Dental Crown in Singapore

What is a dental crown?

A dental crown is a tooth-shaped cap that is placed over a damaged or weakened tooth to restore its shape, size, strength, and appearance. It is also known as a dental cap.

The crown is often used when a tooth is damaged or weakened due to decay, fractures, large fillings, or other dental issues. A crown can also be used for cosmetic purposes to improve the appearance of a tooth.

How do you know if you need a dental crown?

A dental crown may be recommended for various reasons, typically when a tooth is damaged, weakened, or requires significant restoration. Here are common situations that might necessitate the placement of a dental crown:

1. Large cavities:

   • When a tooth has a large cavity that cannot be effectively restored with a dental filling, a crown may be recommended to provide structural support and protect the remaining tooth.

2. Fractured or cracked teeth:

   • Teeth that are fractured or cracked may be at risk of further damage or infection. A crown can help hold the tooth together, preventing further fractures and providing stability.

3. Weakened teeth:

   • Teeth that have been weakened due to decay, large fillings, or root canal treatment may benefit from the additional strength and support provided by a dental crown.

4. Restoration of worn-down teeth:

   • Teeth experiencing significant wear, whether from conditions like bruxism (teeth grinding) or erosion, may be restored with crowns. Crowns rebuild the teeth to their natural shape and functionality, ensuring both aesthetic appeal and proper oral function.

5. Cosmetic improvement:

   • Dental crowns are used for cosmetic purposes to enhance the appearance of teeth. They can improve the colour, shape, and alignment of teeth, providing an aesthetically pleasing result.

6. Protection after root canal treatment:

   • Teeth that have undergone root canal treatment are often more susceptible to fractures. A crown is placed over the treated tooth to provide protection and prevent further damage.

7. Covering dental implants:

   • Dental crowns are attached to dental implants to replace missing teeth. The crown serves as the visible and functional part of the restoration.

8. Repair of damaged teeth:

   • Teeth that have been damaged due to trauma, such as a sports injury or accident, may require a dental crown to restore their structure and appearance.

The decision to recommend a dental crown is based on a thorough examination by a dentist, considering the specific condition of the tooth and the patient's oral health. If a crown is suggested, your dentist will discuss the reasons for the recommendation and provide information on the type of crown that may be most suitable for your situation.

Dental crown material: What are they made of?

Dental crowns can be made from various materials, and the choice depends on factors such as the tooth's location, functional requirements, aesthetic considerations, and the patient's preferences. Here are some common materials used for dental crowns:

1. Porcelain fused to metal (PFM)

2. All-ceramic (E-max) or All-porcelain 

3. Metal (gold or other alloys) 

4. Zirconia

5. Composite resin

6. Stainless steel

Porcelain fused to metal (PFM)

These crowns have a metal substructure for strength, covered with a layer of tooth-coloured porcelain to provide a natural appearance. They are commonly used for both front and back teeth.

All-ceramic (E-max) or All-porcelain 

These crowns are made entirely of ceramic or porcelain material, offering a more natural and lifelike appearance. They are often used for front teeth or individuals with metal allergies.

Metal (gold or other alloys) 

Metal crowns, including gold and other metal alloys, are known for their strength and durability. They are less abrasive to opposing teeth but may not be suitable for visible areas due to their metallic appearance.

Zirconia

Zirconia crowns are made from a strong and durable ceramic material called zirconium oxide. They provide a good balance of strength and aesthetics and are suitable for both front and back teeth.

Composite resin

These crowns are made from tooth-coloured composite resin materials. While they may be less expensive, they are not as durable as some other options and are more prone to wear and chipping. They are often used for temporary crowns or in specific cases.

Stainless steel

Stainless steel crowns are pre-fabricated and often used as temporary crowns, especially for children. They are durable and cost-effective.

The choice of crown material depends on various factors, and your dentist will consider factors such as the location of the tooth, the patient's oral health, aesthetic preferences, and budget constraints when recommending a specific type of crown. It's essential to discuss these options with your dentist to determine the most suitable material for your specific dental needs.

