|Crowns and Onlays. What You Need to Know
Crowns are sometimes referred to as “caps”. They are an artificial replacement for that part of the tooth that is above the gum line. A crown typically covers the entire tooth, replacing most of the enamel. They can be made from metal, gold alloys, metal and porcelain fused together, or entirely of porcelain or other white material. Crowns may be fabricated in a laboratory or on a Computer Assisted Design machine. They are cemented or bonded into place.
Teeth that have cracked enamel, broken cusps, extensive decay, or defective fillings often must be crowned. These situations are more involved than a simple area of decay, and can also be more serious; making a replacement filling insufficient or impossible. Cracked enamel can allow mouth fluids and bacteria into a tooth. Left unrepaired, this can result in a contaminated nerve. Broken cusps or other broken sections can continue to fracture, causing pain and possible nerve damage. Extensive decay usually means that a large part of the tooth structure has been damaged or destroyed making the area to be repaired too large for a simple filling. And a defective filling is broken or fractured or has sections that have shrunk or expanded away from the rest of the tooth, leaving it at risk for nerve exposure. A crown replaces the damaged parts of a tooth and makes it viable again, adding years to its lifespan. Crowns can also be placed to make cosmetic improvements in the appearance of teeth.
An onlay is a restoration that replaces the central portion of a tooth plus a partial crown covering damaged cusps. It is also cemented or bonded into place. An onlay is recommended when a tooth has been extensively damaged, but has a bit more natural tooth structure remaining. It is a more conservative restoration than a full crown.
Crowns and onlays are often required where there has been too much tooth destruction for a “filling” to work. Fillings are not sufficient for repairing cracks, broken cusps, extensive decay, or severely damaged old fillings. There has to be enough of the natural tooth left to support a filling. If not, a crown or an onlay is typically the only solution.
Many patients are concerned about possible insurance coverage for crowns and onlays. While insurance may help, most will not cover all the costs for crowns, and may stipulate an “alternate benefit” of payment toward a a silver filling instead of an onlay. Most plans also have a maximum limit as to the amount of money they will pay for any treatment during a year’s time. It is our responsibility to prescribe what is best for you. The insurance carrier’s responsibility is to control payments.
Even if your insurance only covers a portion of the fee, a crown or an onlay may be the best way to restore your damaged tooth.
Call us if you want to know more. We are always happy to help!