Dental Ceramic Crowns during Covid-19
Tooth Crown options are many and varied and include the latest advanced types of Dental Ceramic Crowns for teeth that need high reinforcement and are metal-free, helping to improve the dental Bite, Colour, Shape and Arrangement of Teeth, in a stronger way than tooth veneers can in a heavy bite or tooth wear situation, for example. Read below for more information and the vast array of choices for different Dental tooth Crowns, their pros and cons and to appreciate which kind of crown material choices and Crown-Prepping Techniques would suit your particular Clinical and Cosmetic situation the best overall!
One of the most common questions I get asked is, "How much is a Crown?" This question always makes me chuckle, as we do over 25 different kinds of Crowns for a start and most people, to be fair, have NO IDEA about the range and features and different degrees of Tooth Preparation (ie: how much tooth is actually drilled away!) for each different kind.
See the picture below of just a small selection of different types of Crowns:
Sometimes patients say to me, "I had a Crown once and it kept falling out, so I don't want another one." Well neither would I if that was the outcome, BUT if Crown provision is left too late, when much good tooth has already decayed/broken away, then the poor Crown has very little good tooth to get a grip of so may then be easily loosened. Or worse still, too much tooth has been drilled away, perhaps into a small pyramid shape ( I have never understood why someone would choose to do that) then likewise, the poor Crown has little foundations to keep it in place.
For Dr.Kilcoyne's SmileSpecialist Crowns, the average amount of tooth we remove is JUST 1mm from the outside, leaving about 80% of the good tooth intact as an Excellent Foundation for our Precision Crowns. You may be surprised to know that delicately removing only 1mm of tooth takes A LOT MORE skill and time to do well, whereas removing large amounts of tooth quickly takes less skill & time.
I suppose it's like comparing just digging a big hole in the road, to carefully going around the Pipes and Wires in the road so you do minimum damage.
Maybe next time the question shouldn't just be 'How much is a crown?', but 'Who is planning and preparing my teeth for a Crown?'
Can you guess which Teeth in the next picture are Dr.Kilcoyne's Crowns and which are real teeth, even when magnified like this ?
Of course the Cosmetics of the case is only ONE factor you must consider, but as a patient it may be the only factor you can see, appreciate or measure. Other important factors include how little tooth removal one can achieve whilst making a strong, well fitting dental Crown - the accuracy of our Crowns fitting is measured in micrometres, where say 40 micrometres is less than the thickness of a single hair, for example.
Also the preparation angles of the sides of the tooth are important - the ideal is near parallel (a 5-8 degree taper actually) on the mesial and distal aspects of a tooth, which to the naked eye looks almost parallel, but one MUST avoid undercuts, which means not accidentally making say a minus 2 degrees angle which to the eye looks parallel still. So now you understand why when I see a 'Pyramid' shaped tooth with angles of 30-45 degrees or just short "stumps" left to place a large Crown upon, how this both makes my job difficult and shortens the life of the tooth as well as weakening its foundations.
Naturally Technicians like some room to make the Crown so it looks good and has enough material to be strong too, but teeth are living things not plaster models to be drilled-down and a good Clinician combined with a good Technician, can produce some Excellent results with minimal tooth removal - it is challenging to do and takes great skill of course, but it can be done.
So do you know which Tooth or Teeth were actually Crowned and prepped expertly by Dr.Kilcoyne - well see the pictures below for the answer:
Yes it was the two front teeth that were expertly prepared and restored to look nice and natural like the other teeth
It's the work underneath that you DON'T normally see, that makes Dr.Kilcoyne's Specialist skills so valuable to you in your future Dental Health and Smile Profile.
So how do Dr.Kilcoyne's Specialist Crown preparations compare to others? See below where we think TOO much tooth has been drilled away, weakening the foundations and future success of any Crowns or Bridges placed - afterall, what is the point of using the strongest or nicest looking Cosmetic Crown materials whilst drilling away too much good tooth and weakening the foundations those Crowns depend upon?
The picture below though whilst not the worst example of tooth destruction I have seen, see how short the Teeth have been drilled down and how Long the Crowns need to be to be level with the other teeth! Now imagine when someone bites and chews on a long crown sat on a short-stump of a tooth-prep like these. They will simply be levered-off or fall out and then that front gap will get even wider as more teeth are lost. That's just one of the reason's Dr.Kilcoyne DOESN'T do Crown preps like those below if at all avoidable.