What are the risks of getting a crown?

While dental crowns are generally considered safe and effective, like any dental procedure, there are potential risks and considerations. Here are some factors to be aware of:

1. Sensitivity:

   • It is common to experience sensitivity in the tooth after a crown is placed, especially when exposed to hot or cold temperatures. This sensitivity usually subsides within a few days to a week. If it persists, it is important to inform your dentist.

2. Allergic reactions:

   • While rare, some individuals may be allergic to certain materials used in dental crowns, such as metals or ceramics. Discuss any known allergies or sensitivities with your dentist before the procedure.

3. Discomfort or pain:

   • Some discomfort or mild pain may be experienced after the crown placement due to the adjustment of the tooth and surrounding tissues. Over-the-counter pain relievers can help manage this discomfort.

4. Chipped or cracked crown:

   • Crowns are durable, but they are not indestructible. Chewing on hard objects, grinding teeth, or biting into very hard foods may cause a crown to chip or crack. Avoiding such behaviors can reduce the risk of crown damage.

5. Infection:

   • In rare cases, there may be complications such as infection around the crowned tooth. Maintaining good oral hygiene, attending regular check-ups, and promptly addressing any signs of infection can help mitigate this risk.

6. Loose crown:

   • If a crown is not properly cemented or bonded, it may become loose or dislodged. In such cases, it is crucial to contact your dentist for prompt evaluation and re-cementation.

7. Gum issues:

   • Poor oral hygiene can lead to gum inflammation or infection around the base of the crown. Regular brushing, flossing, and dental check-ups are essential for preventing such issues.

8. Adjacent tooth issues:

   • In some cases, the preparation of a tooth for a crown may inadvertently affect the adjacent teeth. Your dentist will take precautions to minimise this risk.

9. Aesthetics:

   • While modern dental materials provide excellent aesthetics, the appearance of a crown may not perfectly mimic a natural tooth. Colour matching and overall appearance depend on factors such as the chosen material, the skill of the dentist, and the dental laboratory.

It is important to communicate openly with your dentist about any concerns or discomfort you experience after getting a dental crown. Follow the post-placement care instructions provided by your dentist, attend regular check-ups, and address any issues promptly to ensure the success and longevity of the crown.

Dental crown procedure: How are they made? 

The fabrication of dental crowns involves both clinical and dental laboratory steps. 

The clinical steps involved in the placement of a dental crown typically include the following:

1. Examination and diagnosis:

   • The dentist examines the tooth and assesses whether a dental crown is necessary. Factors such as decay, fractures, or large fillings may lead to the recommendation of a crown.

2. Treatment planning:

   • The dentist discusses the treatment plan with the patient, explaining the need for a dental crown, the type of crown recommended, and any alternatives.

3. Tooth preparation:

   • Local anesthesia is administered to ensure the patient's comfort during the procedure.

   • The dentist removes any decayed or damaged tooth structure and shapes the tooth to accommodate the crown. The amount of tooth reduction depends on the type of crown and material used.

4. Impression taking:

   • An impression (mold) of the prepared tooth and surrounding teeth is taken using traditional putty-like materials or digital scanners for digital impressions.

5. Temporary crown placement (if needed):

   • If the permanent crown is not ready on the same day, a temporary crown may be placed to protect the prepared tooth until the final restoration is ready.

6. Shade matching (for porcelain crowns):

   • If the crown is made of porcelain or ceramic, the dentist may take note of the tooth's shade to ensure the final restoration matches the natural teeth.

Following this, the mold as well as the details of the crown such as the shade, and shape of the desired tooth are sent to a dental laboratory. The dental crown lab steps involve the fabrication of the crown based on the specifications provided by the dentist. 

After the dentist receives the crown back from the lab, another visit will be scheduled to issue the crown. During that visit, these are the steps that will typically take place:

1. Crown try-in:

   • When the permanent crown is ready, the patient returns to the dental clinic for a try-in. The dentist places the crown temporarily to check for fit, colour, and aesthetics.

