CROWNS AND BRIDGES
A crown is a type of dental restoration that, when cemented into place, fully cups over that portion of a tooth that lies at and above the gum line. Since it encases the entire visible aspect of a tooth, a dental crown, in effect, becomes the tooth’s new outer surface. In comparison, dental fillings are restorations that fill in or patch just a portion of a tooth. Other terms that are used to refer to crowns are ‘dental caps’ and ‘tooth caps’.
Crowns can be made from porcelain, metal (a gold or other metal alloy), or a combination of both (porcelain-fused-to-metal). A dental crown might be used to restore, or even improve, a tooth’s shape. A dentist might also recommend a crown to strengthening the tooth, for example following a root canal treatment, or to improve the cosmetic appearance of the tooth.
Dental crowns are fabricated in a dental laboratory using the impression your dentist has made of your tooth after having prepared it. Using the impression, a lab technician can visualize and examine all aspects of your bite and jaw movements. The technician then makes a crown that will fit accurately on the tooth and follow the same bite pattern which you already have. During the fit appointment, the dentist will remove the temporary crown and fit the proper crown in place using a dental cement.
Dental onlays are similar to crowns, but cover only part of the tooth, rather than the whole tooth. In this way, the dentist is able to converse more of your natural tooth. Ideal candidates for onlay work typically have too much damage or decay in the tooth structure to be successfully treated using a filling, but have sufficient healthy tooth remaining to avoid the need for a crown.
Dental onlays are used when old fillings need to be removed or replaced, for example due to decay or a fracture. During treatment, the dentist removes the old fillings under local anaesthesia and takes an impression of the tooth, which is sent to the dental laboratory. The new onlay is made from this mould in porcelain, metal or composite resin material. The onlay is then cemented into place at the next appointment.
If you’re missing one or more teeth, you’re not alone. The American Dental Association reports that adults between 20 and 64 years old have, on average, three decayed or missing teeth. Fortunately, you have multiple options for replacing these missing teeth, including dental bridges. Here are four types of dental bridges that your dentist may recommend.
Traditional Dental Bridges
Traditional bridges were the most popular kind of bridges 10-15 years ago. These bridges consists of one or more pontics (fake teeth) and are held in place by dental crowns. These dental crowns are also called abutments, and they are cemented onto the teeth adjacent to your missing tooth.
Traditional bridges can be used when you have natural teeth on both sides of the gap created by your missing tooth. Bridges are even strong enough to replace molars. The downside of traditional bridges is that your dentist will need to prepare the adjacent teeth by removing their enamel to make room for the crowns that will be cemented on top. Since enamel doesn’t grow back, these teeth will always need to be protected with crowns, even if you later choose a different type of bridge. There is about a 10% risk of becoming painful in the future and requiring root canal treatment. These types of bridges are most destructive to natural teeth for support and so at Hounds Road we try to avoid these if possible.
Cantilever bridges are another option for replacing missing teeth. They are very similar to traditional bridges, but the fake tooth is supported by a crown on only one side, rather than on both sides. So, if there’s only one natural tooth next to the gap, a bridge can still be secured. Like traditional bridges, your dentist will need to prepare the adjacent tooth to support the bridge by removing its enamel. All the complications mentioned above may also occur for that one tooth.
Adhesive bridges are considered a conservative alternative to traditional bridges. These bridges consist of a fake tooth that is held in place by a metal or porcelain framework. This framework is bonded onto the backs of the teeth adjacent to the missing tooth. Since this type of bridge isn’t held in place by crowns, the adjacent teeth don’t need to be filed. This makes these bridges nearly reversible and very tooth friendly.
These bridges may initially feel high on biting as we do not cut natural teeth to make space for the bridge. In most cases, you will get used to it with in 4 to 6 weeks. These bridges should last a very long time and at Hounds Road Dental Practice, we prefer these type of bridges to replace your teeth.
Implant-supported bridges are another option for replacing missing teeth. They can be used when you have more than one tooth missing. Instead of being supported by crowns or frameworks, these bridges are supported by dental implants. Usually, one implant is placed for every missing tooth, and this series of implants holds the bridge in place. However, the bridge may consist of a fake tooth suspended between two implant-supported crowns if placing one implant for every lost tooth isn’t possible.