Crowns & Bridges in Royal Palm Beach
What Is a Dental Crown?
A dental crown is a custom-made “cap” that completely covers the visible portion of a tooth. Once bonded into place, it restores the tooth’s original shape, strength, size, and appearance. Crowns are commonly recommended when a tooth has become too weak for a filling but can still be saved. Unlike fillings, which replace only a portion of the tooth, a crown protects the entire remaining structure from further damage. There are different materials that can be selected based on the situation.
What Is a Dental Bridge?
A dental bridge is basically 3 or more crowns connected to each other. Unlike a crown, a bridge literally “bridges” the gap left by missing teeth, restoring your ability to chew, speak, and smile with confidence. Bridges also help prevent adjacent teeth from drifting into the empty space, reducing bite problems that can develop over time.
Reasons You May Need a Dental Crown
Your dentist may recommend a dental crown for several reasons:
Very Large Cavities
When a cavity becomes very large, there may not be enough healthy tooth structure remaining to reliably support a traditional filling. A large filling can leave the remaining walls of the tooth thin and vulnerable to cracking or breaking under normal chewing forces. In these situations, a dental crown may provide a more predictable and durable long-term solution by covering and protecting the weakened tooth.
Very Large Existing Filling
A tooth with a very large existing filling may have only a limited amount of natural tooth structure remaining. Over time, repeated chewing forces can place stress on the thin walls of tooth surrounding the filling, increasing the risk of cracks or fractures.
Although placing another filling may initially seem like the more conservative option, a restoration that lacks adequate tooth support may fracture, loosen, or fail prematurely. If the filling begins to fail, develops leakage, or the remaining tooth structure becomes too weak to reliably support another filling, a dental crown may be recommended. By covering and reinforcing the tooth, a crown can provide greater protection and help preserve the tooth for many years.
Visible Fracture Line in the Tooth
A visible fracture line may indicate that a tooth is at increased risk of breaking. Some superficial lines, known as craze lines, are limited to the enamel and may not require treatment. However, a deeper fracture that extends into the tooth structure needs closer attention.
Think of it like a small crack in a windshield. The crack does not heal or disappear on its own. It may remain unchanged for a long time, but one unexpected bump can suddenly cause it to extend much farther. Fracture lines within a tooth can behave in a similar way. Repeated chewing forces can gradually cause the fracture to extend deeper into the tooth. If it progresses far enough, the tooth may eventually become impossible to save.
A dental crown may be recommended to surround and reinforce the weakened tooth, significantly reducing the forces that can cause the fracture to spread. Although placing a crown cannot guarantee that an existing fracture will never progress, it can significantly reduce the risk of further fracture and improve the chances of preserving the tooth long-term.
Sharp Pain When Biting Down
A sharp, sudden pain when biting down a certain way, particularly when chewing something hard or when releasing your bite, can be a sign of a cracked tooth. When pressure is applied, the fractured portions of the tooth may flex ever so slightly, which can be perceived as a sharp pain signal. The discomfort may be intermittent and can sometimes be difficult for a dentist to reproduce during an examination.
Because cracks are not always visible on X-rays or during a routine examination, identifying the source of biting pain can sometimes be challenging. If a significant crack is found and the tooth can be restored, a dental crown is recommended to hold the weakened tooth together and reduce movement during chewing. If the fracture has progressed deeper into the tooth and affected the pulp, root canal treatment may also be necessary. In more advanced cases, the fracture may extend so far that the tooth can no longer be predictably restored. For these reasons, persistent sharp pain when biting should be evaluated promptly.
Broken or Fractured Tooth Cusp
A cusp is one of the raised portions of a tooth that helps you bite and chew. When a cusp fractures and a significant portion of the tooth breaks away, the remaining tooth structure may become weakened and more vulnerable to additional fractures. This commonly occurs around large existing fillings, where the remaining walls of the tooth have become thin over time.
Depending on the size and location of the fracture, a small broken cusp may sometimes be repaired with a filling or another conservative restoration. However, when a substantial portion of the tooth is missing or the remaining tooth structure is weakened, a dental crown may be recommended. A crown covers and reinforces the remaining tooth and helps protect it from further fracture. If the fracture extends deeply beneath the gumline or into the root, the tooth may require additional treatment or, in severe cases, may no longer be predictably restorable.
For these reasons, broken teeth should not be ignored or left untreated.
After Root Canal Treatment
A tooth that has undergone root canal treatment may require a dental crown to protect it from fracture, particularly when it is a back tooth. Teeth requiring root canal treatment often already have significant loss of tooth structure from decay, large existing fillings, fractures, or the access opening needed to perform the procedure. This can leave the remaining tooth considerably weaker.