2. Adjustments:

   • The dentist may make adjustments to the crown, ensuring a proper fit and a natural appearance. This may involve shaping the crown or adjusting the bite.

3. Cementation or bonding:

   • Once satisfied with the fit and appearance, the final crown is cemented or bonded onto the prepared tooth using dental cement. Adhesive bonding may be used for certain types of crowns.

4. Final evaluation:

   • The dentist evaluates the final placement, ensures proper occlusion (bite), and checks for patient comfort.

5. Post-placement instructions:

   • The dentist provides the patient with post-placement instructions, including information on oral hygiene, potential discomfort, and what to do in case of any issues.

It is important for patients to follow post-placement instructions and attend follow-up appointments to ensure the success and longevity of the dental crown. Additionally, regular dental check-ups are recommended to monitor the health of the crowned tooth and surrounding oral tissues.

What to expect after getting a crown?

After getting a dental crown, there are several things to expect during the post-placement period. Here is what you can anticipate and some guidelines to follow:

1. Numbness after anesthesia:

   • If local anesthesia was used during the crown placement, you may experience numbness in the treated area for a few hours. Avoid chewing on that side of the mouth until the sensation returns. This is to prevent accidental biting.

2. Sensitivity:

   • It is common to experience some sensitivity in the treated tooth for a few days to a week after crown placement. This sensitivity should gradually decrease. Over-the-counter pain relievers can help manage any discomfort.

3. Temporary crown considerations:

   • If a temporary crown was placed, be cautious with your eating and oral hygiene habits. Avoid sticky or hard foods, and be gentle when flossing around the temporary crown.

4. Oral hygiene practices:

   • Maintain good oral hygiene by brushing and flossing regularly. Pay attention to the area around the crown to keep it clean and prevent gum inflammation.

5. Adjustment period:

   • It may take a few days for you to get used to the new crown, especially if adjustments were made to your bite. If you experience persistent discomfort or if the bite feels uneven, contact your dentist for adjustments.

6. Avoid certain foods:

   • While your permanent crown is strong, avoid biting into very hard or sticky foods, as these can potentially damage the crown or cause it to become dislodged.

7. Follow-up appointments:

   • Attend any follow-up appointments scheduled by your dentist. These appointments allow the dentist to check the fit of the crown, make any necessary adjustments, and ensure everything is healing properly.

8. Report any issues:

   • If you notice persistent pain, swelling, or any signs of complications, such as a loose crown, contact your dentist promptly. Early intervention can prevent more significant issues.

9. Long-term maintenance:

   • Continue to attend regular dental check-ups and cleanings. Your dentist will monitor the condition of the crowned tooth and address any concerns during these visits.

10. Oral health education:

    • If your dentist provided specific post-placement instructions, follow them carefully. These instructions may include information on oral hygiene practices, dietary restrictions, and what to do in case of emergencies.

Remember that each individual may have a slightly different experience, and your dentist will provide personalised guidance based on your specific case. If you have any questions or concerns during the post-placement period, do not hesitate to contact your dentist for assistance.

How do I care for my dental crown?

It is important to care for your dental crown to ensure its longevity and maintain a good oral health. Here are some tips on how to care for your dental crown:

1. Maintain good oral hygiene:

   • Brush your teeth at least twice a day using a fluoride toothpaste. Use a soft-bristle toothbrush to avoid abrasive wear on the crown.

   • Floss daily to clean between teeth and around the base of the crown. Proper oral hygiene helps prevent gum disease and decay around the crown.

2. Choose the right toothpaste:

   • Use a non-abrasive toothpaste to avoid scratching the surface of the crown. Some toothpaste formulations can be abrasive and may affect the appearance of the crown over time.

3. Be gentle when chewing:

   • Avoid chewing on hard objects, such as ice, popcorn kernels, or hard candies, as they can potentially damage the crown. Additionally, avoid using your teeth to open packages or bite on non-food items.

4. Limit sticky foods:

   • Reduce your consumption of sticky or chewy foods that can potentially pull on the crown or get stuck around it. Examples include caramel and toffee.

