Crowns and Bridges

Why Is a Dental Crown Needed?

A dental crown may be needed in the following situations:

To protect a weak tooth (decay) from breaking or to hold together parts of a cracked tooth.         To restore an already broken tooth or a tooth that has been severely worn down.         To cover and support a tooth with a large filling when there isn’t a lot of teeth left.         To hold a dental bridge in place.         To cover misshaped or severely discolored teeth.         To cover a dental implant.

We often use dental crowns to restore beauty and strength to a tooth that has been weakened by decay, injury, or endodontic (root canal) therapy. Dental crowns are caps that fit over the entire tooth. The targeted tooth is prepared by removing damaged areas and shaping it to accommodate the dental crown. An impression of the prepared tooth is made so that the crown can be precisely crafted to fit snugly on the tooth. Once the crown is ready, it is cemented onto the tooth. At Mile High Dental Centers in Denver, Colorado, we primarily use dental crowns as a restorative dentistry option; however, we also use them for aesthetic applications such as fixing minor misalignments and repairing cracks and discolorations.

Metals used in crowns include gold alloy, other alloys (for example, palladium) or a base-metal alloy (for example, nickel or chromium). Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum. Metal dental crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, they rarely chip or break. The metallic color is the main drawback. Metal crowns are a good choice for out-of-sight molars.

Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth (unlike the metallic dental crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown’s porcelain portion can also chip or break off. Next, to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown’s porcelain can show through as a dark line, especially at the gum line and even more so, if your gums recede.

These dental crowns can be a good choice for the front or the back teeth.

All-ceramic or all-porcelain dental crowns provide the best natural color match than any other crown type and may be more suitable for people with metal allergies. However, they are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth.

Temporary versus permanent. Temporary crowns can be made in your dentist’s office whereas permanent crowns are made in a dental laboratory. Temporary crowns are made of acrylic or stainless steel and can be used as a temporary restoration until  the dental laboratory constructs a permanent crown.

Dental Bridges

Achieving a natural looking and realistic smile  after tooth loss is possible with dental bridges. Dental bridges are one method  used by dentists to fill a gap created by a missing tooth or teeth.

Dental bridges can be placed to fill in gaps left by missing teeth. Bridges not only make it easier for patients to speak and eat, but they also prevent surrounding teeth from shifting out of place. Dental bridges consist of one or more artificial teeth that are held in place by the dental crowns. The procedure to place a dental bridge requires two visits: one, to prepare the adjacent teeth and take an impression of the area, and a second, to place the bridge once it has been custom made from the impression.

Dental bridges, like implants and partial dentures, are used to replace missing teeth. There are several types of fixed dental bridges (cannot be removed), including conventional fixed bridges, cantilever bridges, and resin-bonded bridges.

The materials used for the bridge include gold, porcelain fused to metal, or in the right situation, porcelain alone. The amount and type of reduction done to the abutment teeth varies slightly with the different materials used. The recipient of such a bridge must be careful to clean well under this prosthesis.

Typically, conventional and cantilever bridges require shaping of the teeth surrounding a missing tooth. Crowns are then placed on the shaped teeth and attached to an artificial tooth.

A resin-bonded bridge requires less preparation of adjacent teeth. It is often used to replace front teeth, provided  the gums are healthy, and the surrounding teeth do not have extensive dental fillings.

The Dental Bridge Procedure

During the first visit, our dentist examines the health of your gums and other teeth to evaluate if you are a candidate for a dental bridge. If you are a candidate for a dental bridge, you are given a local anesthetic so your dentist can prepare the teeth required to support the bridge. If the support teeth are decayed or badly broken down, your dentist may have to build them back up before they can be used as support teeth for a bridge.

Next, our dentist takes an impression of the prepared teeth with a putty -like material that is used to create a model of your teeth. Your bridge is fabricated based on this model by a skilled on-site lab technician so that it precisely fits the prepared teeth. It is important that your restoration fits perfectly to avoid additional oral health problems such as tooth decay.

While your bridge is being fabricated, our dentist fits you with a temporary bridge so that teeth and gums can be protected from damage until your permanent bridge is ready.

To complete the dental bridge procedure, you must return to our dental office for a second visit to have the bridge fitted and cemented.

What are Dental Crowns and Tooth Bridges?

Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily; crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.

How do Crowns Work?

A crown is used to entirely cover or “cap” a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function. Porcelain or ceramic crowns can be matched to the color of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive.

Your dentist may recommend a crown to:

• Replace a large filling when there isn’t enough tooth remaining
• Protect a weak tooth from fracturing
• Restore a fractured tooth
• Attach a bridge
• Cover a dental implant
• Cover a discolored or poorly shaped tooth
• Cover a tooth that has had root canal treatment

How do Bridges Work?

A bridge may be recommended if you’re missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular joint (TMJ) disorders.

Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the color of your natural teeth.

How are Crowns and Bridges Made?

Before either a crown or a bridge can be made, the tooth (or teeth) must be reduced in size so that the crown or bridge will fit over it properly. After reducing the tooth/teeth, your dentist will take an impression to provide an exact mold for the crown or bridge. If porcelain is to be used, your dentist will determine the correct shade for the crown or bridge to match the color of your existing teeth.

Using this impression, a dental lab then makes your crown or bridge, in the material your dentist specifies. A temporary crown or bridge will be put in place to cover the prepared tooth while the permanent crown or bridge is being made. When the permanent crown or bridge is ready, the temporary crown or bridge is removed, and the new crown or bridge is cemented over your prepared tooth or teeth.

How Long do Crowns and Bridges Last?

While crowns and bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practice good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Keep your gums and teeth healthy by Brushing with fluoride toothpaste twice a day and flossing daily. Also see your dentist and hygienist regularly for checkups and professional cleanings.