If the extent of your cavities is large there might not be enough tooth structure left for us to properly restore the tooth with composite filling material. In this case, we will recommend having a buildup placed in the tooth first then putting a dental crown on top. Think of the crowns as a protective helmet for your tooth. Having a large cavity weakens the structure of your tooth, and if we just place composite fillings in there it might not be strong enough to keep your tooth together. This can lead to tooth fractures in the future, which can lead to tooth loss if the fracture is deep or large. So with a dental crown the tooth will be fully covered and provided with the protection it needs.
There are many types of materials that we can use to make your dental crown. In our experiences and also in dental literature, gold crowns are still the “gold” standard in terms of bio-compatibility and durability. Not only is there rarely a report of patients being allergic to gold, gold is a softer and gentler material that does not wear away and damage the teeth that are biting against it. The only downside is the color. For obvious reasons a gold crown only has one color and it does not match the color of your teeth. For a more aesthetic crown we can either use a porcelain fused to metal crown (PFM), an all porcelain crown, or a full zirconia crown. Porcelain fused to metal crowns are what we usually make for our patients because it’s economical and it still provides good aesthetic results. For our PFMs, we use only high noble metals (high gold content) to ensure good resistance to corrosion and bio-compatibility. Then we have tooth colored porcelain layered on top. Since PFMs have metal underneath, it might not be very aesthetic in some cases, so for those times we will recommend all porcelain crowns. By using all porcelain there will be no metal underneath which can make the tooth look more natural with translucency coming through. This can also eliminate the dark lines that can sometimes develop near the edge of the PFMs. Even though porcelain is a strong material, it’s quite brittle if subjected to extreme force, so if you clench or grind your teeth, the zirconia crown is an option for you. Technically zirconia is classified as a metal, but it actually comes in various tooth color shades, so we can color match it to your surrounding teeth for a good cosmetic outcome.
No matter what your needs are, we have many options to choose from. We know it can get confusing sometimes, so we will make sure we take our time to explain everything to you so that you can make the best decision to match your needs.