Cap (Crown) Replacement

Dr. Pierson, I was recently with a friend who told me that she needed to have a crown replaced for no other reason except that it was 5 years old. It did not require root canal prior to placement and has caused her no difficulty. Is this a common practice?

This is an excellent question. Crowns by today’s standard have a life expectancy of at least 5 years. In most cases, the crowns last far beyond that expectation. It is NOT a common practice to replace a crown, the only reason being “its 5 years old”. However, there can be a number of reasons as to why the crown is being recommended for replacement:

  1. Esthetics – Does the crown still look good? One of the primary materials used to make a crown is porcelain. Porcelain is a “color fast” material (meaning it is resistant to color change). Natural teeth, on the other hand are NOT color fast, as they fade in color as we get older. Most patients think “the crown has changed colors and does not match the color of their natural teeth”. It’s really the other way around. So if the color of the crown is not the same color as the natural teeth, this may warrant a crown change.
  2. Marginal Wear – Crown margins are the area of the crown that comes in contact with the tooth and surrounding gingiva (gums). Marginal wear looks unrealistic because if the crown has a metal substructure, the metal shows around the crown. If the crown has no metal substructure there will be a void between the crown and natural tooth. Most patients do not pick this up until pointed out by the dentist or hygienist. Marginal wear may also lead to tooth decay. In the below photograph, the middle tooth has marginal wear. crown margin failure1
  3. Excessive Wear – Dental crowns can wear out, especially in those cases where a person has a habit of bruxism (clenching and grinding their teeth). A dentist will sometimes detect a small hole on the chewing surface of a dental crown in that area where it makes contact with an opposing tooth (meaning a tooth that touches on the crown when you bite). Since the seal of the crown has now been lost, your dentist will probably recommend a new crown.
  4. Tooth Decay – A simple rule of thumb, “crowns cannot decay but teeth can”! If dental plaque is allowed to accumulate on a tooth in the area where the crown and tooth meet, (the area of marginal wear) tooth decay can and usually does start. In some cases, your dentist must remove the crown in order to remove the decay. This is the worst case scenario, and this will also require a crown replacement.

If you have any other dental concerns or questions, don’t forget to “Ask Dr. Pierson”!

Pierson Dental

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