and abrasiveness (the degree to which they wear down opposing teeth).

When pursuing a Dental Crown in Kitchener you have many options:

  • Gold & Metal: Gold or metal crowns are very durable and don't wear down opposing teeth. Gold and metal crowns do not break and they have the greatest longevity of any material, on average. These crowns allow for less reduction/preparation of your tooth to accommodate fit. Their only drawback is poor esthetics.
    • Consider a gold or metal alloy crown on non-visible upper molar teeth.

  • Porcelain-fused-to-Metal (PFM): PFM crowns have an outer porcelain layer for aesthetics with an inner metal alloy layer for strength. The porcelain on a PFM crown can chip and fracture, although this happens rarely. These crowns require more reduction than do metal crowns. They are highly abrasive against opposing tooth enamel and can cause accelerated tooth wear. This is an important concern in patients who grind their teeth. PFM crowns provide a nice balance between durability and esthetics.
    • Consider PFM crowns on molars and premolars that are only slightly visible during smiling.

  • Full Porcelain (E-Max & Empress): E-Max crowns are made of lithium disilicate while Empress crowns are composed of ceramic glass. Both types are highly esthetic. E-Max is more durable than Empress, but both are weaker than Gold, PFM and Zirconia crowns. Both materials enjoy reasonable longevity but are more prone to fracture. These crowns require the greatest amount of tooth reduction during preparation. Additionally, both types of crown are abrasive to opposing tooth enamel.
    • Consider E-max crowns on premolars and canines in esthetic zones and Empress crowns on upper front teeth.
  • Zirconia: These crowns are made of Zirconium. They are extremely strong and durable with excellent longevity. Zirconia Dental Crowns cause less wear of opposing enamel than full porcelain and PFM crowns.
    • Zirconia crowns are tooth-coloured but more opaque than natural teeth, so they are a reasonable esthetic choice for molar and premolar teeth.

CEREC Same-Day Dental Crowns

What are CEREC Dental Crowns?

CEREC stands for Chairside Economical Restoration of Esthetic Ceramics. What you need to takeaway from that name is the "Chairside" part because it means your Kitchener Dentist can make your crown while you wait.

No more temporary crown for 2 weeks while you wait for experts at a Dental Lab to make your custom crown. You get your crown right away!

CEREC crowns are also referred to as "same-day" crowns. The process has been heavily marketed on the basis that it's just plain convenient for dental patients to get a crown as quickly as possible.

There are, however, some downsides to CEREC Dental Crowns. Want to know what they are?

Limitations with CEREC Dental Crowns

  • Esthetics. When your dental crown is made at a dental lab (the 2-appointment approach), a trained expert in shading and colouring dental crowns is working to make your crown as life-like in appearance as possible. They do this by varying colour and shade to match the variability of natural tooth enamel. A CEREC crown is made in a milling chamber that produces a uniformly-shaded crown with no colour variability. These crowns are less likely to look like natural teeth and tend to stand out more when in the mouth.
  • Limited Materials. A dental lab can use any material available for making a dental crowns (gold, metal alloy, pure porcelain, zirconia, porcelain-fused-metal). For molars and premolars that absorb heavy chewing forces on a daily basis, porcelain-fused-metal (PFM) crowns are the gold standard if you're looking for durability and esthetics. CEREC machines can only make porcelain or zirconia crowns. That's okay for anterior teeth as they absorb less force when chewing. When it comes to molars and premolars, however, using only porcelain or zirconia leaves you with a less durable result.

Pros and Cons of (CEREC and 2-Appointment) Dental Crowns

Pros:

  • protects your root canal treated or cracked tooth to avoid catastrophic fracture and tooth loss
  • highly esthetic compared to a heavily-restored (heavily-filled) tooth
  • high durability

Cons:

  • expense (dental crowns cost roughly $1,250 CAD)
  • possible need for replacement (dental crowns last roughly 15 years depending on diet, patient hygiene and other factors)

Frequently Asked Questions (FAQ)

Financial Questions

Dental Crowns in Kitchener: How much does a Crown cost?

The cost of a dental crown varies with the type of material your Kitchener Dentist uses to make it.

Generally, your Kitchener Dentist will be able to deliver a Crown costing between $1,000 - $1,200. Patients often assume that gold crowns will cost significantly more than other types of crowns but this is actually not the case. The reason for this is that gold is easy to heat and shape while porcelain must be cut in a slow stepwise process under microscope. Therefore, making Gold Crowns requires less processing time, overall.

