A Broken Tooth Crown: The Best Option for Restoring a Damaged Tooth

A broken tooth is an unpleasant and sometimes painful experience that can occur due to various reasons such as physical trauma, extensive decay, grinding, and old fillings. When a tooth breaks, in many cases, a simple restorative solution like filling or composite materials may no longer be sufficient, and a more durable and resilient solution is needed.

Here, a broken tooth crown serves as one of the most important treatments due to its durability. In this article, we will explore what a dental crown is, when we need one, the different types of crowns available, how to repair a broken crown, and the essential care required after getting a crown.

 

What is a Dental Crown?

A dental crown is an artificial covering that is placed over a damaged or weakened tooth to protect it, restore its function, and maintain its natural appearance. Broken tooth crowns are designed to match the shape, size, and color of the patient's natural teeth.

When the structure of the tooth is so damaged that it can no longer withstand the daily pressures of chewing, using a crown is the best solution. Studies show that high-quality dental crowns last an average of 10 to 15 years. This means that your investment today guarantees a lasting smile for over a decade to come.

 

When Do You Need a Dental Crown?

Many people think crowns are only for broken teeth, but in reality, their applications are much broader. A crown not only protects the tooth but also restores its function and appearance. Below are the most important reasons you might need a dental crown:

 

Severe Tooth Fracture

 The most common reason for a dental crown recommendation is extensive fractures that have caused a significant loss of the tooth's natural structure. If the fracture involves more than 50% of the tooth’s crown, simple fillings or bonding are no longer sufficient, and the tooth is at greater risk of breaking further.

In these cases, the dentist will recommend a full crown to preserve the remaining tooth structure and restore chewing function.

 

Structural Weakness of the Tooth, Especially After Root Canal Treatment

 After root canal treatment (also known as a root filling), the tooth naturally becomes more brittle because the pulp (the live tissue inside the tooth) is removed, and the tooth no longer receives blood supply. In this condition, the tooth is much more vulnerable to chewing pressures and potential trauma.

Crowning a root-treated tooth is an effective way to strengthen it and prevent future breakage. Additionally, a crown on a broken root-treated tooth helps prevent further fracture and tooth loss.

 

Presence of Microscopic or Deep Cracks in the Tooth

 Sometimes a tooth that appears healthy on the surface may have small cracks deep inside, which are not visible to the naked eye. These cracks can be caused by continuous pressures such as teeth grinding or chewing hard foods.

These cracks often lead to vague pain, particularly when chewing or consuming hot and cold foods. In such cases, using a crown can act as a protective shield to prevent the crack from spreading and help manage the pain.

 

Old Restorations Losing Effectiveness

 Restorations such as large composite or amalgam fillings may break, leak, or discolor over time. In some cases, old restorations become unreliable due to the deterioration of the tooth edges or secondary decay.

If a new restoration with regular materials is not feasible, or the tooth structure cannot support it, the dentist may recommend using a crown instead of re-filling, ensuring greater durability and protecting the tooth from future issues.

 

Need for Aesthetic Improvement of the Tooth

 In cases where the appearance of the tooth has been severely damaged, such as from severe wear, permanent discoloration, superficial fractures, or genetic deformities, a crown can be used as a solution to restore the tooth's appearance.

Unlike dental laminate, which only cover the front surface of the tooth, a crown covers the entire tooth crown and fully changes the tooth's appearance. Many patients seek crowns for aesthetic reasons, such as to improve discolored, crooked, or short teeth.

 

 

Stages of a Broken Tooth Crown

The process of placing a crown on a broken tooth typically involves two or three dental visits at Dr. Ebadian Clinic, the best dental clinic in Tehran, and includes the following steps:

 

Initial Examination and Assessment of the Broken Tooth

In the first stage, the dentist evaluates the condition of the broken tooth through a clinical examination and imaging. The most common imaging technique is panoramic or periapical radiography, which shows the structural status of the tooth, root, and surrounding bone. The following factors are assessed during this stage:

• Depth of the fracture (Is only the crown involved, or is the root also affected?)
• Health of the tooth pulp (the live tissue inside the tooth)
• Presence of any infection or abscess
• Checking for hidden decay or microscopic fractures

If the pulp of the tooth is damaged or shows signs of inflammation or necrosis, root canal treatment must be performed first. However, if the fracture is limited to the crown and the root is healthy, the crown can be placed directly without the need for a root canal.

 

Preparing the Tooth for the Crown

Once it is confirmed that the tooth is suitable for a crown, the preparation phase begins. This step involves carefully reshaping the tooth to create space for the crown. Depending on the position of the fracture, the dentist may perform the following actions:

• Removing damaged enamel: Using rotary instruments, decayed or broken parts of the tooth are removed.
• Strengthening the tooth structure: If the remaining structure of the tooth is weak, materials such as metal pins or fiber posts are used inside the root to provide the necessary strength to hold the crown.
• Rebuilding the walls: In some cases, a portion of the crown needs to be rebuilt with composite dental materials before impressions are taken, in order to create the proper shape.