Thus as stated before, Dr.Kilcoyne is a Specialist in Advanced Treatments like Crowns and endeavours to give you Crowns which looks good, remove minimum tooth substance (perhaps just 1mm average only), creates good retention and resistance form so when the Crown is glued on, the tooth is actually STRENGTHENED, not weakened by too much good tooth removal !!!
Different kinds of Crowns available:
Metal-free Ceramic Crowns are now available in many choices! Tooth-coloured crowns used to be made of just the weaker porcelain or porcelain and metal together, but metal containing crowns if they use a lot of metal for strength, can sometimes show a dark grey line at the gum margin, should gums shrink over time! However where strength in heavy bites is an important factor, there are other advanced techniques that are good at hiding the metal and still getting a good Cosmetic result with superior strength, without drilling too much good tooth away.
But where just medium strength is required in average-forced bites than with the new technology available today, Crowns (and even larger bridges) can be made entirely of stronger porcelains known as Ceramics, where the cosmetics are most important of all.
So Ceramic Crowns are Cosmetic metal free crowns, using tough ceramic cores under the more cosmetic porcelains. These Ceramics give better strength than porcelain only Crowns, but not as strong or forgiving as metal-based crowns, but will give a superior cosmetic effect to Metal Bonded Crowns. You will read a lot of hype and advertising by the manufacturers of Ceramic Crowns and Bridges that only Ceramic Crowns can achieve, but Ceramic Crowns even with Yittrium Zirconia are still not quite as strong as metal-reinforced porcelain crowns, despite some of the adverts for Ceramic whiter Crowns. When one factors in that slightly more tooth has to be drilled away for ceramic Metal-free Crowns than Porcelain bonded to Metal Crowns or Bridges, I'm sure you can appreciate that one has to balance any superior aesthetic cosmetic smile improvement against weakening of the underlying tooth too. Thus the angle of the teeth, heaviness of the bite, any grinding or clenching habits, amount of good tooth left underneath, lip and smile-lines, gum health etc. ALL have to be assessed, before choosing the BEST kind of Crown for your particular circumstances and needs. Everyone is different and unique so that is why you need an expert opinion AFTER you have been thoroughly examined and had the above factors assessed.
Cerec and Cad-Cam technologies are improving and allow a few units to be made the same day, but because they use a camera to picture the margins then one often has to drill more shoulder-type margins which removes more tooth and isn't as good as a smaller chamfer margin technically when preparing teeth for Crowns. Also the colour blocks means tooth colour cannot be as customised as one would sometimes like, because teeth of course are not just one colour, but a blend of different colours and translucencies which are important to achieve, if the Crown is to look as natural as possible. Thus Dr.Kilcoyne still prefers his Crowns to be hand-made to his specific prescription and to have full clinical freedom to shape the margins as desired and remove minimal good tooth to preserve maximum good tooth overall.
Remember - All Crowns will need replacing again, perhaps every 15 years when done well, so the more good tooth preserved underneath the better, to allow future replacements to be done!
Other Cosmetic Dentistry options to Crowns include Porcelain veneers, Inlays (like a pre-set filling cemented in), Onlays (an inlay that also spreads over the biting surface), Direct White Fillings and Veneers, Ceramic Bridges, Precision Dentures with overlays etc. Of course when looking at improving your WHOLE SMILE you should look at the arrangement, proportions and shape of the complete smile, not just individual teeth options. Thus you may benefit by a number of different treatment options that COME TOGETHER to improve the whole smile, without drilling too much tooth away too.
Dr.Kilcoyne at the SmileSpecialist® Centre offers his Specialist skills and a wide range of choices in Dental Implants, mini Implants, immediate Dental Implants, Crowns, Bridges, Veneers, Precision Dentures, Tooth Bleaching, Teeth Whitening, Cosmetic Bonding, Latest Ceramic Restorations, Second Opinions, Smile Profiling, Gum Disease Treatments, Solutions for tooth wear and worn, uneven teeth, Periodontal Plastic Surgery, TMJ's, Difficult Occlusions, Root canal treatments, Trauma and Emergencies; Anxious or Nervous Patients welcome too!
