What are crowns?
A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size,strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to support a large filling when there isn't enough of the tooth remaining, to attach a bridge, protect weak teeth from fracturing, restore fractured teeth, or cover badly shaped or discolored teeth.
How is a crown placed?
To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of teeth and gums is made and sent off to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.
Will it look natural?
Yes. The dentist's main goal is to create crowns that look like natural teeth. That is why dentists take an impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape, and length of your natural teeth. Any one of these factors alone can affect your appearance.
If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.
Why crowns and not veneers?
Crowns require more tooth structure removal, hence, they cover more of the tooth than veneers. Crowns are stationary and are customarily indicated for teeth that have sustained significant loss of structure, or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.
How should I take care of my crowns?
To prevent damaging or fracturing the crowns, avoid chewing hard foods, ice or other hard objects. You also want to avoid teeth grinding. Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.
"Why do I need a crown?" American Dental Association, 1996; Richard T. Masek, DDS, La Mesa, California; Dr. Paul Bussman, DMD, FAGD, Coleman, Alabama; Sedgwick Dental Associates Barbara E. Karbassi, RDH, DDS, Michael H. Fisher, CDT, DDS, Port Orchard, Washington; Aesthetic Dentistry Associates William Langstaff, DDS, FAGD Villa Park, California, Jeffrey L. Wissot, DDS, FAGD Woodland Hills, California; The Art of Dentistry, Sol Weiss, DMD, Toronto, Ontario, Canada; Terec, a research and development company formed by dental laboratories in the United Kingdom; David A. Hall, DDS, Cedar Rapids, Iowa; Goldstein, Garber and Salama, Atlanta, Georgia Ronald E. Goldstein, DDS, David A. Garber, DMD, Cathy Goldstein Schwartz, DDS, Maurice Albert Salama, DMD, Angela Gribble, DMD, Henry Salama, DMD, Pinhas Adar, CDT
What is a dental implant?
A dental implant is an artificial tooth root (synthetic material) that is surgically anchored into your jaw to hold a replacement tooth or bridge in place. The benefit of using implants is that they don t rely on neighboring teeth for support, they are permanent and stable. Implants are a good solution to tooth loss because they look and feel like natural teeth. Implant material is made from different types of metallic and bone-like ceramic materials that are compatible with body tissue. There are different types of dental implants: one is placed directly into the jaw bone, like natural tooth roots; the second is used when the jaw structure is limited, therefore, a custom-made metal framework fits directly on the existing bone.
Can anyone receive dental implants?
Talk with your dentist about whether you are an implant candidate. You must be in good health and have the proper bone structure and healthy gums for the implant to stay in place. People who are unable to wear dentures may also be good candidates. If you suffer from chronic problems, such as clenching or bruxism, or systemic diseases, such as diabetes, the success rate for implants decreases dramatically. Additionally, people who smoke or drink alcohol may not be good candidates.
What can I expect during this procedure?
The dentist must perform surgery to anchor the artificial root into or on your jaw bone. The procedure is done in the dental office with local anesthesia. Medications may be prescribed for soreness.
How long does the process take?
The process can take up to nine months to complete. Technology, however, is trying to decrease the healing time involved. Each patient heals differently, so times will vary. After the screws and posts are placed surgically, the healing process can take up to six months and the fitting of replacement teeth no more than two months.
What is the success rate of implants?
The success rate for implants depends on the tooth s purpose and location in the mouth. The success rate is about 95 percent for those placed in the front of the lower jaw and 85 percent for those placed in the sides and rear of the upper jaw.
How do I care for implants?
Your overall health may affect the success rate of dental implants. Poor oral hygiene is a big reason why some implants fail. It is important to floss and brush around the fixtures at least twice a day, without metal objects. Your dentist will give you specific instructions on how to care for your new implants. Additional cleanings of up to four times per year may be necessary to ensure that you retain healthy gums.
What is the cost of implants?
Since implants involve surgery and are more involved, they cost more than traditional bridge work. However, some dental procedures and portions of the restoration may be covered by dental and medical insurance policies. Your dentist can help you with this process.
Is my dentist trained in implant therapy?
Dentists who have received training through an extensive program can complete this procedure. Your dentist may perform the procedure or consult with a team of dental health specialists to produce the result discussed with you. Ask your dentist questions about his
or her training in implant therapy.
Dental implants: Are they for me? , Quintessence Books, 1993;
Compendium, September 1997;
Journal of American Dental Association, August 1998;
American Academy of Implant Dentistry; American Academy of Implant Prosthodontics; Consumer Reports.
What is a bridge?
A bridge is a dental appliance that replaces one or more natural missing teeth, thereby "bridging" the space between two teeth. Fixed bridges are cemented into place next to the "abutment" teeth--the surrounding teeth on either side of the space, or "span." Unlike removable partial dentures, fixed bridges cannot be taken out of the mouth by the patient. A fixed bridge is a device that typically consists of three units - a pontic (a false tooth) fused between two crowns that are cemented onto the abutment teeth.
Who should get a bridge?
If you are missing any teeth and are committed to maintaining good oral hygiene practices, you may be a good candidate for a bridge. A bridge is the most natural choice to fill the space in your mouth left by missing teeth. If left unfilled, this space can cause the surrounding teeth to drift out of position and can cause teeth and gums to become more susceptible to tooth decay and gum disease that can cause further tooth loss. Fixed bridges not only correct an altered bite, improve your chewing ability and speech, but they also safeguard your appearance by preventing the collapse of your facial features that can cause premature wrinkles and age lines.
What type of bridges are there?
Besides traditional bridges, another popular design is the resin bonded or "Maryland" bridge, primarily used for the front teeth. This is usually the most economical choice when the abutment teeth are healthy and don't contain large fillings. The pontic is fused to metal bands that can be bonded to the abutment teeth with a resin cement and hidden from view, reducing the amount of preparation on the adjacent teeth. A cantilever bridge may be used if there are teeth on only one side of the span. This involves anchoring the pontic to one side over one or more natural, adjacent teeth. If there are no adjacent teeth to act as anchors, your dentist may recommend an implant--a metal post that is surgically imbedded into the bone and capped with a crown as an abutment. In some cases where the span is large, your dentist may recommend a removable partial denture or even an implant-supported prosthesis.
What procedures are involved?
For a traditional fixed bridge, the first appointment consists of the dentist reducing the adjacent abutment teeth that will act as anchors. Impressions are made, from which a metal framework, including the pontic, is created. By the second appointment, the final bridge is fitted over the teeth. The total treatment time is usually between two or four weeks, depending on the type of bridge. However, because it is often difficult to match the natural shade of your teeth, the treatment time may be longer.
How do I care for a bridge?
With a bridge, it is more important than ever to brush, floss and see your dentist regularly. If you do not control the buildup of food debris and plaque - the sticky film of bacteria formed from food acids - your teeth and gums can become infected, requiring further treatment and resulting in possible loss of the bridge. Your dentist may also recommend using floss threaders that help remove bacteria from hard to reach spaces between the bridge and adjacent teeth and gums. If you maintain optimal oral hygiene care, you can expect your fixed bridge to last as many as 8-10 years, or even longer.