Permanent replacements for damaged or misshapen teeth.
A crown is a covering over the top part of the tooth. It can also be called a cap. A crown covers the sides and top of a tooth, encircling it. Crowns are used to replace missing or damaged tooth structure and are permanently cemented in place. A crown reinforces the top portion of the tooth to restore function and esthetics.
There are situations when crowns are necessary:
Dental crowns can be made of a few different materials. The first is acrylic. Acrylic crowns are strictly temporary crowns and are meant to last a relatively short time. The second is a metal crown. Metal crowns can be made of a base metal alloy like chromium-cobalt or a high-noble metal alloy like gold, silver, and platinum. Base metal crowns are rarely performed because of the similarity in cost to far superior products. Gold crowns are still made and were it not for esthetics; they would still be considered the “gold-standard.” No pun intended. Gold crowns wear exceptionally well against natural teeth and seem to outlast their progenitors. Bonded or layered crowns include a plethora of materials but the only two derivations that matter are: porcelain fused to metal and porcelain layered on ceramic. Porcelain fused to metal crowns have been used successfully for decades. In fact, it has only been in the past decade that porcelain or ceramic crowns have outpaced porcelain fused to metal crowns. Porcelain layered on ceramic, like porcelain fused to zirconia had great initial success but became weighed down by a high incidence of fracture and are not used as often now. Currently, the most popular materials for crowns are Lithium Disilicate and Zirconium Dioxide (Zirconia). Lithium Disilicate was branded as E-MAX and Zirconia was branded as BruxZir. Both Lithium Disilicate and Zirconium Dioxide are available from different suppliers but are sometimes still referred to by these brand names.
Contrary to popular belief, there is no such thing as a metal-free crown. Porcelain is too delicate to be used as a material for chewing without an additive. It is a glass and must be reinforced for dental purposes. Both Lithium and Zirconium are metals. A dentist who professes otherwise, marketing aside, is not being honest with you. If you are concerned about metals in dental restorations, the best options involve gold (incredibly inert) and white filling materials (metal-free). Currently, there is no true metal-free crown that has acceptable long-term properties for dental use. But we’re working on it.
Insurance companies submit statistics on fees charged for procedures. For 2020, the typical fee reported in St. George, UT for a Zirconia or E-Max crown ranged from $1,070 on the lower end to $1,363 on the higher end. So, a crown can range from around $1,000 to $1,400 in Southern Utah. Of course, there are outliers to reporting statistics, meaning you may find crowns cheaper or more expensive. Furthermore, these are cash-paying fees and insurance contracted fees are not included in this reporting. At Red Hills Dental, our fee for a crown with savings from our In-Office Membership Plan will be $965 as of 2020. We strive to make high quality dentistry affordable and convenient.
When a dentist advertises “same-day crowns,” they are trying to sell you on a product that is milled from a machine sitting in their office. Sometimes these are called Cerec crowns (Cerec being a brand name). Crowns produced in the same day are often made from a material that has a softer structure than lab-made counterparts. It is easy to understand given that some of these crowns can be cut in as little as 7-8 minutes and hand polished. When crowns are fabricated in a lab, different materials are used, different methods for production are used, and different (higher-end) machinery and software are used. There are cheap and inferior labs, but there are cheap and inferior dentists too. In-office crown milling uses a softer material by necessity. Hence, many versions of these same-day crowns are more prone to fracture and flexure than their lab counterparts.
Is there a place for same-day crowns? Absolutely. They provide a convenient, esthetic alternative to lab crowns. Having used same-day crown technology for years, the fit and contours can be fantastic. The best use of same-day crowns is with premolar teeth and onlays. Onlays are a form of partial crown that cover a portion of the tooth. Where same-day crowns have not done as well historically is on molar teeth and front teeth. Molar teeth take the hardest hit from chewing, clenching and grinding. In fact, the forces on molars are over 300% more than front teeth. Because of this fact, more fractures are seen with same-day crowns on molar teeth. Because different teeth serve different purposes, different materials should be used, depending on function, beauty and strength. Front teeth may not require strength for chewing like molars but they require far superior esthetics. A back tooth is rarely noticed if the form, color, or polish is slightly off. That same dilemma on a front tooth sticks out like a zebra in a herd of horses. As of today, Dr. Bergman has experienced far superior esthetics with lab-made crowns than with in-office made crowns.