Back teeth are exposed to substantial chewing forces, and without adequate protection, the remaining cusps may fracture over time. A dental crown surrounds and reinforces the weakened tooth, redistributes biting forces, and helps reduce the risk of a catastrophic fracture that could make the tooth impossible to save.
Not every root canal-treated tooth automatically requires a crown. Front teeth with sufficient healthy tooth structure may often be restored more conservatively. The decision depends on how much natural tooth remains, the location of the tooth, existing restorations, the patient’s bite and the amount of force the tooth is expected to withstand.
When a Filling Cannot Be Placed Predictably
Sometimes a tooth still has enough healthy structure to be saved, but it may be extremely difficult or nearly impossible to properly isolate and restore the tooth with a filling. This can occur when a cavity extends too far below the gumline or when the location or shape of the tooth makes proper isolation difficult.
Keeping the tooth dry and free of contamination is critical while a bonded filling is being placed. Saliva or blood interfere with the bonding process and compromise the seal between the filling and the tooth, leading to premature failure, leakage or recurrent decay.
In these situations, a dental crown provides a much more predictable seal and a more reliable long-term restoration. By covering the tooth rather than relying entirely on bonding within a difficult-to-isolate area, a crown can help reduce the risk of future problems.
It is also important to recognize that not all dental adhesives perform equally under less-than-ideal conditions. Selecting an appropriate adhesive system with good tolerance to moisture contamination can play an important role in achieving a predictable and durable seal.
Severely Worn Teeth
Teeth can gradually become worn down from years of grinding or clenching, an unbalanced bite, acid erosion, or a combination of these factors. Mild tooth wear may require little or no restorative treatment. However, when the wear becomes severe, a significant amount of enamel and underlying tooth structure may be lost, leaving the teeth shorter, weaker, possibly sensitive, and more vulnerable to fracture or continued wear.
In advanced cases, dental crowns may be used to rebuild the damaged teeth and restore their proper shape, strength, and function. When many teeth are severely worn, treatment requires careful planning because restoring one tooth at a time without considering the overall bite can create additional problems. The position of the teeth, available space, chewing forces, and relationship between the upper and lower teeth must all be evaluated before treatment begins.
Just as importantly, the underlying cause of the wear should be identified and addressed whenever possible. If grinding or clenching contributed to the damage, a custom mouth guard may be recommended after treatment to help protect the natural teeth and new restorations from the same forces that caused the original wear.
Cosmetic Improvements
Dental crowns can dramatically improve the appearance of teeth that are severely discolored, misshapen, worn, fractured, or otherwise significantly compromised. A carefully designed ceramic crown can restore the tooth’s color, shape, size, proportion, and symmetry while closely mimicking the appearance and translucency of natural enamel.
However, a dental crown requires the removal of a significant amount of natural tooth structure and should not automatically be chosen solely for cosmetic reasons. When a tooth is otherwise healthy, more conservative treatments such as teeth whitening, cosmetic bonding, orthodontic treatment, or porcelain veneers may be preferable because they preserve more of the natural tooth.
Crowns become particularly valuable when cosmetic improvement is needed in addition to restoring a tooth that is already structurally compromised. In these situations, the restoration can address both concerns at the same time, strengthening and protecting the tooth while creating a more natural and attractive appearance.
Reasons You May Need a Dental Bridge
A bridge may be recommended if you are missing one or more teeth and wish to restore your smile without implant surgery or if you do not wish to have a removable appliance. Bridges can:
Alternatives to a Dental Bridge
Unlike a dental crown, there are usually several alternatives to a dental bridge when replacing a missing tooth. The most appropriate option depends on the location of the missing tooth, the condition of the neighboring teeth, available bone, your bite, overall health, and personal preferences.
A dental implant is often the most conservative fixed alternative because it replaces the missing tooth without requiring the neighboring teeth to be prepared for crowns. The implant is placed into the jawbone and supports its own crown independently. When adequate bone is available and the patient is a suitable candidate, an implant can provide an excellent long-term solution. You can learn more about implants here: Implants
A removable partial denture is another option, particularly when several teeth are missing or when implants and bridges are not feasible. Although removable and generally less natural-feeling than a fixed restoration, a partial denture can restore appearance and some chewing function without requiring implant surgery.
In selected situations, a Maryland bridge, may provide a more conservative option. Rather than placing full crowns on the neighboring teeth, the replacement tooth is supported by a framework or wings bonded primarily to the back surfaces of adjacent teeth. These restorations are generally limited to specific situations and are most commonly considered for front teeth.
