Patient Guide for Dental Crowns & Core Buildups

Q: Why can't I just get a large white filling instead of a crown?

This is the most important question. A filling is designed to “plug a hole” in a tooth that is still mostly strong. A crown, on the other hand, is designed to actively hold a weakened tooth together. If a tooth is too compromised, a large filling does nothing to prevent the remaining thin walls from flexing and eventually fracturing, often in an unrepairable way.

Q: What is a core buildup, and is it really necessary?

Yes, it is absolutely essential. The core buildup is the foundation we build your new crown upon. It is a separate procedure from the crown where we remove all old fillings and decay and replace it with a solid, bonded core. Placing a crown on top of an old, potentially leaking filling is the primary reason that new crowns fail from recurrent decay.

Q: How long will my crown last?

With good oral hygiene, a stable bite, and by protecting it from extreme forces (like grinding), your ceramic crown can last for many years, often 15-20 years or even longer. It is one of the most durable and predictable restorations in dentistry.

Q: What happens if my crown chips or breaks?

Modern dental ceramics are extremely strong, but they can still fracture under extreme force, just like a natural tooth. A small chip on a non-critical area can sometimes be smoothed and polished. However, a significant fracture will typically require the crown to be replaced.

Care for Your New Restoration

The Adjustment Period

It is normal for the treated tooth and surrounding gum tissue to be tender for a few days after both your preparation appointment and your final cementation appointment.

What to Expect:

Numbness: The local anesthetic will wear off after a few hours. Please be careful not to bite your cheek, lips, or tongue while you are numb.
Mild Sensitivity: It is not uncommon to experience some mild, temporary sensitivity to cold. This should gradually improve. If you experience sensitivity that worsens or does not get better, please contact our office.

Temporary Restoration Care

You will have a temporary crown in place while your final, custom-made crown is being fabricated. This temporary is functional, but it is not strong and is held on with weak cement. It requires special care.

Do NOT eat anything hard, sticky, or chewy on the temporary crown. Avoid things like hard bread, tough meats, gum, or candies.
Do NOT floss “up” on the temporary crown. You can floss down between the teeth, but then you must pull the floss out to the side. Popping the floss back up through the contact will pull the temporary off.
If your temporary comes off or breaks: This is not an emergency, but you must call our office. The underlying tooth is exposed and vulnerable. It is essential to have the temporary re-cemented to protect the tooth and prevent it from shifting, which could stop your final restoration from fitting.

Bite Adjustment Information

Do NOT eat anything hard, sticky, or chewy on the temporary crown. Avoid things like hard bread, tough meats, gum, or candies.
Do NOT floss “up” on the temporary crown. You can floss down between the teeth, but then you must pull the floss out to the side. Popping the floss back up through the contact will pull the temporary off.
If your temporary comes off or breaks: This is not an emergency, but you must call our office. The underlying tooth is exposed and vulnerable. It is essential to have the temporary re-cemented to protect the tooth and prevent it from shifting, which could stop your final restoration from fitting.

Permanent Prosthetic / Denture Care

Your new crown is a high-strength, precision-milled ceramic restoration designed to restore your tooth’s strength, function, and appearance for many years. Its success is built upon two distinct and critical phases.

Phase 1: The Core Buildup (Building the Foundation)

Think of your crown as a new house, and the core buildup as the concrete foundation it’s built upon. A house built on a weak or crumbling foundation will fail, and the same is true for a crown. Before we can prepare a tooth for a crown, we must first ensure it has a solid core. This often involves:

Removing all old, failing filling materials.
Removing any recurrent decay.
Rebuilding the tooth with a modern, bonded “core buildup” material.

This step is non-negotiable. It creates a clean, solid, and perfectly shaped foundation, ensuring the long-term success of the crown that will sit on top of it.

Phase 2: The Crown (The Protective Helmet)

A tooth that needs a crown has been significantly weakened by decay, fractures, or a root canal. A simple filling is no longer enough to hold it together. The crown’s job is to act like a protective helmet, completely surrounding the weakened tooth to prevent it from fracturing.

This protective principle is known as the “ferrule effect”—think of the metal bands on a barrel. The bands are what hold the individual staves of wood together and give the barrel its strength. Your crown is that band for your tooth. It is the only way to protect a compromised tooth from the immense forces of chewing and prevent it from being lost to a catastrophic fracture.

Long-Term Care

- Treat it Like a Natural Tooth: You can brush and floss your new crown normally. The porcelain itself cannot get a cavity, but the tooth underneath can, especially at the edge where the crown meets the tooth. Meticulous daily hygiene is the key to longevity.
- Avoid Abrasive Toothpastes: Do not use whitening toothpastes. They can dull the glaze and polish of your porcelain over time.

– Protect Your Investment: If you clench or grind your teeth, a protective night guard is essential to prevent the porcelain from chipping or fracturing under extreme forces.