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CROWN AND BRIDGES
Crown and Bridges. A dental crown or “cap” is a covering that fits over a damaged, decayed or unattractive tooth. It can even replace a tooth entirely as part of dental bridgework. Crowns strengthen damaged teeth, allowing them to function normally again.
Usually done over two appointments; to take mouth impressions and insertion after 2-3 weeks
Dentistry is an art as well as a science; dental crowns offer a perfect example of this. A dental crown or “cap” is a covering that fits over a damaged, decayed or unattractive tooth. It can even replace a tooth entirely as part of dental bridgework.
A crown completely covers a tooth above the gum line. This is in contrast to a dental veneer, which only covers a tooth’s front surface and needs natural tooth structure to support it. Therefore, if a tooth is missing a significant amount of structure above the gum line, a crown would be the restoration of choice.
Crowns strengthen damaged teeth, allowing them to function normally again. When crafted from today’s high-tech porcelains (dental ceramics), crowns are virtually indistinguishable from natural teeth. They can even be designed to improve upon a tooth’s original appearance.
There are other materials besides porcelain that we can use to make dental crowns, depending on what qualities are most important. For durability, cast gold can’t be beat. However, this is not always the most aesthetic choice — especially towards the front of the mouth. Other possibilities include porcelain-fused-to-metal crowns (PFM), which have a metal interior for strength and a porcelain exterior for a more natural appearance, and all-porcelain crowns with zirconia, representing the strongest ceramic. We would be happy to discuss the pros and cons of these various options with you.
Crowning or Capping a Tooth
Crowning or capping a tooth will usually take two to three visits. At the first visit, your tooth is prepared to receive its new crown. First, it is shaped to fit inside the new covering. This will involve some drilling to give the tooth a uniform shape. The tooth and the surrounding area will be numbed beforehand. If there is very little tooth structure left to begin with, the tooth may have to be built up with filling material, rather than filed down, to support the crown.
After the tooth is prepared, impressions of your teeth are taken, either digitally or with reliable, putty-like impression materials, and sent to the dental laboratory. There, the impressions will be used to make models of your teeth for the creation of a crown. The models will serve as guides to the highly skilled lab technicians, who will ensure that your new crown is designed to enhance your smile and function well within your bite.
Before you leave the office, a temporary crown will be attached to your tooth to protect it until the permanent crown is ready. At the second visit, your permanent crown will be attached to your tooth with either a resin that hardens when exposed to a special light source, or a type of permanent cement.
Creating a Bridge
Crowns can also be used to create a lifelike replacement for a missing tooth. This is done with bridgework, which spans the space of the missing tooth and requires at least three crowns. Two of those crowns will be placed over healthy teeth on either side of the missing tooth; these healthy teeth are referred to as abutment teeth. The two crowned abutment teeth become supports for a third crown placed in between them; that third crown is referred to as a pontic. If more than one tooth is missing, more crowns will be needed to bridge the gap in between the abutment teeth.
The number of abutment teeth necessary to replace missing teeth is influenced by the number of missing teeth, the size and length of the abutment tooth roots, the amount of bone support each abutment tooth has, as well as where in the mouth the missing tooth is located. For example, if you have three missing teeth, four abutment teeth may be necessary, thereby creating a seven-tooth bridge. Engineering and designing of the bridge requires an understanding of how to replace teeth, as well as the biology of the supporting gum and bone tissue.
Possible Complications of crowns and bridges
As with any dental or medical treatment, crown and bridge procedures have risks. The following possible complications are listed to inform and not alarm you. There may be others that are not listed.
- Tooth breakage during preparation: When the affected tooth is evaluated your dentist knows whether its structure is strong enough to take a crown. If there is doubt, the existing filling may be replaced or the structure reinforced before shaping the tooth. Problems that occur during the preparation can be corrected at that time before taking the final impression.
- Infection of the pulp of the gum: Infection may affect the teeth in two places:In the soft tissue inside the tooth called the pulp and In the gums around the base of the teeth. Whenever the enamel is removed there is a small risk that the underlying pulp may die and become infected. If this occurs, the tooth may need root canal treatment. To avoid gum infection, additional steps may be needed in your dental hygiene routine, especially to clean completely under the bridge. Poor cleaning may cause gum recession, where the gum shrinks away from the neck of the tooth.
- Discomfort: During the treatment of a tooth, surrounding gum may be injured and feel tender as the effects of anaesthesia wear off. Any pain should not last beyond two days. If pain persists please contacts us.
- Altered feeling: If the size of a tooth is changed even slightly, it can have an effect on the way it feels in the mouth, especially when chewing or biting or when the jaws are closed. If this happened please call you dentist as he may just need to adjust this a little.
- Loose crown or bridge: A correctly fitted crown or bridge should be secure. Contact your dentist if your new crown has any movement. A crown may dislodge due to strong force if this happens the crown can be cleaned disinfected and re-cemented.
- Allergic reactions: Allergic reactions to alloy or porcelain are rare. If you suspect an allergic reaction contact your dentist.
Caring for Your Crown and Bridgework
Crowns and bridgework require the same conscientious care as your natural teeth. Be sure to brush and floss between all of your teeth — restored and natural — every day to reduce the buildup of dental plaque. When you have crowns, it is even more important to maintain your regular schedule of cleanings at the dental office. Avoid using your teeth as tools (to open packages, for example). If you have a grinding habit, wearing a nightguard would be a good idea to protect your teeth and your investment.
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