CROWNS & BRIDGES
You are eating dinner and suddenly you are holding half of one of your teeth in your hand. Weakened by a fracture or a large filling, the tooth is now in obvious need of repair. Your dentist may suggest a crown, an artificial replacement of the upper part of the tooth, to restore the function and look of the damaged one. Crowns can be made from several different kind of materials, and based on location, esthetics, and cost, the right one to repair your damaged tooth can be selected. You have one or more missing teeth due to decay or an accident. This loss changes the look of your smile, your bite, and puts stress on surrounding teeth to compensate for the lost tooth. One option your dentist may suggest for replacing the lost tooth is with a bridge. The missing tooth is replaced with an artificial tooth connected between two crowns (caps) which are permanently cemented or bonded on the adjacent teeth.
What are the most common benefits of this procedure?
Crowns and bridges are two restorative techniques that repair damaged or missing teeth. They restore tooth function and appearance. The use of crowns and bridges also avoids shifting teeth that can happen after a tooth is lost. By maintaining or restoring the patient’s bite and their smile the effects of the tooth damage or loss are reversed.
What will happen at the initial consultation?
At the initial consultation your dentist will determine where the caused of your tooth problems lie. If a tooth is damaged, fractured or decayed beyond repair, a crown may be suggested. If a tooth needs to be extracted or has already been removed a bridge may be the solution. The different approaches to solving your dental problems will be presented during the initial consultation and you can decide what is best for your dental goals and your pocketbook.
One important decision if a crown or bridge is needed, is the material the laboratory will use to make the appliance. The replacement tooth or tooth portion can be made from different types of material, such as metal base covered with a layer of tooth-colored material (often porcelain), or all porcelain for those not wanting metal. Metal restorations, such as gold crowns re usually only used when the tooth is not visible. An advantage of a gold crown, though, is the relatively minimal tooth reduction that needs to take place to support it.
Porcelain bonded to metal crowns are more esthetically pleasing than metal alone, although the metal layer reduces the translucency of the crown. The resulting crown is very strong but the tooth must be reduced slightly more to support this type of restoration. A final possible material choice is full porcelain, which can be made to be indistinguishable from a natural tooth. But the natural look does have a price, in that full porcelain crowns are slightly less strong than those that use metal and can be more expensive.
How is the procedure performed?
The procedures for making and fitting a crown or a bridge are very similar. Both require two trips to the dentist’s office. During the first trip, the tooth or teeth that will be crowned will be reduced, that is, prepared to support the crown structure. This involves removing the 1-2 millimeters of tooth structure. Of course, if the tooth damage is the reason for the crown, that is the part that is removed. The reduction process leaves a thimble shave that will receive the crown or crown ends of the bridge.
An impression is made of the reduced teeth and a temporary crown or bridge is put in place to function while the final bridge or crown is being made. The laboratory uses the impression to custom make the final restoration. It is important that the crown or crowns of a bridge fit exactly to avoid decay in the future and provide good function of the artificial teeth. During the second trip, the temporary crown or bridge is removed, the area cleaned, and the final crown or bridge is cemented or bonded into place.