INDUSTRY INSIGHT
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Ask the Dentist
I was recently told I need a crown on a tooth that does not seem to be giving me any trouble . Does this mean the tooth needs a root canal ?
This is a great question ! To answer , I will cover several points : What is a crown ? Why do people need one ? and How does it differ from a root canal ( which is a separate procedure )? A crown , or “ cap ,” simply put , is like a helmet for the tooth that protects it by covering the top and preventing splitting and cracking . It is important to mention that not all crowns are the same . There are various types ( metal , ceramic , and combinations of those ) and methods for making them . Furthermore , there is a wide price range for each .
The “ conventional ” crowns have been around for centuries , as have the methods for making them . Usually two or more appointments are required . The dentist removes tooth from the top and sides to make room for the metal , ceramic or mixed-material crown . He / she then takes an impression , and makes a temporary crown to cover what ’ s left of the tooth . Next , the dentist sends the impression to a lab that could be located anywhere from the local area to California , or as far away as China , which is becoming very popular for dentists . The final crown comes back to the office sometime between a few days and several weeks , at which time you will return to the dental office to get numb again and try the crown . If it fits and looks close enough to your other teeth , the dentist will permanently cement the crown . Otherwise , there will be new impressions , a temporary piece back on and another try whenever that crown comes back , and do it all over .
Another option is to use newer CAD CAM technology called CEREC . With CEREC there is no need to take goopy impressions or use temporary pieces . Instead , pictures are taken with an exceptionally accurate camera to give three-dimensional digital impressions . The digital impressions have proven to be up to 10 times more accurate than traditional methods . Then there is a specialized computer to design an ideal tooth based on the other teeth you have . We use
KEVIN PAWLOWICZ , D . D . S . LOGAN REITER , D . D . S .
VOTED BY PEERS AS ONE
OF PITTSBURGH ’ S TOP DENTISTS 2008 – 2015
WWW . FOXCHAPELDENTISTRY . COM
a milling machine to create the crown . A porcelain oven is used to customize the restoration to match your other teeth . This procedure is complete in one visit , which eliminates multiple appointments and multiple injections to numb the area . We use only high-strength , highly aesthetic all-porcelain restorative material ; no metal . When these crowns are bonded properly to your natural tooth , they can be stronger than if the tooth was bonded to itself . Unfortunately , less then 10 % of dentists have this technology . There are also “ kinda ” CEREC machines , but they aren ’ t CEREC — make sure to ask by name . If your dentist does not utilize CEREC technology , as the moderator for the CEREC study club in the area , I could put you in touch with one of our members who can help you .
Which brings us to the real question , “ Why do you need a crown ?” One common reason for a crown is to reinforce a weakened tooth to prevent fracturing . A tooth can become weak from large fillings or cavities which diminish its strength . Some signs of a weak tooth include pain when biting or temperature sensitivity . However , these symptoms may not always be present until the tooth has cracked deep enough to affect the nerve of the tooth . Unfortunately , once it ’ s gotten to this stage , nerve damage may require that the nerve be removed . The removal of a tooth ’ s nerve is a root canal .
Root canal therapy is necessary when the nerve of a tooth dies or has been irreparably damaged . A root canal saves the tooth by removing the nerve from the inside of the tooth , subsequently removing any infection and then sealing the inside of the tooth to prevent any further problems . This procedure can be performed by a general dentist , depending on his / her training and comfort level ; otherwise you would need to be referred to a specialist called an endodontist . It is important to understand that not all teeth that need crowns require a root canal , and with CEREC , that number is even less . However , all back teeth that have had a root canal should have a crown .
In summary , if the tooth is not giving you any difficulty it certainly does not rule out a problem . If your dentist recommends a crown on a tooth , he / she may be acting proactively rather than reactively ; to prevent a potential problem that may require a root canal or possible loss of the tooth . As always , check with your dentist , call us here at Fox Chapel Advanced Dental Care , or log on to our website www . foxchapeldentistry . com where we have more information , as well as “ before and after ” examples of CEREC crowns . Hope that helps ! Dentally yours , Kevin
Top Dentist in 2015
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This Industry Insight was written by Dr . Kevin Pawlowicz .
Dr . Pawlowicz practices at Fox Chapel Advanced Dental Care on Old Freeport Road in Fox Chapel . He has trained at the Las Vegas and Seattle Institutes and is a member of the American Academy of Cosmetic Dentistry and the Academy of Laser Dentistry . You can learn more about Dr . Pawlowicz on his website , www . foxchapeldentistry . com .
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