Dental Crowns

Crowns for teeth, often referred to as dental crowns, are protective caps placed over damaged, weakened, or decayed teeth to restore their shape, size, strength, and appearance. They are custom-made to fit over the entire visible portion of the tooth above the gum line. Crowns form apart of restorative dentistry.

What is the Dental Crown Procedure?

The dental crown procedure involves multiple steps that typically require two visits to the dentist. It is done to repair or restore a damaged, weakened, or cosmetically unappealing tooth. Here’s a breakdown of the process:

Step 1: Initial Consultation and Examination

• The dentist examines the tooth and takes X-rays to assess the extent of damage or decay and ensure the root is healthy.
• If there is extensive decay or infection, a root canal treatment may be performed first.

Step 2: Tooth Preparation

• The tooth is reshaped to create space for the crown. This involves filing down the tooth’s outer layer.
  • If the tooth is severely damaged or decayed, the dentist may use a filling material to rebuild its structure before shaping it.
• Local anesthesia is used to numb the area, ensuring the process is pain-free.

Step 3: Impression or Digital Scan

• A mold or digital scan of the prepared tooth and surrounding teeth is taken to create a custom-fitted crown.
• The dentist matches the crown’s colour to your natural teeth for a seamless look.

Step 4: Temporary Crown Placement

• A temporary crown is placed to protect the prepared tooth while the permanent crown is fabricated.
• The temporary crown is secured with weaker adhesive, making it easy to remove later.

Step 5: Fabrication (1-2 Weeks)

• The impression or digital scan is sent to a dental lab where the crown is crafted. This can take 1-2 weeks.
• Some dentists offer same-day crowns using CAD/CAM technology, which eliminates the need for a temporary crown.

Step 6: Fitting and Placement

• At the second appointment, the dentist removes the temporary crown.
• The permanent crown is checked for fit, colour, and comfort.
• If everything is satisfactory, the crown is cemented in place using a strong dental adhesive.

Step 7: Final Adjustments

• The dentist makes any final adjustments to ensure the crown feels natural and comfortable when biting or chewing.
• Polishing may be done for a smooth finish.

What are Side Effects of Having Crowns?

Dental crowns are a common and generally safe treatment, but they can sometimes have side effects. These effects vary based on the individual, the materials used, and the placement process. Below is an overview of potential side effects associated with dental crowns:

One common issue is sensitivity or discomfort after the procedure. This can occur because the tooth has been reshaped and is adjusting to the crown.

Patients may experience sensitivity to hot or cold foods and drinks, particularly if the tooth’s nerve remains intact. In some cases, the bite may feel off, which can lead to discomfort when chewing. Adjusting the crown’s fit usually resolves this issue.

Allergic reactions can occur, though they are rare. Some crowns are made from materials like metal alloys, which may cause a reaction in individuals sensitive to certain metals. If you have known allergies, it’s important to inform your dentist beforehand so they can choose a suitable material, such as porcelain or zirconia.

Over time, gum irritation or recession might develop around the crown. Poorly fitting crowns can trap food and bacteria, leading to inflammation or gum disease. Additionally, as gums naturally recede with age, the crown’s edge might become exposed, increasing the risk of decay or sensitivity in the underlying tooth.

Another potential issue is crown damage or loosening. Crowns, especially those made of porcelain or resin, can chip or crack under pressure. If the dental cement weakens, the crown may loosen, exposing the tooth to bacteria and increasing the risk of decay. Regular dental check-ups can help identify and address these problems early.

In some cases, the crowned tooth may develop decay or infection if the seal between the crown and the tooth is compromised. This can occur if proper oral hygiene is not maintained or if the crown does not fit snugly against the gumline. A severe infection might require root canal treatment or crown replacement.

Lastly, while rare, jaw or bite alignment issues can develop if the crown affects how the teeth come together. This can lead to strain on the jaw muscles or temporomandibular joint (TMJ) disorders. Dentists typically assess the bite carefully during crown placement to minimise this risk.

Despite these potential side effects, dental crowns are highly effective at restoring and protecting teeth. Proper oral hygiene, regular dental visits, and prompt attention to any discomfort can help ensure long-term success with your crown.

How to Care for Dental Crowns

Proper care for dental crowns ensures their longevity, maintains oral health, and prevents complications like decay or gum disease. Here are essential tips for caring for your dental crowns:

1. Practice Excellent Oral Hygiene

• Brush twice daily: Use a soft-bristled toothbrush and fluoride toothpaste to clean your teeth and crown gently, removing plaque and food debris.
• Floss daily: Clean around the crown to prevent plaque buildup. Use a floss threader or interdental brushes if flossing is difficult near the crown.
• Consider using an antibacterial mouthwash to reduce the risk of infection and keep gums healthy.

2. Avoid Hard or Sticky Foods

• Minimise chewing on hard items like ice, hard candies, or nuts, as these can chip or crack crowns, especially porcelain ones.
• Avoid sticky foods like caramel or chewing gum, which can loosen or dislodge the crown.
• If you grind or clench your teeth (bruxism), consider using a custom-fitted mouthguard to protect the crown.

3. Protect Your Crown During Sports

• If you play contact sports, wear a sports mouthguard to prevent accidental damage to your crown and natural teeth.

4. Schedule Regular Dental Checkups

• Visit your dentist every 6 months for professional cleanings and checkups. They will monitor the condition of your crown and surrounding teeth.
• Report any issues like sensitivity, discomfort, or looseness to your dentist immediately for timely adjustments or repairs.

5. Maintain a Healthy Diet

• Eat a balanced diet rich in fruits, vegetables, and dairy products to strengthen your teeth and gums.
• Limit sugary and acidic foods and drinks, which can weaken the underlying tooth and increase the risk of decay near the crown’s edges.

6. Address Grinding or Clenching

• Bruxism can wear down or damage crowns over time. Your dentist may recommend a nightguard to prevent this issue if you grind your teeth during sleep.

7. Be Mindful of Gum Health

• Keep the gums around your crown healthy to prevent recession, which could expose the tooth’s base or lead to decay.
• Massage your gums gently during brushing or use a water flosser to enhance blood circulation and cleanliness.

How much do Crowns Cost in South Africa?

The cost of dental crowns in South Africa varies depending on the material, type of crown, and location of the dental clinic. Here are some general price ranges:

1. Metal Crowns (including gold): R3,500 – R9,000. These are durable and often used for molars.
2. Porcelain-Fused-to-Metal (PFM) Crowns: R4,000 – R10,000. These combine durability with a natural appearance.
3. All-Porcelain Crowns: R5,000 – R12,000. Ideal for front teeth due to their aesthetic quality.
4. Zirconia Crowns: R6,000 – R12,000. Known for strength and aesthetics, they are less likely to chip or crack.

In addition, consultation fees range from R300 to R600, and other costs like X-rays or core build-ups (if needed) can add R1,000 to R2,500 to the total. The prices may also vary by city, with Johannesburg and Cape Town often being more expensive than Pretoria​.

​Some clinics offer financing plans, and dental insurance may cover part of the cost, especially if the crown is medically necessary. It’s best to contact your dentist directly to get an accurate quote tailored to your needs.