Planning your case is critical to success - Crowns are three-dimensional so the shape, colour, position and bite affect SO many things in your mouth, have to go next to other teeth or bite against other teeth, so they look good AND function well for years and possibly decades too. That is why the opinion and treatment planning by a Specialist like Dr.Kilcoyne, is MORE important than say the materials used in the Crown. Crowns are hand-prepared, hand-made to specific prescription, such that despite having provided many many thousands of these over a twenty year period, Dr.Kilcoyne has NEVER made or fitted two identical Crowns ever! You are unique and so is the dental solution that suits you best.
In more Cosmetically Advanced Cases, Ceramic crown construction can be combined with Denture construction to ensure both compatible fit, hidden or Cosmetically disguised clasps, with even the gum-work made to the right shade for the patient. All of this needs careful planning and Expert knowledge to get the Optimum combined Cosmetic effect and functional too. See the case below that has front Ceramic Crowns as well as "tooth-coloured" clasps and denture teeth.
The left picture shows the work on models so you can more clearly see that every tooth has been created to match together, even the clasps and the gums. The right picture shows the exceptional Cosmetic result in the mouth, with the cheeks and lips fully retracted so you can appreciate the full attention to detail that Dr.Kilcoyne puts into cases like this:
Dr.Kilcoyne is a Registered Specialist* in this kind of Cosmetic and Functional work.
In Summary - New breakthroughs in adhesives and stronger Ceramic materials now make it possible to make crowns entirely out of porcelain and Ceramic substructures, which then can be bonded to the teeth. This creates good strength with excellent beauty. Unfortunately, it may sometimes be necessary to remove more natural tooth for Ceramic Crowns than some other types of Crowns with metal in. It depends how important the cosmetic superiority of Ceramics is to you! All-Ceramic Crowns maintain a translucency that makes them hard to tell from natural teeth. Without metal, the occasional problem of the dark blue line at the edge of the gums is eliminated. This can allow your dentist to place the edge of the crown above the gumline too, which can be healthier for your tooth and gums (see above examples).When you want to improve your smile, reinforced Ceramic Crowns are a beautiful and natural-looking choice! Whilst some heavy bites may still require metal reinforced crowns, some of the Ceramic alternatives now make these metal-free crowns an option that patients with high cosmetic needs may wish to try, even with some heavy bites, that once might have been previously excluded. It is all about balancing the needs of function and bite, against strength and beauty, as well as considering the costs and result hoped for.
Dr.Kilcoyne is a fully registered UK Specialist in Prosthodontics ,which includes Implants, Crowns, Veneers, Dentures, Bonding etc, to Restore or Replace teeth functionally and cosmetically so you can have a Smile that you can be proud of, without compromise. Yes all this expertise, experience and excellent track-record have a price, but we still believe it is Good Value for the level of Specialist Quality one is getting and can be confident in.
Dr.Kilcoyne has won National Prizes for the Quality of Patient Services, so you don't have to compromise !
We hope whether you seek your treatment from SmileSpecialist® or elsewhere, that the wide range of information provided on our Website will help you in discussions with your own Dentist, so you can fully consider which options best meet your needs, budget and long-term wishes for your Dental Health.
If you'd like a Smile Specialist smile makeover, visit us on the map below as the RED ' O ' TODAY !
Just enter the postcode BD22 8NL into your SAT NAV or google maps on your phone.
Our SmileSpecialist® Centre Dental Practice is on Station Road, opposite the Steam Railway Station at the bottom of the village hill.
You can use the above website menu or just click-a-link here for Specialist or Advanced aspects of Tooth Veneers, Tooth Whitening, Dental Tooth Implants and smaller Mini-Implants, Dental Ceramic Crowns, Gum Diseases and Bad Breath, Root Canal treatments or Dental CPD Courses, are just some of the subjects you can learn more about here on our award winning dental website www.smilespecialist.co.uk.
*Dr.Kilcoyne is a UK registered Specialist in Prosthodontics (GDC No.58373) which includes The Functional and Cosmetic Dentistry aspects of Crowns, Dental Implants, Bridges, Veneers, Fillings, Dentures, Bonding etc. Please do go to our MAKE an APPOINTMENT page to access his Expertise.
The PLANNING of Treatment Options is just as important as the Quality of Treatment - Dr.Kilcoyne can help you get both right, first time!
Wishing you good Dental Health AND a Smile to be proud of, from all at the SmileSpecialist® Team.
As always, Prevention is cheaper and better than Cure - that includes Preventing making bad choices based on costs alone !