What procedure does a dentist follow when a dental crown is made for a tooth?

Before the process of making your dental crown is begun your dentist will anesthetize (numb) both your tooth and the gum tissue which lies around it.

B) Your dentist will shape your tooth.

In order to have adequate strength and, in the case of porcelain type crowns, proper aesthetics, a dental crown must possess a certain minimal thickness. Your tooth in turn must be reduced by this same amount so once the crown is cemented into place on your tooth will not be oversized. In most cases the minimal crown thickness that is required will lie on the order of about two millimeters or so, which is just a little more than a sixteenth of an inch.

In those areas where a portion of your tooth has already broken off your dentist may find that they have very little tooth reduction to perform. As a part of the trimming process your dentist also will ensure that any decay that is present has been removed from your tooth.

Besides reducing your tooth so it is smaller in size your dentist must also shape your tooth in a specific fashion. A tooth receiving a dental crown must be slightly tapered in form so the crown will slip over and onto the tooth.

The greater the amount of tooth structure that extends up into the interior of a dental crown the more stable the crown will be. There can be times when so much of a tooth has broken off that a dentist will feel that they must "build up" a tooth with filling material first (make the tooth taller) before they do the final shaping for the crown.

C) Your dentist will make an impression of your tooth.

Once your tooth has been shaped appropriately your dentist will need to make a copy of it by way of taking an impression. Your crown will then in turn be made from this impression. There are two scenarios by which this impression taking process can take place:

1) Most dentists will take an impression of your tooth using a putty-like material simply called "impression material." This impression will then be sent to a dental laboratory that will in turn use it to create a plaster cast. A dental technician will fabricate your crown so it fits accurately on the plaster cast. Since the cast is a precise representation of your teeth the crown will fit on your tooth also.       Depending on the arrangements your dentist has made with the dental technician, the amount of time required to fabricate dental crowns usually lies on the order of two weeks or so. 2) Your dentist might have a dental ceramic milling machine in their office. These machines are attached to a camera that can take an impression of your tooth optically. From this image the machine can subsequently design your dental crown and then create it by milling down a block of dental ceramic ("porcelain"), all in a matter of some minutes. The obvious advantage of this technique is that a tooth can be shaped and its dental crown cemented into place, all in one visit.       If your dentist does not utilize a ceramic milling machine it can be for good reason. Milling machines can only be used to fabricate all ceramic ("porcelain") crowns. Your dentist may feel that the physical properties and/or the aesthetics of this type of crown are not appropriate for your situation.

D) A temporary dental crown will be made for your tooth.

In those cases where your dental crown will be created by a dental laboratory you will have to wait the two to three weeks required for your crown to be fabricated. During this time period your tooth will be covered over by a temporary dental crown that your dentist has made. The temporary crown, which is typically made from plastic or else a thin shell of metal, will be cemented into place over your tooth. (Information regarding temporary crowns.)

E) Your dentist will select the proper shade of porcelain needed for your dental crown.

If your crown will have a porcelain surface your dentist will need to determine what shade of porcelain most closely matches your tooth's neighboring teeth. Usually a dentist will have a series of small, tooth shaped pieces of dental porcelain (each of a different color) which are collectively termed a "shade guide." Your dentist will select various porcelain samples from this shade guide and hold them in the area your new crown will occupy, until they find the one that most closely matches the color of your tooth's neighboring teeth.

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II) Your second dental crown appointment.

Cementing your permanent crown in place.

At that point in time when the fabrication of your crown has been completed your dentist will proceed with the process of cementing it on your tooth. First your dentist will insure that your tooth is numb. Then, if a temporary crown has been placed, your dentist will remove it.

Before your dentist can cement your new dental crown into place they will first need to evaluate the way it fits on your tooth. To do so, your dentist will place the crown on your tooth, inspect its fit (possibly by way of using dental floss, feeling it with a dental tool, or asking you to gently bite down), remove the crown and adjust it, repeatedly, until they are satisfied. Additionally, and especially in those cases where the dental crown will hold a prominent position in your smile, your dentist will need to evaluate (and probably ask your opinion about) the crown's overall shape and color.

Once you and your dentist both agree that all seems right with your new crown it can be cemented. First your dentist will place dental cement inside your crown and then they will seat the crown on your tooth. After a few moments, so to allow the cement to set somewhat, your dentist will use a dental tool and scrape away any excess cement that has extruded from underneath the edges of your crown. The placement of the crown is now complete.