Dental crowns are synthetic caps placed on the top of a tooth. They are usually made of either ceramic (porcelain), metal or a combination of metal and ceramic or a composite resin.
Dental crowns are typically used to restore a tooth’s function and appearance following a restorative procedure such as a root canal. When decay in a tooth has become so advanced that large portions of the tooth must be removed, crowns are often used to restore the tooth. Similarly if a tooth has broken and would require a large amalgam or tooth coloured filling a crown will be recommended for a long term treatment option.
Dental crowns are also used to attach bridges, cover implants, prevent a cracked tooth from becoming worse, or an existing filling is at risk of becoming loose or dislocated. Crowns also serve an aesthetic use, and are applied when a discoloured or stained tooth needs to be restored to its natural appearance.
Dental crowns can also be used to align teeth if multiple adjacent teeth are prepared. However this generally requires a more aggressive tooth preparation.
Dental crowns are sometimes confused with veneers, but they are quite different. Veneers are typically applied only to the lip facing side of the tooth and are often thinner.
An impression is taken of the tooth to be crowned. The tooth is then reduced in size to accommodate adequate crown material. A balance between crown thickness and preserving as much tooth structure as possible. A second impression is taken, this time of the prepared/reduced tooth. The impression is sent to a dental lab, which manufactures a custom-designed crown. A temporary dental crown is made from the initial impression template. The temporary dental crown is cemented with temporary cement until the permanent dental crown is ready in approximately 2 weeks. Permanent dental crowns are cemented or bonded in place.
Most dentists take 1 hour to 1.5 hours for the first dental crown visit and 30 minutes for the second dental crown cementing visit.
The tooth is reduced in size accommodate the ceramic material which is approximately 1 mm thick. The prepared tooth, opposing tooth and bite is photographed digitally. The dentist then designs the dental crown digitally. Once the dental crown is designed, the design is sent to the milling machine which cuts the dental crown out of a ceramic block. Depending on the ceramic used, the dental crown is generally glazed and fired in a furnace for 30 minutes. The dental crown is then tried in the mouth, adjusted to fit and then bonded in place. The Cerec system allows a dental crown to be completed in one visit. Not every dentist offers Cerec due to the most recent system version retailing at around $200k.
Most dentists take 1.5 to 2 hours to complete a cerec crown.
With proper care, a good quality crown could last up to eight years or longer. It is very important to floss in the area of the dental crown to avoid excess plaque or collection of debris around the restoration.
Certain behaviors such as jaw clenching or bruxism (teeth grinding) significantly shorten the life of a crown. Moreover, eating hard foods, ice or hard lollies can compromise the adhesion of the crown, or even damage the dental crown.
A dental crown is an expensive item. However, to give you an idea of what the dentist actually makes on a dental crown, take an average price of $1500, subtract from this the lab cost say $500 = $1000 and now take off 60% which is the cut that most practice owners take for providing the staff, surgery, materials etc. and the dentist is left with a total $400 or hourly rate of $200. A bit different to thinking the dentist is getting the full $1500.
There is a wide range of prices for dental crowns in New Zealand. Lab manufactured dental crowns are often priced according to the dental technician’s lab fee to the dentist. If a dentist uses a cheap lab often they are able to keep their crown fee low. Lab manufactured dental crowns also vary depending on type of material the crown is made of.
It is also worth checking with your dentist whether they will charge an additional fee for a core build up should this be required. Depending on the state of your tooth and type of crown material used will determine whether a core of filling material is required. Some dentists will charge a core build up as a separate charge and others will incorporate it into the total dental crown fee.
Average dental crown prices in New Zealand:
Composite core $100 – $300
All Ceramic crown $1100 – $2000
Porcelain Fused to Metal crown $1100 – $1800
Composite crown $400 – $600