Tooth crowns (aka caps) are as common as fillings when it comes to tooth restoration. Many people are shocked when their teeth are drilled away to nubs in order to have a crown made. This article will explore why a crown is indicated, as well as treatment alternatives.
Crowns were invented in the late 1700s in a time when full-metal crowns and rock-like cements were the only choices dentists had. Because tooth bonding would not been invented until the 1980s, dentists had to use wood-working techniques to attach crowns to teeth. Dentists needed to create a wedge-within-a wedge effect (a morse taper) to mechanically lock the crown to the tooth. If you ever had to deal with separating two glasses wedged together, you experienced the mechanical retention of a morse taper. Dentists spend years perfecting the proper tooth taper and shape for ideal retention, but unfortunately many fall short.
The fact is your natural teeth are far superior than any manmade synthetic material. Therefore, preserving healthy tooth structure should be the goal of any dental treatment. Whittling teeth to nubs is an antiquated approach that needs serious rethinking on the part of the dental profession. Biomimetic dentists, like Dr. Alex Shvartsman, focus on preserving teeth rather than unnecessarily drilling them away.
Fillings are indicated when there is a “hole in the tooth” that needs to be filled; however, when one or more cusps or 50 percent or more of the tooth is gone, a filling is a poor choice as a long-term restoration. While it is possible to make a giant filling, they generally do not hold up over time and it is not always possible to achieve a proper tooth shape with a large, direct filling.
Today, modern dentists, like Shvartsman, no longer drill down the entire tooth to a stump. Modern materials and technology allow for “partial crowns” or onlays, which are made of strong and durable porcelains that are both tooth conserving and highly aesthetic. Even root-canal-treated teeth can be restored with more conservative onlays and porcelain veneers rather than tooth-mutilating crowns.
o, why do dentists still do antiquated tooth-mutilating crowns? Because it’s easy, fast, takes less skill and effort, and it’s what they are taught to do in dental schools. In addition, dental insurances do not always cover the more modern approaches, mainly because they do not really care about you or your long-term health, just their quarterly profit reports.
Shvartsman uses the latest in CEREC CAD/CAM technology to fabricate these tooth-sparing restorations right in his office during a one-visit procedure. This saves patients valuable time and trips to the dentist. You do not have to wonder if your crown was made in some third world country, using poor quality control and second-rate materials. Next time your dentist tells you that you need a crown, think twice and ask for a more tooth-conserving approach.
For more information contact Dr. Alex Shvartsman, 631-361-3577, SmithtownSmiles.com.
