Category Archives: Porcelain Crowns

Is a cracked crown an emergency?

My front teeth have had porcelain crowns on each of them for over a decade. I have noticed a very thin crack. It’s not very noticeable and it doesn’t seem to be an issue. But I am nervous that it will break when I least expecting it. Is it a dental emergency or potential dental emergency? The crown runs horizontally.

-Jay in Colorado


Since you are aware of the crack, it would be wise to have the porcelain crown replaced. It wouldn’t necessarily be considered a dental emergency, but it could turn into one if you leave it alone.

Since the crack is visible, it does mean the integrity and structure of the crown is compromised. Porcelain restorations sometimes have tiny lines through them which dentist refer to as craze lines which are not visible with the naked eye. But if you can see it, then the crown is at risk.

If you can also feel the crack, this adds concern to the situation. This would indicate that there is some movement that has occurred.

A cosmetic dentist that has an eye for aesthetics may be able to replace the cracked dental crown. And you should be prepared that even an expert cosmetic dentist may recommend having both of the front teeth crowns replaced. This is so that there is no differentiation in the uniformity and coloration with such a highly visible area.

Be careful if a dentist tells you that it is not possible to replace a single crown. That may indicate that they are not confident in their cosmetic dentistry abilities.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Crap! I swallowed my crown. Is this an emergency?

I have had a porcelain crown on one of my molars for a few years now and the other day after lunch, I noticed an uncomfortable feeling while I was chewing. In fact, it was super-sensitive and I wanted to avoid chewing. When I took a closer look, my crown was gone. I guess that means I swallowed it! So now all I have is this tiny tooth stub. Of course, today is Saturday. Crap! What do I do? Do you think this is a dental emergency? It’s not like my tooth is agonizing me or anything, but it sure doesn’t feel normal and I can’t leave it unprotected. Or maybe I can wait until after the weekend and it’s not that big of a deal. Please let me know your thoughts.

– Paul in Virginia


It is understandable that you are concerned about swallowing your crown. Although, don’t feel panicked. So don’t worry, this too shall pass – literally. But all jokes aside, this is not an issue that you need to see an emergency dentist to resolve. A dental crown will have no problem working itself through your digestive system and shouldn’t cause you any discomfort. So you are probably fine to wait to consult with your dentist until Monday, or whenever there are regular business hours. Now here is the interesting part, it is entirely possible to try and retrieve it, clean it up, and re-cement it. Although, that is completely your decision and best that you consult with your dentist about that possibility. It could be that the crown was failing anyway and would absolutely be best that a new one is created.

The bottom line is that what you are dealing with is not a dental emergency. That said, it is expected that you will experience some sensitivity. It would probably be in your best interest to avoid chewing food on it and to stay away from very cold or hot drinks. The outer enamel of the tooth was removed when the tooth was originally prepared for the crown, so that is why it looks like a stub. So there is very little protection left for the nerve endings.

There are some people that find temporary crown kits available at local drug stores. That may help you manage the sensitivity until you are able to get into the dentist. It also wouldn’t be a bad idea to call your dentist to notify them of what is going on, even if you only leave a message. Staff occasionally check messages over the weekend or have certain protocol in place to handle emergency dental situations. So getting that information prior to Monday morning will help notify them of the situation and may possible allow for the earliest appointment time during normal business hours.

This has happened many times, so try not to stress out about it. The sensitivity is actually a positive thing because this means that the tooth is still living and will likely not require a root canal.

This post is sponsored by Cleveland dentist Hylan Dental Care.

A piece of my tooth is missing.

Let me start off by saying that I really don’t like going to the dentist. And last week I noticed that my tooth felt kind of sharp. When I checked it out in the mirror, it appears that a small portion of the tooth is gone. I have never had a filling before and I’m terrified of needles. It isn’t hurting me or anything so I just try not to eat on that side. Do you know if a temporary filling can be done?

– Natalie in Virgina


You are not alone. Did you know that there are millions of Americans that get anxious about dentistry. There are dentists out there that use gentle dentistry techniques and sedation dentistry for fearful patients. Sedation dentistry is safe and simple and many patients will tell you that they don’t remember anything at all about the appointment. You are conscious but will be put into a sleepy, indifferent state. Oral sedation has helped many people deal with and manage their fear of the dentist and only involves taking a pill prior to your dental appointment. If you are just a bit anxious, nitrous oxide is a milder form of sedation dentistry. It is a relaxant gas that is breathed in during your appointment and may work for you.