Finally, you may choose not to replace the missing tooth at all. Depending on its location and your bite, this may sometimes be a reasonable option. However, neighboring or opposing teeth can gradually shift into the open space, potentially changing the bite and making future treatment more complicated.
There is no single replacement option that is best for everyone. Each approach has advantages and limitations, and the decision should be based on the condition of the surrounding teeth, your long-term dental needs, and which treatment provides the most predictable outcome while preserving as much healthy tooth structure as possible.
Alternatives to a Dental Crown
If a tooth truly needs a dental crown, there is generally no alternative treatment that will provide the same level of protection and reinforcement. A crown is recommended because the remaining tooth structure is considered too compromised to be predictably restored with a more conservative treatment. If, for whatever reason, you are unable to proceed with a crown, a filling may sometimes be considered if enough tooth structure remains to place one. Although a filling may not provide the same level of protection or long-term predictability as a crown, it may still be preferable to leaving the tooth untreated or having it removed.
It is important to understand that in these situations, the filling may be considered a compromise and could have a greater risk of fracture or failure. Every situation is different and requires an individual evaluation. If a filling cannot be placed predictably and a crown is not an option, the remaining choices may unfortunately be to leave the tooth untreated and accept the associated risks or to have the tooth removed. Leaving a compromised tooth untreated can allow it to fracture further, develop decay, become painful, or eventually become impossible to save.
Back To TopWhat Is a Maryland Bridge?
A Maryland bridge is a conservative type of dental bridge used primarily to replace a missing front tooth. Unlike a traditional bridge, it usually does not require the neighboring teeth to be significantly reduced. It requires only very minor tooth preparation, often even less than what is needed for a porcelain veneer. A Maryland bridge consists of an artificial replacement tooth with one or more thin extensions, commonly called wings, that are bonded to the back surfaces of the neighboring teeth. Because very little natural tooth structure needs to be removed, it can be an attractive option when the adjacent teeth are healthy.
The main limitation of a Maryland bridge is that it relies primarily on the strength of the bonded connection. Heavy biting forces, grinding, or an unfavorable bite can cause the bridge to loosen or debond. For this reason, Maryland bridges are generally better suited for carefully selected situations where biting forces can be controlled, particularly when replacing a front tooth and when the patient understands and accepts the limitations of this type of restoration.
One advantage is that if the bridge becomes debonded without damage to the supporting teeth or the restoration itself, it may sometimes be possible to clean and rebond it rather than fabricate an entirely new bridge. A Maryland bridge is not appropriate for every missing tooth. The condition of the neighboring teeth, the amount of enamel available for bonding, the location of the missing tooth, and the way the upper and lower teeth come together must all be carefully evaluated before determining whether it is a predictable treatment option.
Which Is Better, a Bridge or an Implant?
In many situations, a dental implant is the preferred option for replacing a missing tooth because it replaces the tooth independently without requiring the neighboring teeth to be prepared for crowns. This is particularly important when the adjacent teeth are healthy and have little or no existing dental work. An implant also helps preserve the bone in the area of the missing tooth and can provide excellent long-term function.
However, an implant is not automatically the better choice for every patient. If the teeth next to the missing space already have large fillings, significant damage, or require crowns themselves, a dental bridge may make more sense. In this situation, the bridge can replace the missing tooth while restoring and protecting the neighboring teeth at the same time.
Other factors must also be considered. Dental implants require adequate bone, a surgical procedure, and several months of healing before treatment is completed. A bridge can usually be completed much more quickly and does not require implant surgery. Certain medical conditions, insufficient bone, anatomical limitations, or personal preferences may also influence which treatment is most appropriate.
Types of All-Ceramic Crowns
Lithium Disilicate Crowns (LiSi, IPS Emax®, etc.)
Lithium disilicate is a high-strength glass ceramic widely used for dental crowns, veneers, inlays, and onlays. Popular examples include IPS e.max® and GC Initial™ LiSi. Unlike zirconia, lithium disilicate has a glass-ceramic structure that provides excellent translucency and allows the restoration to interact with light in a way that closely resembles natural enamel.
One of the greatest advantages of lithium disilicate is its aesthetic potential. It is available in different shades, opacities, and levels of translucency, allowing a skilled dental ceramist to closely reproduce the color and optical characteristics of a natural tooth. For this reason, lithium disilicate is an excellent choice for many front teeth and other highly visible areas.
