Indications and Contraindications of a Dental Crown

Crown and bridges are being served to dental patients routinely as its manufacturing has become fast, readily available. It is a dependable option. 

Although, the crown & bridge is generally considered very safe and it is associated with a low incidence of complications, there are some precautions that need to be considered. 

Indications of a Dental Crown

1. Damage of crown beyond repair
2. Large filling needing replacement
3. Fractured tooth
4. Esthetic enhancement
5. Dental implant coverage
6. To fix dental bridges or dentures
7. Erosion of teeth

1. Damage beyond repair: Cases where the tooth has been damaged beyond repair: If the patient has a large cavity that cannot be fixed with a filling, but the dentist determines that the dentine and pulp are in good condition then he will recommend that a crown be placed to save the tooth.

2. Large fillings need replacing: Fillings need replacing every so often, your dentist may recommend installing a crown instead of re-filling the tooth, the reasons for this are the crown is a long term solution and it is aesthetically more pleasing.

3. Fractured tooth: In the case that a tooth gets fractured due to a dental trauma or progressive tooth decay, it is highly recommended that a procedure known as post and core be performed. The post and core procedure simply put, is the placement of an implant without extracting the root. In this procedure a small rod is inserted into the root of the affected tooth, this rod will slightly protrude and the core or crown will be attached to it. For this procedure, the tooth in question will require a root canal before the post and core can be done.

4. Esthetic enhancement: For patients who have discoloured or uneven teeth, or even for those who have large fillings the use of crowns can greatly improve the esthetic of their smile.

5. To cover dental implants: When a patient has lost a tooth for any reason, and an implant is required to maintain proper function, the implant will be covered by a porcelain crown that has been made to match your existing teeth.

6. To affix dental bridges or dentures: A dental bridge is a prosthetic used to replace missing teeth, these bridges are permanently adjoined to either dental implants or crowned teeth. The dental crowns are used to hold the prosthetic in place.

7. Dental erosion: The tooth enamel can be dissolved by the acidity in foods; when the enamel has been compromised, porcelain crowns are the ideal solution to prevent the progression of tooth decay to the dentine and pulp. Other forms of erosion include tooth abrasion which occurs from improper uses of toothbrushes, brushing too hard, improper flossing or biting on hard foods. And it also includes conditions where natural tooth to tooth friction happens, as in the case of involuntary grinding known as bruxism.

Contraindications

1. Where anaesthesia is contraindicated
2. Where filling can solve the problem
3. Insufficient tooth material
4. Chances of nerve damage
5. Bite misalignment
6. Allergy

As with any medical procedure, it is possible that complications can arise. Among the risk factors and contraindications of dental crown procedures, we can list the following:

1. Contraindication of anaesthesia: Illnesses where the use of anaesthesia is contraindicated. These may include severe heart disease, recent strokes and allergic reactions to anaesthesia.

2. The use of crowns is not indicated in cases where the problem can be solved with a filling.

3. Insufficient tooth material: There is a risk that during the preparation phase, the tooth’s surface can become too thin or be perforated by an instrument.

4. Nerve damage: During the preparation procedure, nerve damage can occur, if this should happen, it will be necessary to perform a root canal.

5. Bite misalignment, although in most cases dental crowns can correct TMJ (temporomandibular joint), if the crown is incorrectly placed, it can exacerbate the problem in some patients. Once the dental crown is in place, your dentist should check the fit taking into account the surrounding teeth as well as the whole bite.

6. Allergic reactions to one or more of the materials. Dental crowns can be made from a variety of materials, choosing the right material will minimize the chances of an allergic reaction.

7. Infections, if the dental crown is not properly sealed or if the damaged tissue was not properly removed, the area might become infected.