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What is a Crown?

A crown is also sometimes referred to as a cap. It is an artificial replacement for that part of the tooth that is above the gum line. A crown typically covers the entire tooth, replacing most of the enamel. Crowns can be made from gold alloy, gold and porcelain fused together, or entirely from porcelain. The material used for crowns is chosen based on each patient’s individual needs. Crowns may be made in a laboratory or in the office on a CEREC machine.

Why do I need a crown?

Teeth that have cracked enamel, extensive decay, or defective fillings often must be crowned. Cracked enamel can allow mouth fluids and bacteria into a tooth. Left alone, it can result in a contaminated nerve. Broken cusps (the pointy parts of a tooth) or other broken sections can continue to fracture, causing pain and possible nerve damage. Extensive decay usually means that a large part of the tooth structure is damaged from a cavity. A defective filling is one that has breaks, fracture lines, or cracks in it, or one that has sections that have shrunk away from the rest of the tooth. Left alone, defective fillings can result in a nerve exposure.

A crown replaces damaged parts of a tooth and adds to its life span. Crowns can also be used to make cosmetic improvements in the appearance of teeth.

Why can’t I just have a filling?

Fillings can be made from various materials and are good for fixing small decayed sections of a tooth where cavities have occurred. They are not good for repairing cracks, broken cusps, extensive decay, or severely damaged old fillings. There has to be enough of the natural tooth left to support a filling. If not, a crown is typically the only answer.

I have a defective filling and need to have a crown. My tooth doesn’t hurt. Why should I have a crown done now?

It is tempting to leave well enough alone when you are told that you have a condition that needs attention, and you feel just fine. It can be a mistake when you are talking about your health and your teeth. A tooth that has a defective filling is a tooth that has bacteria and fluids seeping into it. Acids from the bacteria can eat away at the natural tooth under the filling, eventually reaching the nerve. Once contaminated by bacteria, the nerve may develop an abscess which is often painful. Once the abscess has formed, a root canal must be done to remove the bacteria. A tooth that has had a root canal often requires a crown. So, when a crown is recommended, it is a good idea to have it done before a root canal is needed. It can save you time, pain and money.

If a crown is done, will I be facing a root canal in the future?

Once your dentist has removed your broken cusps, defective fillings and any decay, an assessment is done of the condition of the nerve. Just because a tooth needs a crown, does not mean that a root canal must be done. However, there is a sixty percent chance that teeth receiving crowns will requiring root canal therapy in the future.

It is possible for bacteria to contaminate a tooth nerve without any signs or symptoms for a patient or indication to the dentist. If it turns out that the nerve has been microscopically contaminated, a root canal may have to be performed in the future. Sometimes, this may be done through the top of the existing crown, without the crown requiring replacement. If that is not possible, the crown may need to be replaced. Even though this might happen, it is not reasonable or recommended to perform root canals on all teeth requiring crowns.

Why do crowns cost so much more than fillings?

All dental treatment is expensive because it is performed by hand, by extensively trained and educated dentists, hygienists and staff, on a service by service basis. Unlike items such as shoes and shirts that can be mass produced for retail sales; dental treatment and restorations are unique and individual. Each restoration is made just for you.

Dental treatment and restorations can affect a person’s general health, feeling of well-being, and appearance. Crowns are usually more expensive than fillings because of the laboratory expenses they require.

Will my insurance pay for my crowns?

Your plan may help, but usually will not cover all the costs of  a crown. Most insurance plans have a maximum limit as to the amount of money they will pay for any treatment in a one year period. They also usually have a list of servies that are covered or not covered.

Your dental insurance plan is not like your medical insurance. It is really just a benefit supplied by an employer to help pay for routine dental treatment rather than true insurance that covers a medical catastrophe. The employer usually buys a plan based on the amount of the benefit and how much the premium costs each month. Most benefit plans are only designed to cover a portion of the total cost of dental care for any patient.

Your insurance may pay part of the cost of your crowns, but typically there is always an amount left for you to pay. Insurance may also only cover an alternate benefit for a filling, even though your best option is a crown. Many contracts are designed to pay a minimum amount regardless of what service you actually need. Remember that  the insurance carrier’s responsibility is to control payments, but it is your dentist’s responsibility is to prescribe what is best for you.

If my insurance will not pay for my crowns, why should I have them done?

Your insurance plan can help you pay for treatment that you need, however it was never designed to pay for everything. Most plans typically pay a minimum regardless of what you might require as an individual. Benefits should not be your only consideration when you are making decisions about your teeth. You owe it to yourself to carefully consider the advice your dentist is giving you. People who have lost their teeth often say that they would pay any amount of money to get them back. Your smile, attractiveness, ability to chew and enjoy food, and general sense of well being are dependent on your dental health. Many people would say that it is worth the expense to keep your teeth for a lifetime.

How long do crowns last?

With regular dental checkups and good home maintenance, they can last indefinitely.  In some cases, they may even add to the longevity of a tooth. Even so, it is reasonable to assume that replacements might be needed some time during a person’s life.

Contact our Patient Care Coordinator in Madison, NJ, if you have any questions about your dental health.

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