Lithium disilicate also provides considerable strength, typically with a flexural strength in the range of approximately 400–500 MPa, depending on the specific material and fabrication method. Although this is considerably lower than that of high-strength zirconia, it is strong enough for many single-tooth restorations when properly selected, designed, and bonded.
Another important advantage is its ability to be predictably bonded to the tooth. This can provide excellent retention and may allow for more conservative restorative designs in appropriate situations. Lithium disilicate crowns can be digitally milled or fabricated using traditional laboratory pressing techniques. In the hands of a skilled dental technician, the traditional pressed technique can provide an exceptionally precise fit and remains an excellent method of fabrication.
The primary limitation of lithium disilicate is that it does not have the same fracture resistance as high-strength zirconia or metal. For patients with extremely heavy biting forces, significant grinding or clenching, or certain posterior applications, zirconia or another stronger material may provide a more predictable option, although this may come at the expense of some aesthetic qualities.
Porcelain crowns are dental restorations that are entirely made of porcelain, such as lithium disilicate. There are different manufacturers offering different translucencies. As a rule of thumb, more translucent materials are more aesthetic as they mimic the enamel and blend better with natural teeth. However, the color of your teeth will determine what level of translucency will need to be selected. For example, a discolored tooth will show through the crown if the porcelain exhibits a higher level of translucency. It is a delicate balance that needs to be carefully determined by the lab technician. Lithium disilicate crowns may be digitally milled or fabricated using a laboratory pressing technique.
| Advantages | Disadvantages |
| ▸Great color match ▸Best for front teeth ▸Will not stain ▸Quite durable ▸Excellent fit when properly pressed | ▸Cementation is technique-sensitive & requires extra care ▸More prone to caries formation if the cementation protocol is not strictly followed ▸Difficult to remove the crown when it has to be replaced ▸Harsh on opposing teeth if not properly polished |
Zirconia Crowns
Zirconia crowns were introduced in 2009 and have become very popular among dentists. They are made of zirconia (zirconium dioxide, ZrO₂), a high-strength polycrystalline ceramic known for its toughness, strength, fatigue resistance, and biocompatibility. Zirconia crowns are made from a single-layer material (they can also be layered with porcelain) and are digitally designed, milled, and sintered at 1580°C with different ramp and hold parameters that can take many hours.
All zirconia crowns have yttria content, which affects both strength and aesthetics. Higher yttria content increases the aesthetic appearance of the crown at the expense of strength. In general, zirconia can be divided into three different categories based on yttria content:
3Y Zirconia: It has 3% yttria. It is the most durable of all types and is ideal for back teeth where strength is crucial. The 3Y has the least translucency, around 40%, which gives it a dull appearance that may not blend well with adjacent teeth. For this reason, it is not usually used for front teeth. It has a flexural strength of 1200 MPa.
4Y Zirconia: It has 4% yttria. It is less durable but slightly more translucent (around 45%). It provides a better balance between strength and aesthetics, though in terms of aesthetics, it falls short compared to other materials. It has a flexural strength of 900 MPa.
5Y Zirconia: It has 5% yttria. It mimics natural teeth better due to its higher translucency (around 50%). It is more suitable for the esthetic zone. It is the least durable among the three types but provides better aesthetics. It has a flexural strength of 600 MPa.
| Advantages | Disadvantages |
| ▸Great strength, second only to metal crowns. ▸Requires relatively less tooth reduction. ▸Difficult to fracture. ▸Will not stain. | ▸Color match may not be as great due to higher opacity. ▸Increased wear on opposing teeth if not polished well. ▸Less retentive compared to other crown types. ▸The fit is not as great as cast or pressed crown types. |
Porcelain-Layered Ceramic Crowns
Layered crowns consist of multiple individual layers of porcelain that are applied over the substructure. Each layer serves a specific purpose. The ceramic substructure (known as a coping) acts as the foundation to receive layers of porcelain.
Different materials can be used for the underlying core, including zirconia and certain other high-strength ceramics. Rather than relying entirely on a single milled material, the dental ceramist can use multiple shades and levels of translucency to create depth and individual characteristics that are impossible to reproduce with a completely monolithic crown. For this reason, layered ceramic crowns can be particularly valuable for front teeth and highly aesthetic cases.
The primary disadvantage is that the layered porcelain is generally weaker than the underlying ceramic core. Under excessive biting forces, the outer porcelain may chip or fracture even though the core underneath remains intact. This makes proper case selection, bite evaluation, and material selection especially important. However, if the primary layer is fabricated with proper shape and thickness, many unwanted chips can be avoided. After all, layered crowns have been successfully used since the 1950s.
