Crowns and Bridges:
What is a crown?
A crown is an indirectly-fabricated restoration that covers a tooth to restore it to its normal shape and size. Crowns are used to improve appearance and strengthen the tooth.
Common situations in which a crown is recommended
- Support for a cracked tooth with broken filling
- When a piece (cusp) of tooth has broken off
- To relieve the discomfort of a cracked tooth
- To rebuild a badly broken tooth
- Following a root canal to prevent tooth breakage
- To correct crooked or misshapen teeth
Are crowns important?
Yes. Not putting a crown on a tooth that had a root canal, cusp fracture, or broken large filling may result in failure of the root canal and/ or pain and further breakage with eventual loss of the tooth.
Are there different kinds of crowns?
Yes. Crowns may be made of metal only (these are unsightly), metal and porcelain, ceramic materials only, resin materials, reinforced resin or variations of these techniques.
The differences are primarily in cost * strength *biocompatibility *esthetics.
How is a crown made?
Two appointments are required in most cases when a tooth needs a crown. On the first visit, the tooth is prepared to accommodate the thickness of the crown by removing its outer portion. Sometimes, additional material is added to fill in loss of tooth structure due to decay or removal of old fillings. A mold and model of the teeth are made, which are sent to our laboratory to make a precisely-fitted crown. Two appointments are required in most cases. A temporary crown is placed on the tooth to keep it comfortable and protected until the second appointment, when the final crown is attached
This is an example of before and after pictures of one of our patients. This attractive businessman had an old "porcelain-fused-to metal "crown on his front tooth that affected his smile. The crown was bigger than the other teeth next to it and was a different color and we felt it really "stuck out" and severly compromised his smile. In just two appointments we gave him an esthetic all-ceramic crown that was a great match- he was very happy with his dental work and even told us his bite was better !
So what is a bridge?
Bridges are "fixed” replacements for one or more missing teeth. In terms of materials, the same choices are available as discussed for bridges as for crowns with the addition of Fibre-Reinforced (non-metallic) bridges. To create a bridge we modify the teeth on either side of the
missing tooth (the space) as for crowns.
The appointment schedule is almost identical as for the crown except maybe in the length of appointments.
Certain kinds of Fiber- reinforced resin bridges can be created at one appointment.
Are bridges important?
YES! In the normal, healthy mouth, teeth are in a natural balance. Upper teeth contact lower teeth for balanced function; each tooth contacts its neighbor to balance chewing force. The loss of a back tooth may result in an irreparable, vicious cycle of slow destruction. Initially, the problems are minor but obvious: appearance, food stuck in the gap and diminished chewing ability. In later years, Major problems may occur. With a missing tooth, the opposite and neighboring tooth may drift and lean into the gap. This may cause a loss of balance, possible gum damage, possible jaw joint problems and bone loss. Because the balance in distribution of chewing forces is disturbed, the entire chewing process may become dysfunctional. With today’s increased life expectancy, people are expected to live longer. Maintaining our body longer assists with good health and vitality. Treating problems early prevent further complications later in life
Is there an alternative to bridges ?
Yes. See our dental implants page.
Caring for your crowns, bridges or veneers
A crown, bridge or veneer is “finally” cemented onto the affected tooth after it's been prepared. Final fixation doesn’t mean it cannot come off or be damaged. A metal crown or bridge may last many years, though it's not clear how durable ceramic crowns and bridges are. Fiber-reinforced bridges may break and require maintenance and will last as long as they are serviced periodically. You should brush as usual and your dentist will demonstrate a modified flossing technique. These instructions are VERY important to follow. It is essential you follow your recall appointments so that we may continue to monitor your restorations. Do not attempt to open bottles etc. with your restored teeth. In the future, if you are scheduled for any kind of surgery under general anesthetic, inform the anesthetist about your dental work to prevent damage.
Here is an example of "before and after" pictures of one of our patients. This wonderful lady came to see us with a chipped front tooth and a failing bridge extending from her canine tooth to a premolar tooth in the back. She was in tears over how this affected her smile and self confidence. In just a few appointments we created an esthetic bridge to replace the failing one, placed an esthetic white filling and now her smile is beaming with confidence!
Sometimes we need to use a combination of crowns, bridges, implants and many other procedures for what we call "full mouth reconstruction". Here is another example of one of our patients. She came to us with many dental problems after years of suffering with a severely mutilated smile. She is an attractive lady with a heart of gold, a sunny personality - and bad teeth !
We needed to use all our skills and experience to reconstruct her bite and utilized procedures such as occlusal analysis, equilibration, implants, extractions, bone grafts, crowns, root canals, gum treatments, bridges and of course, lots of T.L.C !