Dental crowns and partial crowns

Why a crown preserves your own tooth

Chewing puts strong forces on every tooth, and a healthy tooth copes with them easily. Once decay has destroyed too much tooth structure, or the walls have become too thin, there is an increased risk that the tooth will break under load. This is where a crown can help: it encases the tooth and spreads the chewing forces evenly again. For root-treated back teeth, too, a crown is often advisable.

Even so, a crown is not the first choice as long as a smaller solution will hold. After all, the tooth has to be prepared for it and loses structure that does not come back. That is why we always look for the solution that preserves as much of your own tooth as possible. Depending on the defect, a partial crown, an inlay or an onlay may be enough on its own. In that case only the destroyed part of the tooth is replaced and the healthy part is preserved. After five years, around 95 out of 100 ceramic crowns are still functioning, and after ten years about 80 to 90 of them. Good care and regular check-ups improve these prospects.

Good to know

You have a choice of materials. As a rule we use metal-free crowns. Zirconia crowns (zirconium oxide) are particularly strong and are therefore often chosen for the back teeth, where the greatest forces act during chewing. For the front teeth, glass ceramic (lithium disilicate) looks even more natural. It is, however, somewhat less resilient. The most natural appearance comes from a layered all-ceramic crown. Its framework is coated by hand in the laboratory, layer by layer, with a fine veneering ceramic (feldspathic ceramic). This layer is more delicate and needs more maintenance, as it can chip over the years. In return, the result is usually indistinguishable from a natural tooth. For price-conscious patients, ceramic composite can be a solution. It wears down more quickly and can discolour. In return it is cheaper and easy to repair. On current evidence, however, it does not last as long as ceramic on average. We will discuss with you which material suits your situation best.

The crown itself cannot decay. The tooth underneath can. The most vulnerable spot is the junction between crown and tooth: this is where new decay is most likely to start. How often that happens depends heavily on how well you look after your teeth. In a study of more than 1,000 crowns and bridges, decay at the margin occurred around four times as often with poor oral hygiene as with good care. So clean between your teeth every day as well, and come regularly for professional dental cleaning and preventive care.

In all honesty: preparing the tooth can leave it sensitive for a while. In about 5 out of 100 crowned teeth, the tooth nerve dies in the years after treatment, and more often in teeth that were already badly damaged. A root canal treatment then becomes necessary. Ceramic is hard-wearing. It can still break. If you grind your teeth at night, we recommend an occlusal splint to take the load off the crown and your own teeth. You can read more on our page about teeth grinding and the jaw joint. Occasionally a crown can also work loose. That can be a sign of a defect that is progressing. If a defect can be ruled out, we simply cement it back in place. Not every tooth can be saved with a crown. If too much structure is missing, or the tooth cannot be preserved even with a root canal treatment, we will discuss replacing it with an implant.