Dental Crowns and Bridges

What is a dental crown?

A dental crown or "cap” is a 360-degree covering that fits over a damaged, decayed or unaesthetic tooth. This is in contrast to a porcelain veneer, which only covers a tooth's outer surface and needs significant natural tooth structure to support it. Therefore, if a tooth is missing a large amount of structure above the gum line, a crown is often the restoration of choice. 

Crowns can strengthen damaged teeth, allowing them to function normally again. When crafted from today's modern porcelain materials, crowns can appear virtually indistinguishable from natural teeth. They can even be customized to improve a tooth's original appearance. 
Besides porcelain, there are other materials that can be used depending on the situation. For durability, cast gold is the best. However, this may not be the most aesthetic choice - especially towards the front of the mouth. Other possibilities include porcelain-fused-to-metal (PFM) crowns, which have a metal interior for strength and a porcelain exterior for a more natural appearance, and all-porcelain crowns with zirconia, the strongest ceramic. 

What is a dental bridge?

A dental bridge is composed of dental crowns and serves to "bridge the gap" when teeth are missing. It spans the space of the missing tooth and requires at least three crowns. Two of these 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 support a third crown placed between them; this third crown is referred to as a pontic. If more than one tooth is missing, more crowns will be needed to bridge the gap 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 two missing teeth, three abutment teeth may be necessary, resulting in a five-tooth bridge. Engineering of a dental bridge requires an understanding of how to replace teeth, as well as the biology of the supporting gum and bone tissue. 

What can I expect during a crown or bridge procedure?

A crown or bridge procedure will usually take two visits. At the first visit, your tooth and surrounding gum will be numbed. The tooth to be crowned is then drilled and shaped to make space for a certain thickness of crown material. If there is very little tooth structure to begin with, the tooth may have to be built up with filling material to support the crown. 

After the tooth is prepared, putty impressions of your teeth and bite are taken 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 for our highly skilled lab technician, who will ensure that your new crown fits well, appears naturally esthetic, and functions comfortably with your bite. 

Before you leave the office, a temporary crown will be cemented to your tooth to protect it until the permanent crown is ready. At the second visit, about three weeks later, your permanent crown will be tried in and luted to your tooth, either with a resin that sets when exposed to a special light, or a type of permanent cement. 

How long do crowns and bridges usually last? 

With proper care, crowns and bridges can last for several years. Along with proper oral hygiene and personal habits, the material choices and skills of both the dentist and dental ceramist play a role in determining the longevity. On average, they can last between 5-15 years. 
How do I care for my crown or bridge? 

Crowns and bridgework require the same conscientious care as your natural teeth. Be sure to brush and floss daily between all of your teeth to reduce the buildup of dental plaque and tartar. When you have crowns, it is important to maintain your regular schedule of cleanings at the dental office. As much as possible, avoid using your teeth as tools. If you have a grinding habit, wearing a nightguard is a great way to proactively protect your teeth and restorations. 

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