The quality of a layered ceramic crown also depends heavily on the skill and artistic ability of the dental ceramist. When fabricated by an experienced master ceramist, a layered crown can reproduce extremely subtle characteristics of a natural tooth and provide an exceptional aesthetic result. This is particularly important when restoring a single front tooth, where matching the neighboring natural teeth can be one of the most challenging procedures in cosmetic dentistry.
| Advantages | Disadvantages |
| ▸Good balance between strength and aesthetics. ▸Great aesthetics in the hands of a skilled technician. ▸The underlying ceramic substructure may remain intact if the outer porcelain layer chips or fractures. | ▸Porcelain can wear opposing teeth at a higher rate. ▸Slightly more tooth structure may need to be removed compared to a zirconia crown, depending on the case. ▸The porcelain layer can chip or fracture. |
Types of Metal-Ceramic Crowns
Porcelain-Fused-to-Noble-Metal (PFM) Crowns
A porcelain-fused-to-noble-metal (PFM) crown combines a strong noble metal substructure with tooth-colored porcelain layered over the outside. The underlying metal provides strength and support, while the porcelain is used to create a more natural tooth-colored appearance. Noble metal alloys may contain gold, palladium, platinum, or a combination of these metals and are highly resistant to corrosion.
PFM crowns have been used successfully in dentistry for many decades and can provide an excellent combination of strength, fit, and aesthetics. However, because space is required for both the metal substructure and the overlying porcelain, more tooth reduction may be necessary compared with a full-metal crown. The porcelain layer can also chip or fracture, exposing the metal underneath.
Another aesthetic limitation is that the underlying metal blocks the natural transmission of light through the restoration. In some cases, a dark or gray line may eventually become visible near the gumline, particularly if the gums recede over time. Many of these aesthetic limitations can be minimized or even overcome by a truly skilled dental ceramist who understands how to properly layer, characterize, and contour the porcelain. However, finding technicians with this level of traditional hand-layering expertise is becoming increasingly difficult as digital design and milling become more prevalent in dental laboratories.
For this reason, modern all-ceramic crowns are often preferred in highly visible areas. Despite these limitations, porcelain-fused-to-noble-metal crowns remain a reliable restorative option, particularly when the strength and predictability of a metal substructure are desired along with a tooth-colored appearance.
| Advantages | Disadvantages |
| ▸ Great strength and durability ▸ Noble metal substructure is resistant to corrosion ▸ Great marginal fit and adaptation ▸ Long clinical history with predictable results ▸ Suitable for both front and back teeth in appropriate situations | ▸ Less translucent than all-ceramic crowns ▸ Generally less aesthetic than lithium disilicate ▸ Porcelain can chip or fracture from the underlying metal ▸ A gray or dark metal margin may become visible if the gums recede ▸ Final aesthetic result is highly dependent on the skill of the dental ceramist |
Porcelain-Fused-to-Gold (PFG) Crowns
A porcelain-fused-to-gold (PFG) crown combines a gold-alloy substructure with tooth-colored porcelain layered over the outside. It is essentially a type of porcelain-fused-to-metal (PFM) crown, but instead of using a base-metal or predominantly palladium alloy, the underlying framework contains a significant amount of gold. The exact percentage of gold varies depending on the specific dental alloy used.
Gold alloys have several desirable properties for crown fabrication. They are highly resistant to corrosion, have a long history of biocompatibility, and can provide an exceptionally precise fit. Gold is also easier for a skilled dental technician to work with and adjust than many harder dental alloys. Another advantage of a gold substructure is its warm yellow color. When properly designed and layered by a skilled dental ceramist, the warm underlying tone can contribute to a more natural appearance than the gray color of some other metal substructures. This can be particularly helpful near the gumline, where a darker metal may otherwise become more noticeable.
The final aesthetic result of a porcelain-fused-to-gold crown depends heavily on the skill of the dental ceramist. In the hands of an experienced technician with exceptional porcelain-layering abilities, PFG crowns can produce beautiful and highly natural-looking restorations while maintaining the strength, fit, and long clinical history associated with a gold-alloy substructure. Although all-ceramic crowns have become more common with the growth of digital dentistry, PFG crowns remain an excellent restorative option in carefully selected cases.
| Advantages | Disadvantages |
| ▸ Excellent marginal fit and adaptation ▸ Gold is highly corrosion resistant ▸ High-gold alloys have excellent biocompatibility ▸ Porcelain exterior provides a tooth-colored appearance ▸ The gold-colored substructure can provide a warmer underlying tone than silver-colored metal alloys | ▸ Less translucent than all-ceramic crowns because the metal substructure blocks light transmission ▸ Usually not as aesthetic as lithium disilicate ▸ Porcelain can chip or fracture away from the underlying metal ▸ High-gold alloys can significantly increase material costs ▸ Requires considerable laboratory skill to achieve exceptional aesthetics |
Types of Metal Crowns
A metal crown is a type of dental restoration used to cover and protect a damaged or decayed tooth. It is made entirely from a dental metal alloy, which may contain gold, palladium, platinum, nickel-chromium, cobalt-chromium, or combinations of other metals. Metal crowns are known for their durability, resistance to wear, and ability to withstand strong biting forces.