5. Regular dental check-ups:

   • Visit your dentist for dental check-ups and cleanings. Your dentist will monitor the condition of the crowned tooth and surrounding oral tissues, addressing any issues early on.

6. Wear a mouthguard (if applicable):

   • If you grind your teeth at night or participate in activities that pose a risk of dental injury (such as contact sports), consider wearing a mouthguard to protect your crown.

7. Avoid excessive force:

   • Be cautious with your crowned tooth when biting or chewing. While crowns are durable, excessive force or using your teeth for tasks like tearing open packages may lead to damage.

8. Address teeth grinding (bruxism):

   • If you grind your teeth, discuss this with your dentist. They may recommend a nightguard to protect your teeth, including the crowned one, from the effects of bruxism.

9. Watch for changes in sensation:

   • If you experience persistent pain, sensitivity, or changes in the way your crowned tooth feels, contact your dentist promptly. These could be signs of issues that need attention.

10. Dietary considerations:

    • Limit acidic foods and beverages, as they can contribute to the breakdown of dental materials over time. Examples include citrus fruits and acidic beverages.

What is the price for a dental crown?

The cost can range from SGD 700 to SGD 3,000 per tooth or more, depending on various factors. Public institutions like polyclinics may charge less, but private clinics often have shorter waiting times.

Can I use MediSave/CHAS to pay for a dental crown?

For dental crowns, CHAS subsidies are available, limited to 4 permanent crowns per calendar year. For CHAS Orange and Blue cards, there is a subsidy of $84.50 and $127.50 respectively. Additional details on CHAS subsidies can be found here.

MediSave typically does not cover general dental treatments, such as dental crowns, unless they involve surgical procedures deemed medically necessary. Non-surgical dental treatments, including routine check-ups and dental crowns, are not eligible for claims under the MediSave scheme. 

FAQ

Is it painful to get a crown?

The tooth and surrounding tissues are usually numbed with local anesthesia during the crown placement procedure, ensuring that you don't feel pain. After the procedure, there might be some sensitivity or mild discomfort, but this is generally temporary.

Are dental crowns permanent?

Dental crowns are not considered permanent in the sense that they will last forever. However, with proper care and maintenance, dental crowns can last for many years. 

The lifespan of a dental crown is typically about 10 to 15 years however it depends on various factors, including the material used, the quality of the crown, oral hygiene practices, and the forces applied during biting and chewing. 

Some crowns, such as those made from materials like porcelain or ceramic, may be more prone to chipping or cracking than others. Crowns made from metal tend to be durable but are not aesthetic and are mainly used for posterior teeth (teeth at the back of your mouth).

To maximise the longevity of a dental crown, it is essential to practice good oral hygiene, including regular brushing and flossing, and to visit your dentist for routine check-ups. Additionally, avoiding habits like teeth grinding or using your teeth to bite hard objects can help prevent damage to the crown. If a dental crown becomes damaged it may need to be replaced. Regular dental examinations can help identify any issues early on, allowing for timely intervention and maintenance.

Can a dental crown be replaced?

Yes, dental crowns can be replaced if they become damaged, show signs of wear, or if there are changes in the adjacent teeth or oral health.

How long does a dental crown last?

The lifespan of a dental crown can vary, but with proper care and maintenance, it can last for an average of 10 to 15 years or even longer. Regular dental check-ups and good oral hygiene practices contribute to their longevity.

How long does it take to get a dental crown?

The process of getting a dental crown typically involves two visits. During the first visit, the tooth is prepared, and impressions are taken. A temporary crown may be placed. The final crown is fabricated in a dental laboratory, and during the second visit, it is permanently cemented or bonded onto the prepared tooth.

Can a crowned tooth get cavities?

While the crown itself cannot get cavities, the tooth underneath the crown can still be susceptible to decay. It is important to maintain good oral hygiene, including regular brushing and flossing, to prevent decay in the surrounding tooth structure.

Can I eat normally with a dental crown?