The cost of same-day crowns is the same as if they were produced by a lab. Why is that? Because the machinery for milling and sintering same-day crowns can cost well over $100,000. . In New York or San Francisco that can easily be $3,500 but in St George, Utah it is between $1,000 and $1,500. Furthermore, in order to make the machinery financially viable, most dental offices have a minimum number of crowns they have to mill each month. It’s simple math. The incoming numbers have to be larger than the outgoing numbers. So, there is often a bias when offices perform same-day crowns. They are favored over lab crowns. For the same reason, if an office has chosen to accept a number of low paying insurances, more high-paying procedures or more volume has to be realized in order to stay in business. At Red Hills Dental, we do not compromise our quality for any numbers. At this time, Dr. Bergman does not perform same-day crowns but that may change as technology and materials progress.
A dental bridge is the combination of multiple crowns together. A bridge is permanently cemented in place and can be as small as two teeth. It can also be placed across two or more implants. Most often, a dental bridge is used to replace a missing tooth in between two other teeth. It is called a 3-unit bridge. The missing tooth in the middle is filled with a fake tooth called a pontic. Just as with a crown, a bridge can be made from different materials. The most reliable type of bridge is a porcelain fused to metal bridge. First, a metal structure is fabricated over the teeth. Then porcelain is stacked on top of the metal to create an esthetic replacement for your teeth. Zirconia bridges and E-Max bridges are great replacements where the biting forces are less and esthetics is of greater concern (particularly the front six teeth).
A dental bridge is the appropriate treatment option when the teeth surrounding the empty space already have large fillings or crowns. Dental bridges have advantages like the following:
A dental bridge is a quick and effective way to restore your dental health. A bridge can be fabricated in just two weeks and it will look and feel like natural teeth. In the interim a temporary bridge is placed. You do not go without teeth when a dental bridge is made.
On average, a bridge is expected to last 7-10 years. Good oral hygiene plays the biggest role in the longevity of the bridge. When bridges are not properly cared for, decay can develop underneath them within 12 months; however, a well-made bridge can last for decades. Historically, insurance companies pay for bridge replacements after 5 years. When a dental bridge fails, all replacement teeth are affected. For this reason an implant is a superior treatment alternative when the adjacent teeth are in good condition.
A few factors determine the fee of a dental bridge; the number of teeth replaced, the material used, the health of the supporting teeth, and geographic location. The number of teeth that are being replaced will affect the fee. Naturally a longer bridge takes more expertise and requires more material and lab work to produce. Materials make a difference as well. Porcelain fused to a gold alloy will be more expensive that porcelain fused to a silver alloy. It is reasonable to assume that more expensive materials will result in higher fees. The supporting teeth may require additional treatment to help retain a bridge. If the teeth are badly broken down or the fillings have decay, treatment is required to adequately support a bridge. Or instead of teeth, implants may be used to retain a bridge. Because implant supply costs add up on top of lab costs, an implant bridge is a higher fee than a traditional bridge. Finally, Southern Utah is one of the most economical places to have dental work performed in the United States. The dental fees in St. George specifically are 20-50% lower than most major cities. The fee for a 3-unit bridge at Red Hills Dental with our In-Office Membership Plan is approximately $2,762 as of 2020. A bridge is not always the best solution for missing or lost teeth but when it is, Dr. Bergman has made thousands of them and uses high-quality materials and top-of-the-line lab services.
We strive to give every patient the comfort, care, and compassion that they deserve. Because of this, our practice has received overwhelmingly positive reviews from the community.