But to answer your question about the broken tooth, it all depends on the severity of your case. A composite filling may work to fill the space. Or if more than half of the tooth is damaged than a dental crown may be the more appropriate treatment. It doesn’t sound like you need to schedule an emergency dentist appointment if you are not in pain. But this issue should be taken care of as soon as practical. It sounds like you may be a good sedation dentistry candidate.

This post is sponsored by Hylan Dental Care.


Three new crowns are very sensitive. What’s wrong?

– Vickie from Tennessee


When new crowns are sensitive like that to hot and cold, it can take a number of weeks for them to fully settle down.

Because of your second opinion, I’m going to assume that there isn’t anything obviously wrong. So the question about why they are sensitive is much less important than the question of what to do about it. Yes, they could be sensitive because part of the tooth is still exposed. Or it could be that they were overly irritated during the crown process. Or some other reason.

But if they are not getting worse, I would recommend just waiting it out. Be gentle with them. Avoid the things that irritate them (except for the flossing – you need to keep them clean). Eventually they should settle down. If they take a turn for the worse, then they may end up needing root canal treatments and you should go back to your dentist to figure out which of the tooth or teeth aren’t healing.

What to do for six front teeth crowns

I had 2 root canals on my front teeth last year (#9, #10) and need to get the crowns replaced now that the backs to the crowns came off during the root canals. I have decided I would like to get all of my 6 front teeth crowned at the same time. They actually are already crowned but the crowns are over 20 years old and I would like to make some changes to the shape and color of them.

I have had consults with 2 dentists and they were quite different. Dentist #1 insists that I need crown build ups for #9 & #10 because of the root canals and that possibly some of the other 4 may need build ups as well. Dentist #2 does not think build ups will be needed. They also differ in price, while I am not trying to be cheap I do not want to be taken either. I saw dentist #1 twice and he had to revise my ‘treatment plan’ cost because he left out a fee the first time. It was an $1800 fee for ‘customization’ — dentist #2 does not charge this fee. It that a common fee to have, I am suspicious of it because on the first visit he did not mention it, it was not until visit #2 when he realized I wanted to maybe round out the edges of my teeth that there was suddenly a fee. Dentist #2 suggested the rounding of the edges. Dentist #1 uses empress c! rowns, dentist #2 lets the lab pick the material based on my molds. De ntist #1 is much more expensive than #2 mainly because of the customization fee. So, I guess my questions are as follows: 1. what fees are standard for crowns (crown, crown build up, diagnostic cast) 2. should the dentist decide the material (empress, procera, etc) or the lab 3. does it matter what lab is used? #1 uses Williams Dental Lab in CA, while #2 uses Georgia Dental Labs) 4. On teeth that are already crowned is it typical to need to do a crown build up on them? 5. Is a customization fee normal? Thank you.
– Mitch from Georgia

There isn’t enough information for me to tell you if either of these dentists will do good work for you, but I’m getting negative vibes about both of them. The “customization” fee of dentist #1 really bothers me, because to me, every case where there are six crowns on the six front teeth should be customized. This after all is your smile and your personality. Was dentist #1 really thinking of just giving you a “one-size-fits-all” smile until you wanted to bring some personality into it?

A question you didn’t address is whether or not the appearance of this work matters to you. If you just want the teeth protected and it doesn’t matter if your smile looks real or fake, then I think you’re on the right track. But if you want this to look lifelike, then I think you need to seek out an expert cosmetic dentist. And I suspect that neither one of these dentists is an artist. Only about one out of every fifty dentists is. And once you’re in the hands of a dentist who is passionate about creating a beautiful smile for you,  he or she will start by asking questions about the kind of personality you want to project with your smile and exactly what customizations you will want – before they even start.

A real cosmetic dentist will insist on doing all-porcelain crowns on these teeth. Empress is one brand of all-porcelain. I’m not impressed with dentist #2 letting the lab choose the material for these six crowns. The choice of material can make a big difference in how the result looks, and there are different preparation requirements for different materials. The material needs to be chosen before you start. A good cosmetic dentist will have a definite opinion about what material works best in their hands and gives the most beautiful result for a particular case.

About the buildups – if they are needed, then you should go with the dentist who recommends them. If they aren’t then that isn’t necessary. I don’t know what to tell you on that one. For natural-looking all-porcelain crowns on these front teeth, it would be common to have a translucent or white fiberglass post and buildup in each of these teeth, if one hasn’t been done. And I can’t tell the quality of the dentist from the laboratory. Different dentists can use the same lab and get very different results. The lab will try to meet the dentist’s standards. An excellent cosmetic dentist does need an excellent cosmetic dental laboratory technician to produce beautiful results.

I hope this is helpful.