Crowns are “indirect restorations” that can be used to attach a bridge, prevent brittle or weak teeth from breaking, or restore a tooth that is already broken. A crown covers a tooth and restores it to its normal size and shape. It is also a way to cover teeth that are discolored, badly shaped or out of position. Made of gold and/or porcelain, crowns are also used to cover implants.
The Dental Crown Procedure
Crowns typically require two or more visits. At the first visit, the dentist prepares the tooth and makes an impression of it. The first visit of the dental crown procedure also involves removing enough of the natural tooth so that a crown that is the size and shape of the original tooth can fit comfortably over it. The tooth is covered with a temporary crown. The impression is then sent to a laboratory where the permanent crown is fabricated. At the next visit, the dentist bonds the new crown over the prepared tooth, adjusting it as needed for fit, comfort and bite.
Choice of Crown Material
One of the steps in the dental crown procedure is to determine what material is most appropriate for the crown in question. Depending on the location of the tooth, the patient’s bite, the health of the gum and bone surrounding the tooth, and whether the tooth directly above or below it is natural or crowned, the crown material may be gold, porcelain fused to gold, zirconia, or an all-ceramic crown. Because Dr. Seznik believes in involving patients in their own dental care and decisions, these options are always reviewed with patients before a final choice is made.
Gold is the strongest material for a crown and recommended if there is a strong bite, if it is a back grinding tooth – such as a molar – or if the tooth opposing the one to be crowned is a natural tooth. Gold is not only the strongest material but is also the gentlest on the gums and is usually the material of choice if the tooth is not visible. Porcelain fused to gold is usually selected when the tooth is going to show, but porcelain does run the risk of fracture, particularly in cases where the patient grinds his or her teeth. For the front- most teeth, all-ceramic crowns are usually chosen for appearance sake, because they are the most natural looking in terms of color, thickness and light refractivity.
During your dental crown procedure, Dr. Seznik will share her analysis with you, take into account your own preference, budgetary considerations and lifestyle choices and together you will decide on the best option for your crown.
A bridge or a “fixed bridge” replaces missing teeth with artificial teeth, literally bridging the gap where one or more teeth used to be present. A dental bridge used to be the standard option to replace one or more missing teeth, but dental implants have now become the preferred choice for a number of reasons. However, bridges may still make sense if the teeth surrounding the missing tooth (or group of teeth) are already compromised or crowned. In that case, a bridge may be the best option.
A bridge may also be a patient’s best option if the recommended wait time for an implant – usually six months – is longer than the patient can comfortably go without the missing teeth either for cosmetic reasons or for functional purposes. For example, if the missing teeth are quite visible, a patient may choose a bridge over implants because they do not want to wait six months for the missing teeth to be replaced.
Missing teeth can affect the way you speak, the way you chew and the way your teeth support each other. Bridges can be used to replace missing teeth, maintain the shape of your face and/or relieve the stress in your bite.
Bridges are anchored by crowning the teeth adjacent to the missing tooth or teeth, which then holds the prosthetic tooth or teeth in place.
Bridges can be made of gold, porcelain fused to gold or all-ceramic. As with the dental crown procedure outlined above, many factors dictate which material is indicated in each case. Together you and your dentist will determine what is most appropriate for your particular bridge.