Dental Crowns & Bridges

Illustration of teeth showing dental implant structure

Frequently Asked Questions

 

What is a dental crown?

A dental crown commonly referred to as a “cap” is a covering made of metal or porcelain that covers the tooth structure that has been lost because of damage or decay. The crown is made to match the tooth shape and size to mimic a real tooth appearance.

The crowns, when cemented into place, cover the visible portion of a tooth.

 

Why do I need a dental crown?

A dental crown may be needed to:

Why would I need a crown?

There are several reasons for a dentist to recommend a crown:

  •         For cosmetic reasons. Crowns protect your teeth and at the same time cover any broken, damaged or decayed teeth making them look good. Many people get crowns to help their teeth look better. Crowns can also cover badly shaped teeth, mismatched teeth or discolored teeth
  •         If the damage to the tooth is severe You don’t have other options. Your dentist may recommend a crown when other restoration options aren’t enough to protect the tooth because.
  •         Reinforcement. Crowns can provide support to a teeth with large fillings.
  •         Crown is typically used if you have a bridge or an implant.
  •         In case you have a bridge, dentist puts a crown on both ends of missing tooth for securing the bridge.
  •         If you have a bridge: you’ll get crowns on either end of the missing tooth to help secure the bridge.
  •         A crown will be used to cover the implant.
  •         You’ll probably get a crown to protect the weakened tooth in case of a root canal.

 

What types of crown materials are available?

Permanent crowns can be made from all metal, porcelain-fused-to-metal, all resin, or all ceramic.

  • Stainless steel crowns are used for children’s teeth because they don’t require multiple dental visits to put in place and so are more cost- effective than custom-made crowns and prophylactic dental care needed to protect a tooth without a crown. These crowns are prefabricated crowns that are used on permanent teeth primarily as a temporary measure.
  • Metals used in crowns include alloys that have gold, palladium, nickel, or chromium. Metal crowns are very durable and long lasting in terms of wear down, and only require a minimal amount of tooth to be shaved off. 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 matched to the color of the teeth beside them. They have a more natural tooth color. However, sometimes the metal under the crown’s porcelain cap shows through as a dark line. Other drawbacks are that the crown’s porcelain portion can chip or break off and there can be more wearing down of the teeth opposite them in the mouth.
  •   All-resin dental crowns are less expensive than other crown types. However, they wear down over time and are more likely to break than porcelain-fused-to-metal crowns.
  • All-ceramic or all-porcelain dental crowns provide the best natural color match than any other crown type. They are also a good choice for people with metal allergies. However, they are not as strong as porcelain-fused-to-metal crowns. They also may wear down the opposite teeth. All-ceramic crowns are a good choice for front teeth.
  • Pressed ceramic crowns have a hard inner core. They replace the metal liner that is used in the all-ceramic crown-making process. Pressed ceramic crowns are capped with porcelain, which provides the best natural color match. They are also more long-lasting than an all-porcelain crown.

 

How much time will a dental crown take and what are the steps in getting a dental crown?

In your first visit, the dentist will take x-rays to examine the affected tooth.

The tooth that will have the crown is filed down to make room for the crown itself. How much of the tooth is filed depends on the material that will be used in the crown and condition of the affected tooth.

Once the tooth is filed, your dentist will either make an impression of your tooth or take digital scans that will provide a “mold” of your tooth’s dimensions.

Your dentist will place a temporary crown until your permanent crown is ready. This temporary version is usually acrylic and is cemented into place. Depending on where your dentist has crowns made (either in the office or off-site at a lab), it will probably take about two weeks for the permanent crown to be finished.

When your permanent crown is ready, you will go back to the dental office and get the temporary crown removed. Your dentist will do some checks so that the permanent one matches your other teeth, both with fit and color. Once everything looks good, the new crown will be cemented into place. Your natural tooth remains under the crown. For some reason if the crown is not seating well over your teeth, your dentist may choose to take further course of action which could be talk to the lab or retake the impression.

 

What are “onlays” and “3/4 crowns?”

Onlays and 3/4 crowns are crowns that don’t cover as much of the underlying tooth as traditional crowns. Traditional crowns cover the entire tooth.

 

How much does it cost to get a dental crown done?

Crown costs like any other procedure is determined by the contracted fee from insurance companies. The actual cost of making crown is based upon the material used, type of crown, the cost of the lab which build the crown and of course cost of doing business.

 

Can I get my crown work done outside the USA where it can be done cheaply?

Go to a dentist/doctor whom you trust and you will be taken care of well.

 

How to care for a temporary crown ?

Avoid chewing hard foods which can break or move the temporary crown

Avoid chewing sticky food, gums etc which can stick to the temp crown and can potentially get pulled off

Minimize over usage of the side of the mouth which has temp crown in place

Be gentle in flossing and only slide the floss instead of lifting it upside

 

How long will my dental crown last?

Crowns can last 5 to 15 years or maybe more if you maintain a good oral hygiene practices. Lot of patients tend to grind their teeth or chew on a pencil or nails. That will cause damage to the crown.

 

Why does my crown hurt?

A loose crown will cause a throbbing pain. If for some reason your crown is loose, you will have to visit a dentist. Usual causes are teeth grinding, chewing on hard objects etc.

Also if you are not taking good care of your teeth, bacteria can grow under the crowned teeth like the way they do under usual teeth and cause infection which can reach the nerves.

 

Do I need to take care of a crowned teeth?