Although not aesthetically pleasing due to their metallic color, they are ideal for molars or other back teeth where appearance is less important. Metal crowns also require less tooth reduction compared to other types, preserving more of the natural tooth structure.
Full Cast Gold Crowns (Yellow-Colored)
Gold crowns remain one of the longest-lasting and most predictable dental restorations ever developed. They are made from gold alloys rather than pure gold, combining gold with other metals to provide the strength and physical properties needed for a dental restoration. Although they are less popular today because of their metallic appearance, gold crowns offer several important advantages.
Gold crowns require relatively minimal tooth reduction, can provide an exceptionally precise fit, and are highly resistant to fracture. They also produce relatively little wear on the opposing natural teeth compared with some harder restorative materials. Because of their excellent durability and long clinical history, high-gold crowns remain an excellent option for back teeth where strength and longevity are more important than appearance.
To benefit from the desirable properties of gold, a high-gold dental alloy containing approximately 40–75% gold may be used, although the exact composition varies depending on the specific alloy. It is important to understand that a crown can appear yellow or gold-colored without necessarily containing a high percentage of actual gold. The color of a dental alloy results from its overall composition, and combinations of other metals can produce a yellow or gold-like appearance even when the gold content is relatively low.
Unfortunately, some providers may refer to a yellow or gold-colored crown as a “gold crown” even when the alloy contains only a small amount of actual gold. For example, dental alloys can contain metals such as copper, silver, palladium, platinum, zinc, indium, or gallium. Certain combinations, particularly alloys containing copper, can produce a yellow or gold-like appearance even when the actual gold content is relatively low. For this reason, the appearance of the restoration alone does not indicate how much gold it contains. If the gold content is important to you, ask about the specific dental alloy being used and its composition rather than relying solely on the term “gold crown” or its yellow appearance.
| Advantages | Disadvantages |
| ▸ Exceptional potential for long-term longevity ▸ Requires the least amount of tooth reduction ▸ Extremely accurate fit ▸ Gentle on opposing teeth ▸ Rarely fractures or chips ▸ Excellent choice for back teeth | ▸Metallic gold appearance ▸Higher material cost ▸Not ideal for visible front teeth |
Full Cast Noble Metal Crown (Silver-Colored)
Noble metal crowns are made from dental alloys containing noble metals such as gold, palladium, and platinum. These metals are valued in dentistry because they are highly resistant to corrosion and oxidation and have a long history of successful clinical use. Depending on the specific alloy, a noble metal crown may appear yellow or silver in color.
It is important to understand that the term “noble metal” does not necessarily mean “gold.” Under the American Dental Association (ADA) classification, a noble alloy contains at least 25% noble metal (Gold, Platinum, Palladium, etc.) by weight, while a high-noble alloy contains at least 60% noble metal, with at least 40% being gold. Therefore, two crowns described as noble-metal restorations can have very different compositions and may contain substantially different amounts of actual gold.
Noble metal crowns offer excellent strength, corrosion resistance, and durability. Because metal can function predictably at relatively thin dimensions, these restorations may also allow for more conservative tooth preparation compared with some ceramic crowns. They are highly resistant to fracture and can provide many years of service when properly designed and maintained. Their primary disadvantage is appearance. Depending on the alloy, the crown will have a metallic yellow, gold, or silver-gray color rather than the appearance of a natural tooth. For this reason, noble metal crowns are most commonly considered for back teeth where durability and function are more important than aesthetics.
| Advantages | Disadvantages |
| ▸Highly corrosion resistant ▸Precise fit ▸Excellent long-term durability and longevity. ▸Very gentle wear on opposing teeth. ▸Better retention on short teeth compared to other crowns. ▸Less likely to cause allergic reactions than many base metals ▸Can require less tooth reduction than many ceramic crown ▸Does not fracture. | ▸Metallic appearance ▸More expensive than base metal alloys |
Base Metal Alloy Crowns (Silver-Colored)
Base metal alloy crowns contain little or no noble metals. Common examples include nickel-chromium and cobalt-chromium alloys. These materials are extremely strong, highly resistant to fracture, and can often be made relatively thin, allowing the dentist to preserve more natural tooth structure.