Dental Crowns in Kitchener: Will my dental insurance plan cover a Crown?

If you have dental insurance, they may cover dental crowns. The most common dental plans that cover crown placement will do so at a 50% rate. Thus, patients often pay a $500 - $600 co-payment on a single dental crown. Where a patient and their partner both have dental benefits, their insurance may cover a dental crown at 100%.

Best practice is to ask your Dentist in Kitchener to submit a pre-determination for treatment costs to your insurer.

Practical Questions & Maintenance

Dental Crowns in Kitchener: How long can I wait to get my Dental Crown?

In Dentistry, there are some things that are not time-dependant. However, with dental crowns, once your Dentist recommends one you should try to get it done sooner rather than later. But why? Lots of things accumulate wear and tear over time (think about cracks in your car bumper after a minor accident). Generally, as these things continue on without repair, cracks become larger and eventually a more major problem can occur.

This is the reason why you'd want to be timely about proceeding with a dental crown. Sooner rather than later is best. I have had patients tell me "well I'll wait until it breaks more to crown it". You can certainly do that but you increase the likelihood that the tooth breaks down to a point where it cannot be properly crowned. Or worse still, the next break could be a split or root fracture that your Kitchener Dentist cannot properly repair.

Dental Crowns in Kitchener: How do I best maintain my Crown?

Dental Crowns are not removable and they do not change the shape of your tooth or alter accessibility for cleaning. Accordingly, you can brush and floss around your dental crown daily to maximize its longevity.

Dental Crowns in Kitchener: How long does a Dental Crown last?

How long will your crown last? Most studies follow different treatments (i.e. dental bridges, implants, dentures) for only 10 years. Dental crowns enjoy a high survival rate at 10 years. The most common reason for failure or replacement is tooth decay near the gum line. This is the area where the crown-tooth interface exists.

In some cases, the cavity is in an area that your Kitchener Family Dentist can access and they will be able to repair it with a simple bonded dental filling. In other cases, however, the cavity is between teeth and repair is not possible. Under these circumstances, your Family Dentist will recommend a new crown.

Aesthetic/Cosmetic Questions

Dental Crowns in Kitchener: Can you whiten Dental Crowns?

Unfortunately, you cannot whiten the porcelain or zirconia on tooth-colour dental crowns. This means that you have to be strategic about aesthetics when you are pursuing placement of one or more crowns. If a whiter smile is important to you, have your Kitchener Dentist work with you to whiten your teeth before getting your crown(s). Then, they can match the shade of your crown(s) to the whitest version of your teeth.

If you don't have time to whiten for 1-2 weeks before getting your crown(s), you may want to go with something 1-2 shades brighter/whiter than your current tooth colour. This way, when you whiten your teeth, they will match your crown(s) reasonably well, and your entire smile will be brighter!

Kitchener Dental Crowns: Veneer Vs. Crown - Which is better?

Both Dental Veneers and Dental Crowns can be used cosmetically, to alter the shape of your tooth and to brighten its colour.

A dental veneer covers the outer, visible wall of your tooth or teeth while a dental crown covers your tooth entirely, all walls right down to the gum line.

So, what's better for you?

Well, dental veneers are less costly but provide far less reinforcement or strengthening compared to dental crowns.

Dental veneers tend to be suitable for teeth in the front of the mouth such as incisors and canine teeth.

Teeth in the back that absorb a lot of wear and tear during chewing, such as premolars and molars, would be better off with the bonus strengthening effect of a dental crown.

Finally, it's important to note that having dental crowns loosen and pop off happens very infrequently compared to dental veneers simply because the crown covers more of the tooth and has a larger bonded surface area.

If you'd like a brief synopsis about dental crown indications and benefits, please visit the Canadian Dental Association's page on Dental Crowns.

Thanks for reading today!

By Dr. Kyle Hornby, Kitchener Dentist

If you are in need of tooth repair or other Emergency Dental Services in Kitchener, give us a call at (519) 576-8160 or request a consult here.

Our Kitchener Dental Office is conveniently located in Downtown Kitchener and we are a short drive away for families in Waterloo, Breslau & St. Jacobs. Our central location means we truly offer family dentistry near you!

This article is meant to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Accordingly, always seek the advice of your Kitchener Dentist or other healthcare provider regarding a dental condition or treatment.

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