OVERVIEW

What are porcelain-fused-to-metal crowns? What are all-ceramic crowns?

Porcelain-fused-to-metal crowns and all-ceramic crowns are both types of dental prostheses, commonly referred to as "false teeth" (dentures).

Made from ceramic materials, dentists "cap" them over damaged teeth—after first grinding down the affected teeth slightly—to restore function and improve aesthetics.

• Porcelain-fused-to-metal crowns: These have a metal base with ceramic fused on the outside to mimic the appearance of natural teeth. They closely resemble real teeth and offer high durability.

• All-ceramic crowns: These omit the metal base, shaping the ceramic directly into the form of a dental crown (the visible part of the tooth). They provide better aesthetics while maintaining considerable strength.

What is a "cosmetic crown" in porcelain-fused-to-metal crowns?

"Cosmetic crowns" are substandard prostheses—not proper, legitimate dentures.

Unscrupulous "dentists" often grind down multiple misaligned teeth (including healthy ones) to quickly achieve an aesthetically pleasing appearance. They then cover the ground teeth with a row of uniform "crowns." While these may look good initially, they often lead to toothaches, gum bleeding, pus discharge, or even loose teeth over time.

Ultimately, patients are forced to remove these low-quality crowns and seek proper restorative solutions.

Therefore, never trust false medical advertisements like "seven-day quick teeth straightening" or "painless, non-invasive perfect teeth."

Besides porcelain-fused-to-metal crowns, what other types of dental crowns are there?

• Based on materials, dental crowns can be categorized as metal crowns, porcelain-fused-to-metal crowns, or all-ceramic crowns, differing in appearance and hardness.

• By restoration method, they can be single crowns (for individual tooth damage), post-and-core crowns, or fixed bridges (for missing teeth), each suited for different dental conditions.

SYMPTOMS

What are the hazards of poorly made porcelain dental restorations?

Properly fabricated dental crowns not only restore the original tooth shape but also largely regain the function of the natural tooth.

However, sometimes due to various reasons, the resulting restoration may appear imperfect. Some even violate medical standards, such as certain "cosmetic crowns," which we refer to as "poorly made restorations."

Street vendors offering "quick dentures" or "cosmetic crowns" are typical examples of poorly made restorations.

Various poorly made restorations can severely harm teeth, causing issues ranging from gum bleeding and bad breath to more serious consequences like tooth loosening and eventual tooth loss.

CAUSES

Is a dental crown necessary after root canal treatment for porcelain teeth?

Root canal treatment, commonly referred to as nerve removal, is typically performed when severe, untreatable pulpitis occurs.

After root canal treatment, since the tooth loses the nourishment from its original pulp nerves and blood vessels, it not only becomes insensitive to hot or cold stimuli but also grows brittle over time. With daily use, the tooth may eventually fracture or crack.

Therefore, dentists often recommend undergoing "crown restoration" treatment—commonly known as "getting a dental crown"—about a month after completing root canal therapy.

With the protection of a dental crown and proper oral hygiene, the treated tooth can last longer and function more effectively.

Why does the tooth hurt after getting a porcelain crown?

There are several reasons why a tooth might hurt after getting a crown.

• If adjacent teeth were slightly ground down to accommodate the crown, and those teeth still have their nerves intact, the pain may be due to irritation from the bonding agent used during crown placement. In such cases, there's usually no need for immediate concern, as the discomfort often resolves on its own.

• If pain occurs when consuming hot or cold foods, or if there's spontaneous pain at night, pulpitis may be suspected. Once diagnosed, the crown should be removed for root canal treatment.

• If adjacent teeth that have undergone root canal treatment (with nerves removed) were ground down for crown placement but exhibit spontaneous pain, biting pain, or tenderness to tapping, an X-ray should be taken to check for root inflammation. If periapical inflammation is confirmed, the crown must be removed for repeat root canal treatment.

• Another possible cause is poor contact between the new crown and neighboring healthy teeth, leading to food trapping and subsequent gingivitis. In such cases, the dentist may need to adjust the crown's fit or remake it to ensure proper alignment.

• Lastly, pain could also result from root fractures, high bite points, or other issues.

DIAGNOSIS

When is a dental crown (porcelain or all-ceramic) needed?

