Crowns & Bridges

Crowns & Bridges

What Are Crowns?

A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Prosthetic crowns are made of metal, porcelain fused to metal substrates, or new all-white restorative materials. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to support a large filling when there isn't enough of the tooth remaining, attach a bridge, protect weak teeth from fracturing, restore fractured teeth, cover badly shaped or discolored teeth or protect a root-canal filled tooth with compromised strength.

How is a crown placed?

The tooth is numbed and prepared for the crown by removing any decay or weakened areas. The remaining tooth structure is then reshaped to meet proper crown preparation design. If necessary, a restorative material, usually a composite resin, is added to the remaining tooth structure to ensure that the prosthetic crown will have a good foundation. This procedure is called a "build-up." After the tooth is prepared, an impression of teeth and gums is made and sent to the lab for the crown fabrication. On the next visit, the dentist cements the permanent crown onto the tooth. During the second appointment, the new crown is placed on the tooth. Adjustments may be required to exact the perfect fit, so that the crown will feel comfortable in the mouth and will conform to the bite. When the crown fits seamlessly and contacts the neighboring teeth correctly, the crown is cemented on the tooth.

Will it look natural?

Yes. The dentist's main goal is to create crowns that look like natural teeth. That is why dentists take an impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape, and length of your natural teeth. Any one of these factors alone can affect your appearance. If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.

What is the difference between a cap and a crown?

There is no difference between a cap and a crown.

How long do crowns last?

Crowns should last approximately 5-8 years. However, with good oral hygiene and supervision most crowns will last for a much longer period of time. Some damaging habits like grinding your teeth, chewing ice, or fingernail biting may cause this period of time to decrease significantly.

How should I take care of my crowns?

To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice or other hard objects. You also want to avoid teeth grinding. Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease. Regularly scheduled examinations and hygiene appointments must be adhered to, or the same bacterial assault which causes decay and makes dental care necessary may cause the restorations to fail.

What is a bridge?

A bridge is a dental appliance that replaces one or more natural missing teeth, thereby "bridging" the space between two teeth. Bridges are cemented into place on the "abutment" teeth--the surrounding teeth on either side of the space or span. Unlike removable partial dentures, bridges cannot be taken out of the mouth by the patient.
A bridge is a device that typically consists of three units-a pontic (a false tooth) fused between two crowns that are cemented onto the abutment teeth.

Who should get a bridge?

A person with missing teeth and committed to maintaining good oral hygiene practices, is a good candidate for a bridge. A bridge is the most natural choice to fill the space in the mouth left by missing teeth. If left unfilled, this space can cause the surrounding teeth to drift out of position and can cause teeth and gums to become more susceptible to tooth decay and gum disease that can cause further tooth loss. Bridges not only correct an altered bite, improve the chewing ability and speech, but they also safeguard the appearance by preventing the collapse of facial features that can cause premature wrinkles and age lines.

What types of bridges are there?

Besides traditional bridges, another popular design is the resin bonded or "Maryland" bridge, primarily used for the front teeth. This is usually the most economical choice when the abutment teeth are healthy and don't contain large fillings. The pontic is fused to metal bands that can be bonded to the abutment teeth with resin cement and hidden from view, reducing the amount of preparation on the adjacent teeth.
A cantilever bridge may be used if there are teeth on only one side of the span. This involves anchoring the pontic to one side over one or more natural, adjacent teeth. If there are no adjacent teeth to act as anchors, an implant is recommended--a metal post that is surgically embedded into the bone and capped with a crown as an abutment. In some cases where the span is large, a removable partial denture is recommended or even an implant-supported prosthesis.

What is the procedure of its fabrication?

For a traditional fixed bridge, the first appointment consists of the dentist reducing the adjacent abutment teeth that will act as anchors. Impressions are made, from which a metal framework, including the pontic, is created. By the second appointment, the final bridge is fitted over the teeth. The total treatment time is usually around one week, depending on the type of bridge. However, because it is often difficult to match the natural shade of your teeth, the treatment time may be longer.

How do I care for a bridge?

With a bridge, it is more important than ever to brush, floss and see the dentist regularly. If buildup of food debris and plaque -the sticky film of bacteria formed from ffood acids-is not controlled, the teeth and gums can become infected, requiring further treatment and resulting in possible loss of the bridge.We recommend using floss threaders that help remove bacteria from hard to reach spaces between the bridge and adjacent teeth and gums. Crowns on the bridge cover most of the exposed portion of your tooth and decay does not affect a bridge since it is made of metal and /or porcelain. However, where the natural tooth meets the crown of the bridge can become decayed. If optimal oral hygiene care is maintained, a bridge can last for many years.