Is it Time to Replace Your Dental Crown? A Comprehensive GuideAre you experiencing discomfort or pain when chewing or biting down? Is your dental crown showing signs of wear and tear, such as discoloration or a widening gap between the tooth and crown? If so, it may be time to consider replacing your crown.
While dental crowns are designed to be durable and last decades, they are not immune to the effects of time and daily wear and tear. In fact, research shows that around 11% of crowns experience complications within an average of 6 years of being placed.
But don't worry - getting a crown replaced is a common procedure that can help restore the function and aesthetics of your teeth.
In this article, we will review the most common situations in which a dental crown needs to be replaced. You will also learn about the steps involved in the replacement procedure, the different techniques, and what to expect.
- Dental crowns may need to be replaced due to decay, infection, gum irritation, fracture, or cosmetic concerns.
- To replace a dental crown, there are three phases: evaluation and preparation, crown removal, and new crown placement.
- The removal of an old crown may involve different techniques, such as applying vibrations, using hand instruments, using the Richwil Crown Remover, or cutting the crown with rotary instruments.
- A new crown will be custom-made to fit the prepared tooth, and the dentist will cement it into place and make necessary adjustments to ensure proper fit and bite.
When should your crown be replaced?When the dental crown wears out or deteriorates, it may be time to replace it.
The main challenge to the longevity of dental crowns is time. As time passes, the risk of complications increases. In an article published in The Journal of Prosthetic Dentistry, 1476 crowns were evaluated. Of these, 156 (11%) experienced some complications within an average period of 6 years.
The most common situations where the dental crown must be replaced are the following:
1. Tooth decay:
As the crown ages, it can trap plaque more quickly and easily. This can lead to decay around the crown or in the tooth below.
You may notice a black discoloration or a widening gap between the tooth and the crown. If this happens, your dentist will need to remove the crown to clean and reshape your tooth. However, if left untreated, decay can cause the crown to loosen and fall out, or even cause an infection.
If the crown no longer fits properly, it can cause bacteria to accumulate in the underlying tooth and reach the nerves. You may experience pain or discomfort when chewing. In this case, your dentist may have to remove the crown to perform a root canal.
3. The crown is hurting your gum tissue:
If the crown is poorly shaped, has become rough over time, or is too high or too low, it can irritate or even damage the gum tissue around the tooth.
This can cause pain, swelling, and even gum recession. In this case, your dentist may reshape your crown or place a new, well-fitting one to properly line up the teeth and protect the surrounding gum tissue.
4. Fracture of the tooth or crown:
Crowns are designed to be strong and durable, but they can still crack or break under certain circumstances. This is especially true of porcelain crowns, which are the most fragile.
This can happen if you bite down on something hard, grind or clench your teeth, or if you have experienced trauma to your mouth.
Sometimes the fracture can also affect the tooth underneath. If the damage is severe, a new crown may be needed to restore the structure and function of the tooth.
5. Cosmetic purpose:
Whether the crown is discolored or you simply want to improve the appearance of your smile, replacing an old and worn-out crown can also be an option.
Cosmetic concern comes up often when it comes to front teeth. In this case, a new crown can be placed to match the color and shape of the surrounding teeth, giving you a natural-looking and attractive smile.
Dental crown replacement procedure:The steps for replacing a crown do not change much from a regular crowning procedure. What is new is the removal of the old crown and the treatment of the associated underlying conditions (decay, fracture, etc.)
There are 3 different phases: evaluation and preparation, crown removal, and the new crown placement.
1. Evaluation and preparation phase:
During your first visit to the dentist, many factors discussed above will be looked at to determine if you need a crown replacement procedure.
To do this, your dentist will ask you questions about the age of your crown. A crown typically lasts between 10 and 15 years. If your current crown is nearing or past its lifespan, they may recommend a replacement.
Your dentist will also check the crown's fit and any damage or complications, such as cavities, fractures, or infections.
Finally, they may take an x-ray of the tooth to get more details.
2. Old crown removal:
Once the decision to replace the crown is made, your dentist will remove your crown with one of these techniques. Some of these methods can be uncomfortable. So you may expect to get local anesthesia to numb the area around the tooth in order to avoid any pain during the procedure.