Of course yes. Like normal teeth, a crowned teeth still has a normal teeth but just has a cap on top. The area of remaining tooth is still vulnerable to cavities and bacteria grown. Keeping good oral hygiene habits is very essential.

 

What happens if I develop cavity under my crown?

If a cavity forms under the crown, it will need to be removed so the cavity can be filled.

 

What problems can happen on a dental crown?

Sometimes crown can fall off. Usually this is due to an improper placement or some impact. Contact your dentist’s office immediately. Your dentist may be able to re-cement your crown in place; if not, a new crown will need to be made.

Dark line on crowned tooth next to the gum line. A dark line next to the gum line of your crowned tooth is normal, particularly if you have a porcelain-fused-to-metal crown. This dark line is simply the metal of the crown showing through.

You may experience some heat and cold sensitivity. Your dentist may recommend toothpaste recommended for sensitive teeth. If you have pain or sensitivity that occurs when you bite on something, it could mean that the crown is high on the tooth. If this is the case, call your dentist.

Porcelain crowns can get Chipped and may need to be replaced.

Crown can become loose due for multiple reasons. Teeth grinding, chewing on very hard surfaces are very common reasons. A loose crown allows bacteria to get in and cause decay to the tooth that remains. If your crown feels loose, contact your dentist’s office.

Metals used to make crowns are usually an alloy of metals. In very rare cases, an allergic reaction to the metals or porcelain used in dental crowns can occur. 

 

When Is a Dental Bridge Needed?

Bridges are used when 1 or a few teeth are missing. They replace the missing tooth or teeth with false ones.

 

What kind of dental bridge options are available?

A permanent or fixed bridge is cemented onto specially prepared teeth on either side of the space. Permanent or fixed bridges can be made from metal, ceramics, or a combination of the two. False teeth are mounted onto the base of a bridge to fill the space where the teeth are missing.

Sometimes, though, a removable bridge can be used. A removable bridge clips to the teeth on both sides of the space. You can put a removable bridge in and take it out yourself. Most of the time, a removable bridge has an acrylic base with metal clasps or a frame that is made of cast metal.

 

What are all the options for a missing teeth?

Clinicians are routinely faced with the need to restore a single tooth in an otherwise non restored dentition. Traumatic incidents, caries and congenitally missing teeth are common etiologies.

In these situations, the treatment options include a traditional fixed partial denture aka bridge, a resin-bonded restoration and a single-tooth implant. Although each is a viable treatment alternative, the implant restoration has definite advantages. It has become an esthetic, functional restoration with long-term predictability, and it is the ideal treatment for a single-tooth replacement in a pristine dentition.

  1. The Fixed Partial Denture or a Bridge

The traditional treatment for a single edentulous space is a conventional fixed partial denture. A major shortcoming of this alternative is the significant tooth reduction of the abutments. In addition, the longevity of a fixed partial denture is estimated at 8-10 years. Consequently, a young patient would require numerous replacements of this restoration over a lifetime.

However, in some instances, a fixed partial denture is the most appropriate choice. For example in lot of cases, the lack of bone prevents placement of implants and, thus, fixed partial dentures are the treatment of choice.

 

Implants

Since the early 1980s, the use of osseointegrated implants has become a well-established and predictable treatment. Initially, oral implants were used in the completely edentulous situation. Later, a high degree of success was achieved with implants in partly edentulous jaws.The single-tooth implant has also become a predictable treatment option.

Implants offer significant advantages over resin-bonded or conventional bridges. They prevent the needless restoration of sound teeth adjacent to the edentulous area as would be required for a fixed partial denture. In instances where the adjacent teeth have no restorations, a single-tooth implant provides the opportunity to preserve the integrity of the existing teeth.

For young people with congenitally missing teeth, a single-tooth implant is undoubtedly the restoration of choice.

 

Implants Vs Bridge

Many factors must be considered when choosing between a 3-unit bridge and an implant for the replacement of a single tooth. Often the bias of the dentist plays a role rather than objective appraisal of the treatment options. There are advantages and disadvantages to both forms of treatment.

A 3-unit bridge is within the training and experience of most restorative dentists. This form of restoration requires the reduction of the abutment teeth resulting in an increased incidence of endodontic therapy and root decay

 

Dental Crowns and bridges

 

If the abutment teeth have large restorations, they would benefit from abutment preparation. However, if the teeth have small restorations or if they are virgin teeth, they would be damaged by abutment preparation and be placed at increased risk. In addition, cement loss or wash out under a retainer can lead to tooth loss. Bridges constitute a single restoration. Based on clinical experience, if one part of the bridge fails, the whole restoration fails, often with the loss of an abutment tooth. Despite these disadvantages, a 3-unit bridge is usually completed in a short time, often with the financial support of dental insurance, and esthetic control is fairly predictable.

Implants require training that is not sufficiently addressed in most undergraduate dental programs and, therefore, is not within the practice realm of all restorative dentists. An implant takes longer to complete than a 3-unit bridge, but costs about the same if grafting is not required. Dental insurance seldom helps with financial support for implants. In addition, the implants can be more demanding if bone and soft tissues are inadequate. Areas of tissue deficiency should also be addressed with grafting in the pontic space for 3-unit bridges, but often these defects are ignored.

The tremendous advantage of the single-tooth implant lies in the fact that the adjacent teeth are not prepared. These teeth are left in their current state of health and are not linked as part of a larger restoration. The adjacent teeth have a better prognosis, as they are not subject to a higher incidence of endodontic therapy and decay as a result of tooth preparation.

 

Disclaimer: This information is provided by Rachna Pall DDS and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

 

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