Dental Crown / Tooth Cap Types Procedure & Care

A dental cap or crown is a prosthetic that is placed over damaged or decayed teeth to restore tooth shape and function. Generally, they are the most preferred treatment when a patient’s tooth can’t be restored using filling material. They also protect the tooth from further damage and decay.

A dental crown’s shape, color, thickness, etc., can differ based on the material they are formed of, but its primary purpose is to restore tooth structure, so it is almost always customized based on the patient’s tooth and arch size. Dental crowns normally cover the entire visible portion of the tooth.

Why is Dental Capping Required?

Dental capping is generally performed to protect the remaining tooth structure and restore tooth appearance, shape, size, strength, and function in the oral cavity. You may need a tooth crown for one of the following conditions:

• Protect a weak/cracked tooth from fracturing
• Restore a broken or worn-down tooth
• Restore a severely decayed tooth after root canal treatment
• As a part of a dental bridge
• Cover unaesthetic, misshapen, or severely discolored teeth that can’t be repaired otherwise
• Protect a filling from getting dislodged

Tooth Capping Procedure

Typically, all dental treatments begin with a thorough dental examination. During your first visit, the dentist will perform an oral examination and take an intraoral periapical (IOPA) radiograph of the tooth to assess its root strength and the bone condition around it. If you need any dental treatments like fillings, cleaning, etc., they will be performed before the capping procedure.

Then, the tooth structure will be reduced on all sides to make space for the crown. The amount of tooth structure reduced depends on the type of crown to be inserted. A doctor will take an impression of the reduced tooth and structures around it to fabricate the customized dental cap. Finally, they will place a temporary dental cap over the tooth.

After a couple of days, once the permanent crown has been fabricated, the dentist will remove the temporary crown and cement the permanent crown over the tooth. 

Oral Care After Dental Cap Placement

Once the crown has been placed, you need to maintain proper oral hygiene to maintain them for a long time. Some oral care tips you should follow are:

• Brush your teeth at least twice a day. Floss at least once a day or after every meal, if possible.
• Avoid hard foods that are difficult to chew and can crack the crown.
• If you have bruxism (teeth grinding or clenching habit), get a night guard to protect your crown and surrounding teeth.
• If you have an anterior crown, do not bite fruits or use your teeth to open packages.

Dental/Tooth Cap Types

The type of dental crown to be placed depends on the tooth’s location, gum tissue health, function, amount of natural tissue remaining, the color of surrounding teeth, etc. 

Different types of dental crowns are based on the amount of tooth structure they cover:

• Onlays: An onlay is a pre-molded tooth coverage that only covers the occlusal portion of the tooth. It preserves the majority of the tooth structure but has a high chance of dislodgement and tooth fracture and hence isn’t preferred nowadays.
• ¾ crowns: 3/4 crowns are permanent crowns that do not require full coverage for cementation. For these crowns, one surface of the tooth crown is not reduced, and the majority of the tooth structure is protected.
• Full coverage crowns: A full-coverage crown is fitted over all the visible surfaces of the tooth. They are the most common dental crowns used nowadays.

Types of crowns based on their longevity are:

• Temporary caps: Temporary crowns are made of white-colored acrylic resins. They usually only last for a few days and cover the tooth while a permanent crown is being fabricated. 
• Permanent crowns: Permanent crowns easily last for 10-12 years if the patient maintains proper oral hygiene. They can be placed individually, over an implant, or be a part of a dental bridge or denture.

Dental Cap Material

There are a lot of different types of materials that are used to fabricate dental crowns, some of which are listed below:

• Metal: Metal crowns can be fabricated from alloys of different metals like gold, palladium, nickel, stainless steel, and chromium. They rarely chip or break and usually last for a long time, therefore, they are often preferred for posterior teeth like molars where aesthetics are not a big concern.
• Porcelain-fused-to-metal (PFM): PFMs are fabricated with a metallic inlay covered by porcelain material to give a more aesthetically pleasing look. They are usually preferred as they are affordable and do not require too much reduction of the tooth structure. However, its porcelain cap can sometimes chip while eating hard foods, brushing, etc., so the patient has to be careful if they get PFM crowns.
• All-resin: All-resin crowns can easily chip or wear down and are, therefore, generally only used as temporary crowns.
• All-ceramic or all-porcelain: These crowns are aesthetically superior to all other types of crowns mentioned above, but they aren’t strong and can easily chip away. They are usually only preferred for anterior teeth or in patients with metal allergies.
• Zirconia: Zirconia crowns offer superior strength and durability and are currently the preferred option for tooth capping. They do not have a metal crown, so they are very aesthetically pleasing, and unlike porcelain and resin, they can easily withstand occlusal forces to resist wearing and chipping.
• Pressed ceramic: Pressed ceramic crowns have a hard inner core covered with porcelain to give tooth-like aesthetics and long-lasting results.

Risks and Complications involved in dental cap

While tooth capping is generally very safe, occasionally, it can lead to some complications like:

• Tooth Sensitivity
• Chipping of natural tooth structure
• Fracture of the crown
• Allergic reaction to the crown material
• Gum disease, etc.