You had a crown done on your back molar a few years ago but now your dentist is telling you that it needs to be replaced. How many times can you do it before you can't replace it anymore and how does your dentist remove it for replacement?
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How many times can you replace a crown?
The answer would be that it depends on the condition of your tooth underneath the crown and also the reason as to why you are replacing the crown.
You don't like the tooth cap and there is nothing wrong with it
You can replace the crown as many times as you want if there is nothing wrong with it. What we mean by that is that there is no tooth decay underneath the cap. In this case, your dentist can simply remove it and just remake a new one without harming the underlying tooth structure. Sometimes people don't like the color of their teeth or they just had teeth whitening done so they want the color to match.
There was tooth decay underneath it
If you had a cavity underneath the crown, you will most likely need to have the cavity removed. After the cavity removal, you will have less natural tooth structure left. This will make your tooth cap less stable afterwards.
Now imagine each time you had to drill away more of the tooth, the less tooth there will be left over. This would mean that there would be a limited amount of times that you can replace the crown. Of course this all depends on how big the cavity was each time! If it was really big one, you probably only have one chance. The next time it happens, there won't be enough of the tooth left over to get a tooth cap on it!
Receding gum line from the crown
If you have gum disease and the gums happen to be receding, it may cause a cosmetic issue that you may want to address. You can replace it many times if this is the case because all you have to do is remove it and then just extend the crown to cover it fully. You don't need to drill away a lot of tooth structure for this procedure so it preserves the structural integrity.
Your crown is broken
If your crown is fractured or cracked, it can be easily replaced. You just need to remove the broken piece and take a new mold of the tooth to have a new cap made. You don't need to remove additional tooth structure for this so you can replace it many times.
How often should you replace a crown?
There is not a length of time that you need to wait for to replace a crown. You should only do a crown replacement if there is something wrong with it such as these reasons:
It is a cosmetic issue.
It is broken.
Receding gum line.
Cavity underneath it.
As long as none of the above occurs and it is still functional, you might as well keep it in your mouth and let it work. We want our dental restorations to last as long as possible. After all, you paid for it so you want to get the most value out of it as possible by keeping it in service and function.
Our dentists in long island city therefore do not have a time interval recommendation as to when it should be replace since it is not dependent on time but rather on the condition of the tooth. If you have a porcelain crown that has lasted for over 30 years, we call that a success.
How does a dentist remove a crown to replace it?
The procedure to replace it, is quite similar to the first time that you had it made except for the part where your dentist needs to remove the dental crown. There are 4 ways that your dentist can get the crown off of your tooth.
Wiggling it off with pressure
If the crown was glued in with temporary cement, you may be able to grab it and simply wiggle it off by moving side to side. This may or may not work if it was glued in with permanent cement.
Grab the restoration with a hemostat.
Wiggle it from side to side.
Restoration should pop off.
This technique works the best for temporary crowns that were glued in with temporary cement. Your dentist can usually remove it within 5-10 seconds.
The pros of using this method is that you can reuse the crown because it won't be damaged. Since it is one of the most conservative ways to get it off, if you use this technique a crown can be removed and put back on.
Richwill crown and bridge remover
Despite the tough sounding name, this product is actually a food-grade water soluble resin that sticks to crowns and dental bridges and pulls it off. It looks like a gummy candy or jelly bean in appearance, we've attached a photo of what it looks like.
Dip the remover into hot water for a few seconds.
Place the remover onto the crown that you wish to remove.
Have the patient bite down into it.
Spray cold water onto the remover.
Ask the patient to open forcefully.
The crown should be off the tooth and stuck to the remover.
This method is equally as conservative as wiggling it off because it does not damage the restoration. It can be reused by simply applying fresh glue and placing it back on the tooth.
Remove a crown at home
There are instances where your dentist is unable to remove the crown. They may tell you to try to chew gum or sticky foods that can remove the crown at home while you're eating. They may recommend this technique if they don't want to damage the crown while taking it off. Perhaps they want to reuse the crown.
Morrell crown remover
This is a tool that hooks onto the crown on one end while on the other end there is a pneumatic tapping mechanism that can lift the crown off.
This method is less conservative than wiggling or using the gummy removers because the tapping motion may potentially damage the crown. In our experience, sometimes it does and sometimes it doesn't damage it. If it becomes damaged, then the crown cannot be reused.
A con is that the technique is a lot more "barbaric" than the other 3 and patients may not appreciate the tapping in their mouth.
Cutting the crown off
This is the most aggressive way for your dentist to remove the crown. They will basically section the crown in half by cutting into it. The damage is permanent and irreversible so you cannot reuse the dental crown afterwards.
Dental numbing gel and the numbing shot.
Cut off the old crown by drilling it in half.
Remove each half separately.
Refine the tooth preparation.
Take an impression or mold of your tooth.
Make a temporary crown.
Wait for dental lab to make the new crown.
Glue in new crown.
We usually have to resort to this method if we can't get it off with the other three. There are situations where we also jump straight into this such as if we know that we don't want to reuse the crown again.
How do you prevent your crown from needing replacement?
The whole idea isn't to replace the crown as often as possible. What you actually want is to only have it made once and never replace it again. You can do this by taking good care of it. Crowns don't need any special cleaning techniques, you can just treat it as if it was any other tooth in your mouth so maintain your oral hygiene regime.
Brush for at least 2 minutes twice a day with a fluoride or hydroxyapatite toothpaste.
Floss before you go to bed.
Use a mouthwash like Listerine or even coconut oil pulling.
Make sure to go for your dental check ups and teeth cleaning twice a year!
