Services
Crowns
What are crowns?
A crown is a restoration that covers or "caps" a tooth to restore it
to it's normal shape and strength. Crowns are necessary when a tooth is 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 attach bridges, and cover badly shaped or discoloured teeth.
How is a crown placed?
To prepare a fractured or decayed tooth for a crown, the weak or decayed tooth
matter is drilled away until a post-like structure remains. If the remaining
tooth structure is too weak to support a crown, an artificial "post and
core" must first be placed. In the traditional method, an impression of
the teeth and gums is then made and sent to an outside laboratory for the crown
to be fabricated. The dentist would make you a "temporary crown"
which you would wear for 1.5 to 2 weeks until your final crown was fabricated
and seated. At ProActive Dental Studio, the use of Cerec 3 technology prevents
our patients from having any of this done. Once the tooth is prepared, a camera
sends a digital image of the preparation to a computer screen where our dentists
can design the restoration. When this is complete, they send the
information to a milling chamber which fabricates your custom-colour and custom-fit
crown in about 10 minutes. (more on cerec technology)
Will it look natural?
Yes. The dentist's main goal is to create crowns that look like natural teeth.
To achieve a certain look, a number of factors are considered, such as colour,
bite, shape, and length of your natural teeth. Any one of these factors alone
can affect 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 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 structural damage, or to replace missing teeth. Crowns
may be placed on natural teeth or dental implants. Veneers are generally recommended
where the appearance of the tooth is the primary concern, not the structure of the tooth.
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 grinding your teeth. Besides visiting
your dentist, and brushing daily, 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 gum meets the tooth. Plaque in that
area can cause dental decay and gum disease. We always recommend that our patients
who are having major restorative work done (implants, crowns, veneers, bridges) do
a course of bleaching prior to having the work done. If the restorative work is
matched to the yellow or grey teeth, there is no way to change the colour.
Fixed Bridges
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 "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
a great choice to fill a space in the mouth left by missing teeth. If
left unfilled, this space can cause the surrounding teeth to go 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 enhance the appearance of your smile, but they also improve
your chewing ability and speech. They can also safeguard you 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 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 is capped with a crown as an abutment. In some cases where the span is
large, your dentist may recommend an implant 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 two weeks, depending on the type of bridge.
We always recommend that our patients who are having major restorative work
done (implants, crowns, veneers, bridges) do a course of bleaching prior to
having the work done. If the restorative work is matched to the yellow or
grey teeth, there is no way to change the colour.
How do I care for a bridge?
With a bridge, it is more important than ever to brush, floss and see your
dentist regularly.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 years, and even longer.
Sources:
Robert Margolin, DDS, FAGD; "An Update on Conventional Fixed Bridges Part 1: Patient Assessment and Selection," by D.L. Gutteridge, et al., Dental Update, April 1994; Inlays, Crowns and Bridges, by Leslie C. Howe, et. al., Butterworth-Heinemaann Ltd., 1993; "Crown and Bridge Procedures: Success Begins with Home Care," GP, Dec. 1992; Change Your Smile, by Ronald E. Goldstein, DDS, Quintessence Publishing Co., Inc., 1988; "Fixed Bridges and Crowns," American Dental Association, 1985.