Yes, once the crown is securely in place, you can typically eat a normal diet. However, it's advisable to avoid biting on hard objects or chewing excessively sticky foods to prevent potential damage to the crown.

Do dental crowns require special care?

Dental crowns do not require special care beyond regular oral hygiene practices. Brushing, flossing, and attending regular dental check-ups are essential for maintaining the health of the crowned tooth and surrounding tissues.

What happens if I swallow a dental crown?

If you accidentally swallow a dental crown, it is important to remain calm. Dental crowns are typically small and smooth, and they are designed to pass through the digestive system without causing harm. However, there are a few things you should consider:

• Size and material: If the crown is relatively small and made of materials that are unlikely to cause harm, it will likely pass through your digestive system without any issues.

• Seek medical advice: It's advisable to consult with your dentist or doctor if you have concerns. They can provide guidance based on the specific circumstances.

• Monitor for symptoms: In most cases, swallowing a dental crown should not cause any symptoms or complications. However, if you experience difficulty breathing, chest pain, or any other severe symptoms, seek immediate medical attention.

• X-rays: In some cases, a dentist or doctor may order an X-ray to confirm that the crown has safely passed through your digestive system.

Remember, it is always better to err on the side of caution and seek medical advice if you have any concerns. While it is generally not a cause for major concern, professional guidance can help ensure your well-being.

Dental implant vs crown vs bridge: What are the differences?

Dental implants, dental crowns, and dental bridges are all dental restorative options, but they serve different purposes and are used in different situations.

How do I know if I need a crown or a filling?

Whether you need a dental crown or a filling depends on the extent of tooth damage or decay. Typically, smaller defects or cavities can be restored with fillings. Dental fillings are typically more conservative and able to preserve more tooth structures. However, if the defect or decay is too extensive, then the filling will be prone to failure and a dental crown may be suggested by your dentist. 

A crown is used to restore large defects that compromise the structural integrity of a tooth. If a tooth has a large decay or has fractured as a result of trauma, a dental crown may be suggested by your dentist. A dental crown may also be used in areas with aesthetic demand such as when restoring heavily broken-down front teeth as the result is typically more natural and long-lasting than a filling.

Additionally, crowns may be used after root canal treatment to protect the tooth that previously consist of a large cavity.

Which crown is better ceramic or metal?

The choice between ceramic (porcelain) and metal crowns depends on various factors, including the specific needs of the patient, the location of the tooth, and personal preferences. 

Both types of crowns have their advantages and considerations:

Ceramic crowns:

• Aesthetics: Ceramic crowns closely mimic the appearance of natural teeth and are often preferred for front teeth or visible areas.

• Biocompatibility: Ceramic is biocompatible, meaning it is well-tolerated by the body, and there is a minimal risk of allergic reactions.

• Less tooth reduction: In some cases, less tooth structure may need to be removed for a ceramic crown compared to a metal crown.

• Colour matching: Ceramic crowns can be colour-matched to blend seamlessly with neighboring teeth.

Metal crowns: 

• Durability: Metal crowns, especially those made from alloys like gold or base metal alloys, are known for their durability and resistance to wear.

• Strength: Metal crowns can withstand biting and chewing forces well, making them suitable for molars and other posterior teeth (teeth at the back of the mouth).

• Less wear on opposing teeth: Metal crowns cause less wear on the opposing teeth than ceramic crowns.

• Cost: Metal crowns are often more cost-effective than all-ceramic crowns.

Considerations:

• Visibility: If the crown is for a front tooth, aesthetics may be a significant consideration, favoring ceramic crowns.

• Tooth function: For molars and teeth involved in heavy chewing, the strength and durability of metal crowns may be advantageous.

• Allergies: Some individuals may have metal allergies, so biocompatibility should be considered when choosing materials.

In recent years, all-ceramic crowns have become increasingly popular due to advancements in material technology, providing a balance between aesthetics and strength. Your dentist will consider your individual needs, discuss the pros and cons of each option, and help you make an informed decision based on factors such as appearance, durability, and cost.