 

Taking Impressions of the Tooth and Jaw

The next step is to take an accurate impression of the prepared tooth and the adjacent teeth. This impression is sent to the dental laboratory to create a custom-made crown that fits the shape, color, and size of the tooth. Important points in this step:

• The impression can be taken using traditional materials (silicone or alginate) or digitally (with an intraoral scanner).
• At this time, a temporary crown is placed on the tooth for protection, which will remain in place until the next appointment.

The temporary crown may not be as precise or aesthetically pleasing as the final crown, but it will provide adequate chewing function.

 

Placing the Final Crown on the Broken Tooth

At the next visit, the final crown is received from the laboratory. This crown may be made of ceramic, zirconia, metal-ceramic, or resin-reinforced materials. Depending on the type of fracture, the tooth's position (front or back), and the patient's preference, the material for the crown is selected.

At this stage, the dentist:

• Places the crown on the tooth and checks its fit in terms of shape, contact with neighboring teeth, and color.
• Bonds the crown to the tooth using special dental cement.
• Cleans off excess cement and adjusts the bite to ensure the patient feels comfortable.

If the patient experiences any high spots or abnormal pressure when biting, the crown will be adjusted using specialized tools.

 

 

Types of Crowns for a Broken Tooth

The choice of crown type depends on several factors, such as the location of the tooth, the patient's budget, oral sensitivities, and aesthetic preferences. Typically, a crown for a broken back tooth differs from a crown for a broken front tooth. Below are the most common types of crowns:

• All-Ceramic Crown: These crowns are made entirely of ceramic or porcelain, making them the best option for front teeth in terms of aesthetics. These crowns, as broken front tooth crowns, have translucency and color similar to natural teeth.
• Zirconia Crown: Zirconia is a very strong yet aesthetically pleasing material. These crowns are highly durable and are a great choice for back teeth that endure heavy chewing forces. They are commonly used for broken molars.
• Porcelain-Fused-to-Metal (PFM) Crown: These crowns consist of a metal layer underneath and a porcelain layer on the outside. The strength of the metal is combined with the appearance of the porcelain. However, over time, the metal edges may become visible.
• Full-Metal Crown: These crowns are usually made of gold or durable alloys and offer the highest durability. However, due to their unnatural appearance, they are typically used for hidden teeth.

 

 

This table shows the best type of crown for a broken tooth based on different types of teeth:

Location of Tooth	Recommended Crown	Reason for Selection
Front Teeth	All-Ceramic	High aesthetics, color and translucency similar to natural teeth
Premolars (Small Molars)	Zirconia or Porcelain-Fused-to-Metal (PFM)	Balance between strength and appearance
Molars (Large Molars)	Zirconia or Full Metal	High durability and resistance to chewing pressure
Root-Treated Teeth	Zirconia or PFM	High protection needs, greater strength against fracture

 

Advantages and Disadvantages of Dental Crowns

Dental crowns, as one of the most effective treatment methods, play an important role in preserving and restoring broken teeth. However, like any other treatment, it has its own advantages and disadvantages, which we will discuss below:

 

Advantages of Dental Crowns for Broken Teeth

• Protection of Remaining Tooth Structure: A dental crown acts as a protective covering, fully encasing the remaining tooth structure and protecting it from the pressures of chewing, daily wear, and environmental damage.
• Restoring Natural Function of the Tooth: By restoring the shape, size, and original function of the tooth, the crown helps the patient regain the natural function of their mouth.
• Prevention of Tooth Extraction: In cases where the root of the tooth is still healthy but the crown is severely damaged, the use of a crown can serve as an effective alternative to tooth extraction. By strengthening the remaining structure, the crown helps maintain the natural tooth in the mouth.
• Improvement of Smile Aesthetics: For front teeth that are broken or misshapen, the use of ceramic or zirconium crowns can completely restore the appearance of the tooth.

• Increased Patient Confidence: Patients with broken or discolored teeth may feel embarrassed when smiling or speaking. Restoring the tooth with a crown helps bring confidence back to their daily life.

 

Disadvantages and Limitations of Dental Crowns

• Shaping Healthy Tooth Structure: To place a crown, the dentist must grind down part of the healthy tooth structure to create space for the crown.
• Risk of Loosening or Falling Off: If the adhesive used for the crown does not work properly or if the patient does not maintain good oral hygiene, there is a risk of the crown loosening or even coming off.
• Limited Lifespan: Despite their durability, crowns are not permanent. Depending on the type of materials used, the condition of the tooth under the crown, and the patient’s care, the average lifespan of crowns ranges from 10 to 15 years.
• Sensitivity After Treatment: Some patients may experience sensitivity to hot or cold temperatures after the crown is placed.

 

 

Cost of a Crown for a Broken Tooth

The cost of a crown for a broken tooth in Iran depends on various factors, such as the type of crown, the extent of tooth damage, the dentist's experience, and laboratory fees. In 2024, the price for a crown starts at around 2 million Toman for simple ceramic crowns and can go up to 10 million Toman for more advanced crowns like zirconia.

