What is good Dentistry? What makes a good Dentist?  If you asked a lay person, a dentist, a dental assistant, and a dental receptionsist, chances are you would get four different answers.  In this blog, we do not attempt to answer that question, as our answer would go on for several pages and bring up a whole host of questions.  The purpose of this blog is simply to educate the public on one particular dental procedure that can have LARGELY varying degrees of quality, and ultimately, success.

          Many of us have heard of a dental crown.  You may know of it as a “cap”.  A crown is a “full coverage” dental “restoration” designed to restore a broken down, cracked, decayed or otherwise weakened tooth back to function and esthetics.  Your tooth will be restored using porcelain and/or metal materials so that yo can continue to use it to eat and smile.  This may seem simple enough, but are all crowns made alike?  Is one crown done by one dentist as good as another?  Is there a good crown and a bad crown? Is there a right way and a wrong way to do a crown?  The answer to these questions are NO, YES, and YES!  Consider the quality factors below, and make your own opinion.  The discussion assumes the tooth has already been determined to need a crown.  Read on, then, if you require a crown on your tooth, be sure that these quality standards are attended to by your dental office.

Photos below are for illustration purposes only.

1) ARE THE “MARGINS” OF THE CROWN SEALED?

“Margins” are where the crown meets the tooth.  They go 360 degrees around the tooth and provide a “seal”, when done properly.  One high quality measure your Dentist should take is to fit your crown before cementing it and take an xray with it on: the “margins” can then be visualized in a way the human eye cannot provide.  If there is a gap that is quite large in a microscope, than this is just large enough for a ton of microscopical bacteria to get in that gap and give you a new cavity under your brand new crown much sooner than you’d like!

2) DOES YOUR CROWN HAVE GOOD CONTOURS?

This one’s a little more technical, but just as important.  If your Dentist uses a good laboratory technician to make your crown, they will understand what a natural tooth should be shaped like, and your crown will replicate this and adapt to your mouth much better than a poorly contoured crown.  A poory contoured crown will trap food, cause periodontal disease and pain, aggravate your gums, and need to be replaced sooner rather than later.  Of particular note are the “contacts”, which is where the crown meets the adjacent teeth.  A good lab and dentist will carefully craft this area, so food will wash away from the gums, just like your original tooth should have when it was healthy and natural.  Does your Dentist use a top quality lab? Is it local and easy for the dentist to communicate with.  Beware “dental corporations” that often send their crowns away to other continents, particularly China, where quality standards are lower or questionable, in exchange for a lower lab cost to the dentist.

3) HOW IS THE BITE?

“Occlusion” in Dentistry is an art and a science.  It refers to the relationship of the upper teeth to the lower, and the way they meet together when touching (when you close your jaw).  Many forces take place in any directions when the teeth meet together, and these forces need to be carefully considered by your Dentist and lab technician, especially when fabricating your crown.  Your Dentist should have you “bite down” on paper to “check your bite”, but there is much more going on (or there shoud be!) than just feeling “comfortable” with the way your new crown “feels”.  Your Dentist should absolutely care about “occlusion” and take in to consideration the way ALL your teeth meet together before and after your crown is fabricated.