Porcelain crowns are valuable and reliable dental restorations, offering both strength and esthetic appeal. In most cases, a porcelain crown will last many decades (or even a lifetime).
But what happens if a porcelain crown needs to be removed?
This guide delves into the nuances of removing porcelain crowns, from the techniques employed to the considerations and challenges involved.
Quick Answer: How is a Porcelain Crown Removed?
The Essentials:
Is It Doable?: Yes, dentists can remove porcelain crowns. How they do it depends on various factors, including the crown's condition and adhesive strength. In most (but not all) cases, the crown will need to be destroyed in order to remove it.
Cost: Expect to pay $700-$1,700 for a new crown (though this rate varies wildly). Check your insurance and talk to your dentist about payment options.
Alternatives: Minor cracks or chips might not require full removal; they could be filled or smoothed out. Consult your dentist for options.
Aftercare: Manage any post-procedure pain with over-the-counter meds and avoid extreme food temperatures for a day or two. Keep up with your oral hygiene but be gentle around the treated area as long as you have a temporary crown on the tooth.
Follow-Up: Don't skip your follow-up appointment to ensure everything is healing nicely and discuss your next steps.
Techniques for Removing Porcelain Crowns
Instrumentation and Expertise
Dentists have specialized tools like crown removal forceps at their disposal, specifically designed for removing crowns that are still in good condition or haven't been permanently cemented. The method's success hinges on various factors — primarily the cement used and the adhesive bond's strength.
However, it should be noted that in almost all cases, if a crown is permanently cemented on a tooth, removing the crown will require the destruction and replacement of the crown. In other words, it can’t simply be “pulled off” the tooth and reused.
Considerations and Complexities
When dealing with a crown that has been permanently cemented, the task becomes more complex due to the durable bond created by dental cement. Here, other approaches might be necessary.
Sectioning the Crown
In instances where removing the crown intact is not feasible, dentists will 'section' or cut the crown into parts for safer extraction. While effective, this method renders the original crown unusable and necessitates a new one.
Signs That a Crown Needs Removal
Indicators for removal can range from decay underneath the crown to visible physical damage or even gum-related issues. The final decision to remove a crown is usually based on these symptoms, along with a thorough evaluation by a qualified dental professional.
Common reasons for a crown to be removed:
Recurrent decay (in other words, a cavity underneath or around the edges of the crown)
Fractured or chipped crown (in some instances, the chipped portion can be smoothed off and the crown won’t need to be removed)
Esthetic concerns (such as a color mismatch or a metal collar that has become visible over time)
The tooth is needed as an abutment (“anchor tooth”) for a bridge
What to Expect During the Crown Removal Process
The process typically involves administering local anesthesia to ensure patient comfort. However, the specific steps can vary depending on the crown's condition and the dentist's preferred approach.
Common steps include:
Local anesthesia administration (to numb the underlying tooth and surrounding gums)
Sectioning of the crown (essentially, cutting the crown into two or more pieces with a dental handpiece and burs)
Removal of the sectioned crown (this is commonly done with crown removal pliers or a special crown removal elevator/”crown splitter”)
Resulting treatment of the tooth (often, this will be a new crown or bridge)
Post-Removal Steps
After a crown is successfully removed, your dentist will evaluate the state of the underlying tooth and discuss potential restoration options, which may include placing a new crown or considering alternative treatments (such as root canal or extraction).
It’s important to maintain adequate oral hygiene during this transitional period.
Cost Implications
The financial aspect of crown removal and replacement can be a significant concern for many. The cost of a new crown can range from $700 to $1,700+, depending on the material and your geographical location.
It's crucial to check with your dental insurance to understand what portion of the costs might be covered. Discussing payment options with your dentist ahead of time can also help in budgeting for the procedure.
Alternative Solutions
If your crown has minor damage but is still largely intact, complete removal may not be necessary. Some alternative solutions include:
Smoothing: Minor chips can sometimes be smoothed out, avoiding the need for a new crown altogether.
Re-cementing: If the crown has come loose but is otherwise undamaged, it may be possible to re-cement it in place.
Types of Crowns
While this article focuses on porcelain crowns, it's worth noting that there are various types of dental crowns. Generally speaking, whether your crown is metal, ceramic, porcelain-fused-to-metal, or porcelain, the outlook is the same.
Post-Operative Care
After your crown has been successfully removed, there are some essential post-operative care tips you should follow:
Pain Management: While the procedure itself is generally pain-free thanks to local anesthesia, you may experience some sensitivity afterward. Over-the-counter pain relievers are usually effective in managing this.
Eating and Drinking: Avoid extremely hot or cold foods and beverages for the first 24-48 hours to reduce sensitivity.
Oral Hygiene: Continue to brush and floss regularly but be gentle around the site where the crown was removed to avoid irritation.
Follow-Up Appointments: Make sure to attend any scheduled follow-up appointments with your dentist to assess healing and discuss the next steps for restoration.
By following these post-operative care guidelines, you're setting yourself up for a smoother healing process and successful long-term dental health.
The Importance of Professional Assessment
No one but a trained dental professional can accurately assess whether a crown needs removal. If you suspect issues with your porcelain crown, seeking immediate professional care is crucial. Also be aware that many crown-related issues can only be detected with x-rays — so don’t skip your routine dental visits!
Addressing Common Misconceptions
Concerns often arise about the pain associated with crown removal or potential damage to the existing tooth. Rest assured, with advancements in dental techniques and the use of anesthesia, the procedure is usually painless and low-risk.
Final Thoughts
Removing a porcelain crown is a fairly straightforward and low-risk procedure. While some circumstances will allow a crown to be removed and recemented, in the vast majority of cases your crown will need to be sectioned (cut off) and removed.
Always consult with your dental healthcare provider for a tailored evaluation and treatment plan concerning crown removal.
FAQs
Are porcelain crowns hard to remove?
The difficulty of removing a porcelain crown depends on various factors such as how long the crown has been in place, the type of cement used, and the condition of the underlying tooth. Generally, removing a porcelain crown will result in the destruction of the crown, and thus a need for a replacement crown.
Is it painful to remove a permanent crown?
The use of local anesthesia usually ensures that the process of removing a permanent crown is comfortable and pain-free for the patient. However, you might experience some mild discomfort or sensitivity after the anesthesia wears off. Your dentist will provide appropriate after-care instructions to manage any post-procedure discomfort.
Is it hard for a dentist to remove a crown?
The challenge in removing a crown for a dentist lies in preserving the integrity of the underlying tooth while safely detaching the crown. Thanks to advanced dental techniques and specialized tools, most dentists are well-equipped to remove a crown without causing any significant damage to a tooth.
How does a dentist remove a cemented crown?
For a cemented crown, dentists usually employ one of two techniques. The first involves using specialized crown removal forceps to grasp and gently pry the crown off of the tooth — however, this only works if the cement bond is not too strong. The second technique, known as sectioning, involves cutting the crown into pieces for easier removal, especially when the crown is strongly bonded to the tooth. This method renders the crown unusable and necessitates the fabrication of a new one.
* Though the author of this post is a licensed dentist in the state of Kansas, this information is provided for informational and educational purposes only. Please use your best judgment and contact emergency medical services in the event of an emergency.