Their primary disadvantage is their silver-colored metallic appearance, which generally makes them better suited for back teeth where aesthetics are less important. Some base metal alloys, particularly those containing nickel, may also be unsuitable for patients with known metal sensitivities or allergies. Although they can provide excellent durability, noble and high-gold alloys are generally considered more desirable when their additional cost is acceptable.
| Advantages | Disadvantages |
| ▸Very high strength ▸Thin restorations require less tooth reduction ▸Lower cost than noble metal crowns ▸Excellent wear resistance | ▸Silver-colored appearance ▸Nickel-containing alloys may cause allergic reactions in susceptible individuals ▸Slightly less biocompatible than noble metal alloys |
Stainless Steel Crowns (Silver-Colored)
Stainless steel crowns are prefabricated metal crowns most commonly used on primary (baby) teeth. Unlike laboratory-made crowns, they are available in preformed sizes and are selected, adjusted, and cemented during the dental appointment. They are thin, durable, cost-effective and an excellent short-term option for protecting compromised baby teeth until they naturally fall out.
| Advantages | Disadvantages |
| ▸ Does not require an impression. ▸ Can be fabricated and delivered in a single visit. ▸ Great protection until the baby tooth exfoliates. ▸ Relatively inexpensive | ▸ Metallic silver appearance ▸ Fit & contours may not be as precise as lab-made crowns |
The Dental Crown or Bridge Procedure
Most crowns are completed in two visits. During the first appointment, the tooth is reshaped, a digital or conventional impression are then taken, a temporary crown is fabricated and cemented on your tooth. At the second appointment, the temporary crown is removed, the final crown is evaluated for fit, appearance, bite and comfort. Once everything is confirmed, it is permanently bonded or cemented into place.
Consultation & Treatment Planning
The first step is a thorough evaluation of the tooth or missing tooth area. We will examine the condition of the tooth, surrounding teeth, gums, bite, and existing restorations, and review any necessary X-rays. We will then discuss whether a crown or bridge is appropriate, review alternative treatment options when applicable, and explain the benefits, limitations, and expected outcome before proceeding with treatment. We will also take impressions for study models. This allows the dentist to thoroughly evaluate the case and properly plan for the treatment appointment.
Tooth Preparation (Visit 1)
Local anesthesia is used to keep you comfortable throughout the procedure. The tooth is carefully shaped to create the necessary space for the crown or bridge while preserving as much healthy tooth structure as possible. Any decay, weakened tooth structure, or failing restorative material is removed and replaced to provide proper support and retention for the final restoration.
Impressions or Digital Scans (Visit 1)
Once the tooth preparation is complete, a highly accurate impression or digital scan is taken to capture the shape of the prepared tooth, neighboring teeth, and your bite. This information is used by our in-house dental technician to fabricate a custom crown or bridge that fits precisely, functions properly, and blends naturally with the surrounding teeth.
Temporary Crown or Bridge (Visit 1)
A temporary crown or bridge is fabricated and placed to protect the prepared tooth or teeth while the final restoration is being made. The temporary restoration helps maintain appearance, tooth position, and basic function. Because it is placed with temporary cement, very hard or sticky foods should be avoided until the final restoration is delivered.
Final Placement (Visit 2)
Once your final crown or bridge is ready, the temporary restoration is removed and the new restoration is carefully evaluated for fit, bite, shape, and appearance. An x-ray may be taken to evaluate the fit. Any necessary adjustments are made before it is permanently cemented or bonded into place. Your bite is checked again after placement to ensure the restoration feels comfortable and functions naturally with the surrounding teeth.
Caring for Your Crown or Bridge
Although crowns themselves cannot decay, the natural tooth underneath still can! Daily brushing, flossing, and regular professional cleanings remain essential to help prevent cavities and gum problems around the restoration. Patients with bridges should also clean underneath the artificial tooth using floss threaders, super floss, or specialized interdental cleaning devices to prevent plaque and food accumulation around the supporting teeth. Routine dental examinations allow small problems to be identified before they become more significant.
A dental crown may be strong, but ceramic crowns can still chip or fracture, particularly when exposed to excessive biting forces. Only full-metal crowns do not fracture. You should be able to eat normally with your crown or bridge, but avoid placing excessive forces on the restoration, just as you should with your natural teeth. If you grind or clench your teeth, a custom mouth guard may also be recommended to help protect your restoration.
