Dental crowns explained Richmond VA

What is a dental crown?

A dental crown is a tooth-shaped “cap”. It is placed over and affixed to a prepared tooth. It covers the tooth to restore its shape, size, strength, and improve its appearance.

Once placed, the crown fully covers the entire visible part of a tooth that lies at and above the gum line.

When is it appropriate to use a dental crown?

You may ask yourself “How do I know if I need a dental crown?” Common reasons include:

  • Preservation of tooth structure. – for example to preserve structure if small  fracture lines are visible)
  • Improved tooth function or replacement
  • Cosmetic reasons

These situations are described below.

Crowns are used for tooth preservation

A dental crown may be needed in the following situations:

  • To protect a tooth with large fillings or a root canal
  • To hold together and protect the  tooth from further cracking
  • To restore severely worn teeth

A crown may also be used as a support or complete tooth replacement mechanism

  • To hold a dental bridge in place
    To cover an implant

Finally, crowns are commonly used for cosmetic or functional improvements

  • To cover misshaped or severely discolored teeth
  • To enhance cosmetic appearance, improve chewing function and even speech

Commonly used types of dental crowns

For most people, the best crown is one that cannot be distinguished from a natural tooth.
There are essentially four or five types of crowns commonly offered in most practices.
These include Ceramic crowns, Porcelain, Porcelain Fused to Metal, Zirconia. Stainless Steel and Gold. Also, temporary resin crowns are placed while a permanent crown is prepared in the laboratory.

Porcelain Crowns

All Ceramic Crowns or all Porcelain Crowns


Porcelain Fused to Metal (PFM) Crown note that the metal lip is only visible
on the lingual (tongue side) of the crown.


Gold Crown for back teeth (very durable, good for teeth grinders)
They have largely been replaced by more natural looking alternatives.


Milled crowns are made using an intraoral scanner and cut from
a Zirconia blank.

Zirconia or milled crowns are constructed from a digital image of the underlying and opposing teeth. They can be produced either in a dental office or in a dental lab. Milled crowns are convenient as they only require one visit with no need for a temporary crown or an impression.

Which type of dental crown is best? Ceramic, porcelain fused to metal (PFM), Zirconia or a gold crown?This depends on a case by case basis. It involves a joint decision between you and your dentist.

Ceramic, porcelain crowns

All ceramic or porcelain crowns are excellent at matching the color of natural teeth. They work well for the front teeth as they appear translucent and natural. If the gum recedes over time these crowns will still appear natural at the gum line. They are less durable than PFM crowns as PFM crowns have the underlying structure of high noble metal. This remains intact should at one point ceramic component fracture. Porcelain and ceramic crowns are harder than the opposing natural teeth. To prevent unnecessary wear and enable a proper bite, the crown should be cut to precisely fit the contour of the opposing tooth.

PFM crowns

PFM crowns yield a natural appearance and typically last longer pure porcelain or ceramic crowns. The metal alloy component provides strength and a precision fit to the underlying tooth substrate. The strong alloy component minimizes the need to remove tooth material. Bound with an adhesive this resists the eventual incursion of bacteria that can damage the tooth and cause crown failure. PFM crowns have a higher cost for time and materials yet generally last longer than their porcelain or ceramic counterparts.

Gold alloy crowns

Gold alloy crowns are typically used in less visible parts of the mouth such as the bicuspids or molars. Unlike conventional ceramic or porcelain crowns less tooth substance needs to be excavated to prepare a substrate for a PFM or gold crown. Gold crowns can last more than 50 years and are often prescribed for individuals who grind their teeth (bruxism). The gold crown will wear down the opposing teeth less than a ceramic or porcelain one.

Temporary Crowns

All-resin dental crowns are less expensive than other crown types. However, they are a crafted from a softer material and wear down faster over time. This makes them more prone to fractures than porcelain-fused to high noble-metal-crowns. These crowns are mostly used as a temporary solution before a more permanent restoration is utilized.

Stainless steel crowns are prefabricated crowns that are used on permanent teeth primarily as a temporary measure. The crown protects the tooth or filling while a permanent crown is made from another material.

