This is a summary outlining the treatment and timetable for a full gold crown. Actual treatment may differ depending upon the specific clinical situation.
A full gold crown is usually placed on the very back teeth where there is a large amount of tooth wear or excessive grinding occurs. Shortage of room and the force on these teeth often mean that a tooth coloured restoration is inappropriate. Typically a tooth that needs a crown will already be heavily restored and may have been hurting on biting. This is usually due to internal cracks in the teeth flexing or the nerve of the tooth being infected or dying. Indeed the tooth may already be dead and be in need of, or have had root canal therapy. At this surgery we routinely take an X-ray of a tooth to be crowned. This is to evaluate the tooth’s suitability to be crowned and if a root therapy needs to precede the procedure.
First Appointment
( 1/2 hour )
To take impressions of your mouth for the fabrication of stone models (study models). These are used to help in the design and treatment planning of your crown. The models are also used to replicate your bite in the laboratory during the manufacture of your crown. Another use of the models is to form a vacuum moulded template to allow a temporary crown to be made for coverage in the time between the 2nd and 3rd appointments. The X-ray for the tooth is usually taken during this procedure.
Second Appointment
( 90 minutes – done in the mornings)
This is a very long appointment that comprises many procedures. For this reason it is important not to be late as even 10 or 15 minutes can leave the dentist with not enough time to complete all the procedures.
Typically the appointment will run as follows. A local anaesthetic will be given following application of topical numbing paste. All existing restorations and decay will be removed from the tooth. A new core (and possibly posts) will be placed that is mechanically and chemically attached to the tooth and tooth root. We do not use amalgam in this practice. The material will set in a few minutes so the next stage of preparation can continue on the same appointment. The tooth is cut to size with the design allowing room for the future crown to have resistance to fracture, smooth margins, aesthetic appearance, good contacts and emulation of natural tooth form.
Also done during this appointment is impression taking which involves placing 2 small cords around the gums and an accurate mould of your tooth is taken ( these cords are only there for a few minutes. ) These models are then sent to the dental ceramist’s laboratory in Sydney. It is a deliberate policy of my practice to have no work manufactured overseas.
The last part of this appointment is to place a temporary crown. The temporary protects the tooth and gums whilst the permanent crown is being made. It should be treated with care as it is much weaker than the finished crown.
(A 10 day break is needed for the laboratory to fabricate the crown)
Third Appointment
( 1 hour )
The temporary crown is removed. In most instances no anaesthetic is needed for this appointment. The permanent crown is tried in for fit and the bite adjusted. This usually takes up most of the appointment as the difficult bite is the reason for choosing gold in the first place. The tooth is then permanently cemented in. In rare instances it may have to be returned to the laboratory for a shape change. No eating should be done on the new crown for one hour after the appointment.