Full mouth restoration with crowns

Crowns are used for root canal treated teeth, restoring missing teeth with implants, bridges and core build-up over the healthy roots, in certain conditions like amelogenesis imperfecta, dentinogenesis imperfecta where the tooth enamel and the dentin is affected respectively. Crowns are preferred over large cavity fillings.

Crowns are also indicated for fixing spacing between the teeth and when the patient is not willing to or unfit for orthodontic treatment, especially in the midline spacing which greatly affects the look of the patient's smile.

So a full mouth dental crown procedure is recommended, if the majority of your teeth is badly damaged / decayed, some of your teeth have been root canal treated. In this case you not only need a lot of dental crowns (or bridges), but you'll probably need some other treatments. This makes the entire procedure lengthy and expensive, but the end result is going to be an amazing smile.

In case most or all of the teeth are missing, not only a full set of crowns are needed but also quite a few implants to support the crowns. This is a more complex procedure, we recommend reading our article about full mouth dental implants, that focuses on the implant surgery part of the treatment.

There are many different types of crowns, each with their own pros and cons. Some of them look more natural but expensive, others are more affordable but their esthetics are limited. Some of them are harder, others require to trim your tooth lesser. Others can be manufactured in one day, while you are sitting in the chair in the clinic. Some are ideal for front teeth while others are more suited for molar teeth.

Here is a short list of the commonly used crown types:

• All metal crowns: This is made up of stainless steel in combination with chromium, nickel and carbon. Also nickel based metal crowns are available which has higher percentage of nickel, iron, carbon and manganese. They have excellent strength and are also cheaper but they does not fulfill the esthetic demand. Read more about metal crowns.
• Gold crowns: Gold crowns has pure gold or gold alloys consisting of platinum and palladium, but 40% of its composition is gold. While they fail on the aesthetic side, gold is an excellent material, one of the bests for dental crowns. They are also used with porcelain (porcelain fused to metal). Read more about gold crowns.
• Porcelain fused to metal crowns (PFM): They consist of metal on the inner side of the tooth which is not visible or slightly visible and the outer facing of the crown has a porcelain covering over the metal. This is also rarely used now as we have many advanced materials available now giving excellent results. The main disadvantage is that the metal beneath the porcelain affects the translucency of the porcelain giving it an artificial look. Read more about PFM crowns.
• Resin crowns: They are resin cover facing over a metal crowns. They give metallic appearance, less expensive and even strength is lower. They can be custom made and also pre-fabricated (readymade) crowns are available. They are used commonly as temporary crowns and in primary teeth for pediatric patients. Read more about resin crowns.
• All ceramic crowns and porcelain crowns: They are widely used now as they give excellent results, perfect fit without compromising the strength of the material. Dental ceramics are basically composed of inorganic compounds with non-metallic properties typically consisting of oxygen and one or more metallic or semi-metallic elements, most commonly aluminum, calcium, lithium, zirconia, silicon, titanium etc.
  Whereas porcelain is a type of ceramic composed of glass-matrix phase and one or more crystalline phase like leucite. Ceramics and porcelains are available in a wide range and various systems for its different uses, according to the strength needed and the method of fabrication (preparation). Read more about zirconia, E-max, Lava and all porcelain crowns.

Full mouth porcelain or zirconia crowns give you a great look but they are among the most expensive solutions. You might get porcelain fused to metal crowns for your back teeht and use some sort of ceramic crowns for the front teeth.

There is no exact list for that. It varies from patient to patient depending on the age, oral hygiene and health.

Patient's co-operation is equally important for full mouth rehabilitation as it requires multiple visits and care to be taken during the entire procedure.

These are the most common treatments that you might need while reconstructing your whole mouth with crowns:

• Full mouth cleaning / scaling: This includes professional cleaning of the teeth. This improves gingival health and helps in maintaining oral hygiene
• Cavity filling and restoration: Teeth which are decayed needs to be filled to avoid any progress of the cavities deeper. Only larger cavities require crowns to support the tooth.
• Composite build-up: Composite build-up is done for chipped off tooth or abraded teeth, destroyed natural crowns also requires build-up over which artificial crown is placed. Also done for closing smaller gaps between the teeth to avoid food entrapment and for improve aesthetics.
• Root canal treatment: Root canal treatment is required when a cavity progresses to the entire thickness of the hard structure of the tooth (enamel and dentin) and infects the inner pulp.
• Extraction: For extensively decayed teeth which cannot be restored and with poor probability of success if treated. In such cases usually an implant is placed in the jawbone to support the crown or bridge.
• Crown lengthening procedure: Crown lengthening is usually needed when the height of the natural teeth is insufficient to hold the artificial crown.
• Implants/ Bridges/ Over-dentures: In cases of missing one or multiple teeth, implants or bridges can be used. Overdentures are used for multiple missing teeth.
• Orthodontic treatment: For proper alignment of the teeth which cannot be covered with artificial crowns. They are generally preferred for younger patients with good oral health.
• Periodontal surgery: Required when gums are not healthy enough and the underlying bone is lost. Deeper cleaning is beneficial for successful treatment.

The cost of this treatment cannot be estimated, but be prepared to pay well over $10,000. The price depends on the number and size of the crowns required and the materials used. (Metal is more affordable, ceramic crowns tend to be more expensive.) It also depends on your location, the dentist's fees structure and whether the treatment is (partly) covered with insurance / dental plan or not.

It also depends on the complexity of the treatment. The actual price may vary depending on various conditions. It is advised to take a written quotation from your dentist before the treatment. Any additional treatment if required gets added to the actual cost.

Will I feel pain during crown placement procedure?
There might be slight discomfort and sensitivity during the treatment as the tooth is trimmed for crown placement. For that you will be given temporary crowns which will definitely reduce the level of discomfort.

How long does the treatment take?
It depends on the complexity of the treatment and additional treatment if any. The entire duration for full mouth dental crowns ranges from a few weeks to 3-4 months or even 6 months if in case any surgery is needed.

What complications might occur with crowns?
Loose crowns may be seen, tooth decay beneath the crown may occur if oral health is not maintained. Sensitivity and pain in the tooth and gums of the associated tooth if encountered should be checked by the dentist to determine and treat the underlying cause.

What care do I need to take?
Proper care and maintenance of oral hygiene is the key to long term success of the treatment. Proper brushing twice a day, daily flossing and mouth rinsing improves oral health. It is advised to visit your dentist every 6 months.

Can I eat everything after full mouth restoration?
Yes, you can eat the food of your choice but better to avoid sticky and hard solid food to avoid the fracture of the restoration or popping out of the crown. During the treatment, avoid too spicy and hot/cold drinks to avoid sensitivity.