For children, a stainless steel crown is commonly used to fit over a primary tooth that’s been prepared to accept it. The crown covers the entire tooth and protects it from further decay or fracture. When the primary tooth falls out to make room for the permanent tooth, the crown comes with it. In general, stainless steel crowns are used for children’s teeth because they don’t require multiple dental visits to put in place and are more cost-effective.

What is the process of making a crown?

Crowns and Bridges – How we make them and why it matters to you
We take great care in taking impressions, the selection of crown materials, the labs we use and in the final placement and function of the crowns or bridge.

Full Arch Impressions – quality begins here
We always take full-arch impressions by hand. The impression determines the crown-to-tooth fit and the contact to opposing teeth. A precise fit is essential for strength, comfort, and longevity. It also blocks microbial ingress where the crown bonds to the tooth. Thus, there is little if any need to adjust the crown at the time of fitting. This assures the optimal placement, strength, adhesion, and seal.

Bio-materials – some are better than others
Advanced Dentistry of Richmond uses mostly porcelain fused to high noble metal crowns.
High noble metals, such as platinum/gold alloys, provide the best bonding surface to the tooth. They are non-allergenic to gums and best protect the tooth from bacteria. Over many years the porcelain portion of the crown may fracture or chip. The tooth remains protected by the underlying gold alloy layer.

Why is a dental lab important to you?
We work only with a select group of scrutinizing dental laboratories. They require exact impressions from the patient’s mouth. They do not accept any “guess-work”. Skilled technicians fabricate crowns with the best fit and natural look. This includes custom staining and shaping for optimal esthetic results.

What can you expect when you visit us for a crown?
During your first visit, we inspect the tooth and assess the level of decay or need of reconstruction. We’ll take X-rays to determine the condition of the root and spread of non-visible decay.
Next, we decide on the best treatment. Considerations include a multi-sided filling, a crown, an onlay, bridge or an implant. This depends on the severity of the decay, tooth position, bite and other factors.

What is the process for crown preparation?
When we select a crown, we use a fine drill bit to remove previous fillings and tooth decay. This preserves as much of the tooth as possible. This takes longer than using a rough drill bit. A fine bit preserves enamel for a better bonding surface. We use a lot of water to cool the tooth during the tooth preparation process to prevent damaging the underlying tooth nerve.

What is the process, if a lot of tooth structure is missing?
We might have to build up missing tooth structure with a core build-up paste, which hardens and improves the fit and adhesion of the new crown.

What happens after tooth preparation?
Once we finish preparing the tooth, we take impressions for both the upper and lower arches. These not only capture the contours of the prepared tooth but also that of the opposing tooth to assure a good bite.

Finally, we fit and cement a temporary crown on the tooth. The front desk will schedule a visit n 10-14 days for the placement and cementation of the permanent crown.

Do you only use high-quality dental laboratories?
Once you are fit with the temporary crown we send your impressions to a dental laboratory. The dental technician receives specific instructions on materials to be used and how to color and shade the new crown.  The few dental laboratories we use are thorough and precise. Their crowns have an excellent fit. This saves considerable time for placement. It also provides an excellent seal and cement perfectly to the underlying tooth. Such well fitting crowns crown will last longer.

What happens on the second visit?
On your second visit, we fit the crown. We check your bite and the contact surfaces of opposing teeth.

You’ll have a chance to inspect the new crown. You can judge how natural it looks and how the color and texture matches the surrounding teeth.

Finally, we cement the new crown to the prepared tooth with a long-lasting cement.

How many visits in the dental office does it take to get a new crown?
A simple porcelain fused to high-noble metal crown placement involves two visits. The interval between visits is about 14 days.

A well-placed crown can provide years of perfect function and satisfaction.

Advanced Dentistry of Richmond is located in the beginning of the West End of Henrico next to Richmond, VA area. We are off of 64 west. Exit Glenside Dr south, west on Forest Ave, to Bayberry Ct. We’re located on the second floor, 7204 Glen Forest Dr, Suite 203, Richmond, VA 23226. Call us now at (804) 282-7260.

Published 10/9/2017