Additionally, depending on the type of impression, the material of the crown, and other factors, the cost of a crown for a front tooth may differ from that of a back tooth.

 

Post-Crown Care

Although a dental crown can help enhance both the appearance and natural function of the teeth, its success and longevity largely depend on the care taken after the crown is placed. Below are the key points to ensure the health of both the crown and the surrounding teeth.

 

Care in the Early Days After Crown Placement

During the first 24 to 72 hours after receiving a crown, the surrounding tissues are still sensitive. Paying attention to the following recommendations can help prevent pain or damage:

• Avoid eating until the numbness wears off to prevent accidentally biting your tongue or cheek.
• Consume soft, cold, and non-sticky foods.
• If you have sensitivity to heat or cold, temporarily avoid foods or beverages with extreme temperatures.

 

Maintaining Proper Oral Hygiene

One of the most important factors for the success of a crown on a broken tooth is regular and effective oral hygiene. Although the materials used in crowns are resistant to decay, the natural tooth under the crown can still be susceptible to cavities and gum disease.

• It is recommended to brush at least twice a day with fluoride toothpaste. This helps prevent plaque buildup around the gums.
• Use a soft toothbrush to avoid damaging the gums around the crown.
• Proper cleaning of the edges of the crown is crucial, as the junction between the crown and natural tooth is a sensitive area where plaque tends to accumulate.

 

Using Floss Designed for Crowns

Flossing between teeth, especially around the crowned tooth, is essential to prevent gum inflammation and bacterial buildup. Improper flossing can damage the crown or gums.

• Use special floss or floss with a handle to clean between teeth without applying pressure to the crown.
• For individuals who have difficulty using floss, a water flosser or interproximal cleaning devices can be helpful.

 

Dietary Guidelines and Necessary Avoidances

Although the crowned tooth is durable, it is not as resilient as a natural tooth under extreme pressure. Poor dietary habits can lead to breaking or loosening of the crown.

• Avoid chewing hard substances such as ice, hard candies, sunflower seeds, nuts in their shells, and bones.
• If you grind your teeth, consult with your dentist and consider using a night guard.
• Avoid consuming highly sticky foods like toffee or gum, as they may cause the crown to detach.

 

Regular Follow-ups with the Dentist

Even if you do not feel any issues, regular dental visits are necessary to check the condition of the crown and the health of the surrounding gums.

• Visit the dentist every six months for a checkup and professional cleaning.
• If you experience pressure, sensitivity, loosening of the crown, or a change in the color of the surrounding gums, schedule an appointment immediately.
• If your crown was placed with temporary cement, do not forget to follow up for permanent bonding.

 

 

Can Crowns Be Repaired?

 Despite their high durability and resilient design, dental crowns may become damaged, cracked, loosened, or even break over time. But can they be repaired? The ability to repair a broken or damaged crown depends on the type of damage, the material of the crown, the location of the tooth, and the extent of the damage.

 

Surface Cracks or Minor Damage

 In some cases, fine cracks appear on the surface of crowns, especially in ceramic or porcelain crowns. If these cracks are superficial and do not affect the overall structure of the crown, the dentist may repair them with specialized resin materials. However, these repairs are typically temporary, and if the crack progresses, the crown will need to be replaced.

 

Chipping or Minor Breakage

 Chipping is a common issue in ceramic crowns, especially in PFM crowns where the ceramic is placed over metal. If the chipping is limited and does not exert pressure on the critical areas, the dentist may repair it with composite or dental bonding materials.

In cases of more extensive damage or if the crown has lost its aesthetic appeal, full replacement of the crown is recommended instead of repairing the broken crown.

 

Loose Crown

 Sometimes a crown becomes loose due to various reasons such as the wear of the cement, decay in the underlying tooth, or excessive pressure. If the crown itself is still intact but the adhesive has worn off, the dentist can reattach it using bonding materials.

However, if there is decay in the underlying tooth, the decay must first be treated, and then a decision will be made whether to reattach or replace the crown based on the extent of the damage.

 

Complete Crown Detachment

 A complete detachment of the crown usually occurs due to poor oral hygiene, excessive pressure from teeth grinding, or consumption of very hard and sticky foods. In this case, if the crown remains intact and the tooth structure underneath is undamaged, it can be reattached.

However, if the crown is cracked or the tooth structure is deteriorated, a new crown or additional treatments such as a dental implant will be necessary.

 

Color or Aesthetic Changes in the Crown

 Although ceramic crowns are resistant to discoloration over time, they may lose their original appearance due to excessive consumption of tea, coffee, tobacco, or surface wear. In such cases, surface polishing or, in more severe cases, replacing the crown is recommended.

 

 

Conclusion

A broken tooth is a common yet completely treatable problem. With the use of modern dental technologies and options such as dental crowns for broken teeth, the health, function, and appearance of the damaged tooth can be fully restored.

Choosing the right type of crown, the skill of the dentist, and post-treatment care all play crucial roles in the durability and success of this restorative method. If you have a broken tooth or feel that your tooth is at risk of damage, visiting a specialist dentist and getting accurate advice is the first and best step to preserve your smile.