• Severe tooth structure loss due to cavities, wedge-shaped defects (caused by incorrect brushing methods, especially horizontal brushing leading to notched areas at the gumline), or tooth wear, making direct filling difficult or posing a risk of tooth fracture, thus requiring restoration. However, if resin or other filling materials are used directly, these materials have relatively low strength and are prone to breakage. Porcelain or all-ceramic crowns offer greater hardness, restoring the tooth's original appearance and function.

• After root canal treatment, teeth lose nourishment from nerves and blood vessels, making them more prone to fractures. A crown serves as a protective measure to maintain the tooth's functionality post-treatment.

• For severe aesthetic issues caused by developmental abnormalities (such as enamel hypoplasia, fluorosis, microdontia, or tetracycline-stained teeth), crown restoration can improve both appearance and function.

TREATMENT

How is a porcelain crown done when one tooth is missing? What is a fixed bridge?

If a tooth is missing in the middle of a row of teeth and you don’t want a removable denture that needs to be taken out daily, opting for a fixed restoration means the adjacent teeth on either side must be slightly ground down to serve as "abutments"—called "bridge piers"—to support the artificial tooth replacing the missing one. This restoration spans the gap like a bridge. The more professional term for this solution is a "fixed bridge."

However, this method causes relatively greater damage to the patient’s healthy teeth. Nowadays, more people are opting for dental implant technology, which does not harm the neighboring teeth.

How long does a porcelain crown last?

Many factors affect the lifespan of a dental crown, including the original health of the tooth, the quality of the new crown, the patient’s usage habits, and daily care.

Generally, if the tooth under the crown remains stable, the root has no inflammation, the crown meets medical standards, the patient avoids excessive chewing with it, maintains good oral hygiene, and undergoes annual dental check-ups, the crown can last over a decade without major issues—or even longer.

Therefore, the patient’s responsibility is to choose a reliable dentist and ensure proper daily use and cleaning.

What should I do if my gums start discharging pus after getting a porcelain crown?

Some patients experience symptoms like gum fistulas, pus discharge, or pain when biting after getting a crown. In such cases, they should seek immediate dental care to identify the cause.

Usually, this indicates root inflammation, requiring crown removal and root canal treatment. Severe cases may need apical surgery.

How to choose between porcelain-fused-to-metal crowns and all-ceramic crowns?

With current technology, both porcelain-fused-to-metal and all-ceramic crowns can effectively restore damaged teeth.

The main differences are that all-ceramic crowns, lacking an opaque metal base, look more natural, while porcelain-fused-to-metal crowns are stronger. However, technological advancements are narrowing this gap.

Price is another factor—all-ceramic crowns are generally more expensive, which may influence cost-sensitive patients.

What is the general process for getting a porcelain crown?

In dental specialty hospitals, this is typically handled by the prosthodontics department.

• Step 1: Develop a comprehensive treatment plan. The patient completes necessary pre-restoration procedures, such as teeth cleaning, root canal treatment, or extractions.

• Step 2: The tooth to be restored is slightly ground down. A dental impression is taken using specialized materials to create a plaster model, which the dentist uses to design the crown. A temporary crown is often placed to maintain function and aesthetics during fabrication (usually a few days to a week).

• Step 3: Once the crown is ready, the patient returns for fitting. The dentist bonds the crown to the tooth with adhesive, adjusts the bite for comfort, and ensures proper chewing function.

• Step 4: If discomfort arises, revisit the dentist promptly. Otherwise, schedule regular follow-ups.

DIET & LIFESTYLE

What should be paid attention to after getting porcelain or all-ceramic crowns?

After getting a dental crown, you should be more careful when using it, especially for front teeth—avoid biting on overly hard foods. Daily monitoring of its condition is also necessary.

Particular attention should be paid to brushing. Additionally, regular use of dental floss and mouthwash helps maintain the health of both the crowned tooth and surrounding teeth.

Of course, an annual dental check-up is essential to detect and address potential issues early.

Can I get my teeth cleaned after getting porcelain crowns?

Absolutely.

In fact, people often neglect the hygiene of porcelain crowns, sometimes even more so than their natural teeth.

Over time, tartar can accumulate at the edges of the crown, leading to gum bleeding and eventually periodontitis. Common symptoms include gum recession, alveolar bone loss, and tooth loosening, which may ultimately require the removal of the affected tooth and its fixed prosthesis.

Therefore, it is necessary to undergo professional dental cleaning (scaling) at least once a year, with special attention given to fixed prostheses like porcelain crowns, to ensure their long-term health and durability.

PREVENTION

None