How Long Do Crowns and Bridges Last?
Many dental insurance plans may provide benefits for replacement of a crown or bridge after approximately five years, although coverage varies significantly between plans. This should not be interpreted as the expected lifespan of the restoration. Ideally, we hope your crown or bridge will serve you well for at least 7–10 years, and often considerably longer.
The longevity of a crown or bridge depends on several factors, including oral hygiene, diet, biting forces, grinding or clenching habits, the condition of the supporting tooth, the restorative material used, and routine dental maintenance. Generally speaking, full-metal crowns, particularly gold alloy crowns, have an exceptional history of longevity and may last 15–20 years or even longer when properly maintained. Ceramic crowns and bridges can also provide many years of reliable service, but like natural teeth, no dental restoration can be expected to last forever.
Can a crown get a cavity?
The crown itself cannot decay, but the natural tooth underneath still can. Good oral hygiene is essential to prevent decay around the edges of the restoration.
Is a bridge better than an implant?
Not necessarily. Dental implants are often considered the preferred treatment for replacing a missing tooth because they can replace the tooth without requiring treatment of the adjacent teeth. However, an implant is not always the better option. Sometimes a dental implant is the more appropriate choice, while in other situations a bridge may provide a more practical and predictable solution. The condition of the neighboring teeth, available bone, your bite, overall health, treatment time, and individual circumstances all need to be considered before deciding which option is best for you.
Will my crown look natural?
Yes. Modern ceramic materials can closely reproduce the color, translucency, shape, and surface characteristics of natural teeth, allowing a well-designed crown to blend beautifully with the surrounding teeth. However, different ceramic materials offer different advantages and limitations in terms of strength, translucency, and esthetics. The ideal material is case-specific and should be selected based on the location of the tooth, your bite, the color of the underlying tooth, and the level of esthetics required.
Can a night guard damage my teeth?
A properly fitted and appropriately designed night guard should protect your teeth rather than damage them. However, poorly fitting appliances can be uncomfortable or create undesirable pressure. This is one advantage of having the fit and bite evaluated professionally rather than an over the counter type.
Can a bridge replace multiple teeth?
Yes. A dental bridge can replace one or several adjacent missing teeth, depending on their location, the number and condition of the supporting teeth, your bite, and your individual clinical situation. Bridges may range from relatively small two-unit restorations to larger bridges involving several teeth, sometimes extending to five or six units in carefully selected cases. However, as the length of a bridge increases, the forces placed on the supporting teeth also become more significant. For this reason, longer bridges require careful evaluation and treatment planning to determine whether they can provide a predictable long-term result.
Can crowns or bridges be repaired?
Sometimes, but even then, the results are quite unpredictable. Very minor chips in a ceramic crown or bridge can occasionally be smoothed and polished. However, larger fractures or fractures that extend completely through the restoration generally cannot be repaired and may require complete replacement. If a crown or bridge becomes loose but remains intact, it may sometimes be possible to clean and recement it, provided the restoration and the supporting tooth or teeth remain in good condition. The appropriate treatment ultimately depends on the type and extent of the damage and the condition of the underlying tooth.
Back To TopExternal Patient Education Resource
Crowns: ADA MouthHealthy – Dental Crowns
Bridges: ADA MouthHealthy – Dental Bridges
Why Choose Dentist Dr. Shayan Ghodsi?
Dr. Ghodsi is meticulous about his work and pays close attention to every detail of your treatment. His philosophy is to recommend the treatment you truly need while preserving as much healthy natural tooth structure as possible. Every crown and bridge is carefully planned, and tooth preparation is performed with precision to remove the appropriate amount of tooth structure while providing the necessary space, strength, and support for the restoration.
Another important advantage at Lakeview Dental is our in-house master ceramist and laboratory technician. Having the ceramist directly involved allows for close communication between the dentist, patient, and laboratory throughout the restorative process. This is particularly valuable for highly visible front teeth and cosmetic smile makeovers, where subtle differences in color, translucency, shape, texture and symmetry can significantly influence the final result.
Our goal is not simply to place a crown or bridge, but to provide a carefully planned restoration that looks natural, functions properly, and serves you reliably for many years.
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Dr. Shayan Ghodsi DMD
Royal Palm Beach Cosmetic Dentist
“Felt very comfortable, everyone was very pleasant and professional. The dentist was very approachable and honest. Did not push unnecessary procedures. I’m very grateful for his kindness and professionalism. I highly recommend him and his staff. Thank you so much.”
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