Here are the most common techniques for removing the crown:
1. Apply vibrations to the crown to help loosen it:This involves using an ultrasonic instrument that emits high vibrations (scalers) to loosen the cement. After a few minutes of application, the crown will be easier to remove. This technique is one of the most comfortable and less traumatic for your crown and tooth.
2. The Richwil Crown Remover:This is also a comfortable and gentle technique for your tooth and crown. It uses a thermoplastic material that your dentist heats to soften it and make it stick to your teeth (like chewing gum). You must then bite down on it, apply firm, constant pressure and then open your mouth with a quick, forceful movement.
This technique has been reported to be 100% successful for temporary crowns and 60% successful for permanent crowns.
Removing a crown with the Richwil Crown Remover
3. Using hand instruments:Your dentist may use specific hand instruments, such as crown removers and pliers, to remove your crown. These techniques can be effective, but they may be less comfortable for you and put a lot of pressure on the tooth and crown.
Removing a crown using hand instruments
4. Cutting the crown with rotary instruments:This technique aims to preserve the underlying tooth by cutting the crown. It involves using rotary instruments to split the restoration for easy removal.
Removing a crown by cutting it off
3. New crown placement:
Once the old crown is removed, your dentist will prepare the tooth by removing any decayed or damaged parts and shaping the tooth to fit the new crown.
Your dentist may use the old crown after adjusting and reshaping it. However, if the crown or tooth is badly damaged, they may consider a new one.
First, your dentist will take impressions of the prepared tooth to create a custom-made crown that fits perfectly. In the meantime, he may place a temporary crown over the prepared tooth to protect it.
At your next appointment, your dentist will remove the temporary crown and cement the new crown into place.
Finally, he will make any necessary adjustments to ensure it fits properly and feels comfortable in your mouth.
Is crown replacement procedure painful?As mentioned above, some techniques for removing an existing crown can be uncomfortable. Your dentist may numb the area to reduce discomfort during the procedure.
After the procedure, you may experience some sensitivity or pain for a few days. This is temporary and can usually be managed with over-the-counter painkillers.
When can a dental crown not be replaced?There may be situations where a crown cannot be replaced. In this case, extraction of the affected tooth may be the only remaining option. Here are some of the most common scenarios where a crown cannot be replaced:
- Severe decay or damage to the underlying tooth: If the tooth under the crown is severely damaged by decay, trauma, or infection, it may not be possible to save the tooth with a new crown. In these cases, your dentist may recommend tooth extraction to prevent further complications.
- Insufficient tooth structure: In some cases, the tooth may not have enough remaining structure to support a new crown. This can occur if the tooth has been severely worn down or if a large portion of the tooth has been lost due to decay or damage.
- Gum disease or periodontitis: When the bone surrounding the tooth is infected and severely damaged by gum disease, it may not be possible to save the tooth with a new crown. In this case, extraction may be the only option left.
- Tooth infection: When the infection becomes too extensive and persists despite root canal treatment, it may no longer be possible to save the tooth.
How to increase the lifespan of your new crown?After investing in a new dental crown, it's important to take good care of it to ensure it lasts as long as possible. Here are some tips to help increase the lifespan of your new crown:
- Practice good oral hygiene: Brush twice a day with fluoride toothpaste, floss daily, and ask your dentist if you can start using mouthwash or fluoride supplements. This will help prevent decay and gum disease that can compromise the health of your crown and the underlying tooth.
- Avoid hard or sticky foods: Try to avoid biting down on hard or sticky foods like ice, hard candy, or caramel, as these can put extra stress on your crown and potentially damage it.
- Wear a nightguard: If you grind or clench your teeth while you sleep, ask your dentist about getting a custom nightguard to protect your crown and underlying tooth from excessive pressure.
- Visit your dentist regularly: Attend regular dental check-ups and cleanings to ensure your crown is properly maintained and to catch any potential issues early on.
- Address any dental problems promptly: If you experience pain, or sensitivity, or notice any damage to your crown, contact your dentist right away. Prompt treatment can help prevent further damage and prolong the life of your crown.
- Avoid chewing on non-food objects: Avoid using your teeth to open packages or bottles or to bite your nails, as these habits can damage your crown and cause it to wear down more quickly.
- Clinical complications in fixed prosthodontics https://www.sciencedirect.com/science/article/abs/pii/S0022391303002142
- Removal of failed crown and bridge https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3917642/
- Richwill Crown and Bridge Remover