Dental Crowns and Bridges

A tooth crown is used to entirely cover or cap a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function. A dental crown is used to improve the function and appearance of a tooth, concealing it in part or in whole. In some instances, the original shape of a tooth can be restored. Whenever dentists perform a dental restoration a popular and most efficient solution is to use a dental crown. Unlike the dental fillings which repairs and covers only a portion of the tooth, dental crowns renew the whole of the tooth’s surface with remarkable results.
There are many reasons why crowns in dentistry are popular, for instance, you can avoid having one of your natural teeth replaced by an artificial one. Instead of a dental implant, dental crown caps can be used to avoid the removal of your natural teeth. A crown maintains the tooth’s structure which may have lost its shape or deteriorated to a high degree. When the dental crown is placed on top of the tooth, the normal shape and look is recovered.

A crown is recommended:

  • To protect a weak tooth from fracturing
  • To restore a fractured tooth
  • To replace a large filling when there isn’t enough tooth remaining
  • To attach a bridge
  • To cover a discolored or poorly shaped tooth
  • To cover a tooth that has had root canal treatment

Types of Crowns

Porcelain or ceramic crowns can be matched to the colour of your natural teeth. Other materials include gold and metal alloys and acrylic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive. Metal free dental crowns are becoming popular nowadays. Such crowns on teeth look very natural. With metal free dental crowns we can do restoration matching shape, the colour / shade and light transmission as same level of other teeth.

Multiple fractured teeth Metal ceramic crowns cemented

There are different types of crowns available:
Metal crowns: Compared to other crown types, less tooth structure needs to be removed with metal crowns. The metals used in these crowns include gold alloy, palladium, nickel or chromium. Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. The drawback of metal crowns is its metallic colour.
Porcelain-fused-to-metal: These crowns can be matched to your teeth colour. Porcelain-fused-to-metal crowns can be a good choice for front or back teeth.
All resin dental crowns: Theses are less expensive than any other crowns. They are more prone to fractures than porcelain- fused-to-metal crowns.
All-ceramic/all-porcelain dental crowns: These porcelain crowns provide the best natural color match than any other crown type. These crowns may be more suitable for people with metal allergies. These types of crowns are not as strong as porcelain-fused-to-metal crowns and they wear down opposing teeth a little more than metal or resin crowns. All-ceramic crowns are a good choice for front teeth. Nowadays instead of metal Zirconia is used which gives better colour match.
Stain less steel crowns in Paediatric dentistry: The stainless steel dental crown provides an effective and practical way for restoring badly broken down teeth in children. On young permanent teeth the stainless steel crown can act as an excellent temporary filling and is often replaced with a porcelain crown once the child has reached adulthood. Alternatively, the stainless steel crown is very durable and can be expected to provide good functional service for many years or until that time when the tooth is ready to fall out.

Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily, crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.

A bridge is recommended if the patient is missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular joint (TMJ) disorders.

 Before  After Acrylic Bridge

Bridges span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These natural teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns and bridges that cover the abutments. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the colour of your natural teeth.

While crowns and tooth bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practice good oral hygiene. A bridge can loose its support if the teeth or bone holding it in place are damaged by dental disease.

Types of dental bridges:

bridge-cemanted
 Before  Bridge Cemented
  • Traditional bridges: involve creating a crown for the tooth or implant on either side of the missing tooth, with a pontic in between. Traditional bridges are the most common type of bridge and are made of either metal or metal fused to ceramics.
  • Cantilever bridges: are used when there are adjacent teeth on only one side of the missing tooth or teeth.
  • Maryland bonded bridges: (also called a resin-bonded bridge or a Maryland bridge) are made of plastic teeth and gums supported by a metal framework. Metal wings on each side of the bridge are bonded to your existing teeth.

Procedure

Before either a crown or a bridge can be made, the tooth (or teeth) must be reduced in size so that the crown or bridge will fit over it properly. After reducing the tooth/teeth, your dentist will take an impression to provide an exact mould for the crown or bridge. If porcelain is to be used, your dentist will determine the correct shade for the crown or bridge to match the colour of your existing teeth. Using this impression, a dental lab then makes your crown or bridge, in the material your dentist specifies. A temporary crown or bridge will be put in place to cover the prepared tooth while the permanent crown or bridge is being made. When the permanent crown or bridge is ready, the temporary crown or bridge is removed, and the new crown or bridge is cemented over your prepared tooth or teeth.

Once the procedure is done, it is permanent and cannot be removed by the patient. Post treatment patient should maintain proper dental hygiene in order to maintain healthy crowns and bridges. Dental crown cost or dental crown price may vary depending upon the type of crown you choose. Immediately after the dental crown procedure your tooth may be sensitive as the anaesthesia begins to wear off. If the tooth that has been crowned still has a nerve in it, you may experience some heat and cold sensitivity. In such cases, it is recommended to brush teeth with toothpaste designed for sensitive teeth. Dental crown pain or sensitivity that occurs when you bite down usually means that the crown is too high on the tooth. If this is the case, consult your dentist.

FAQS

Can we chew with dental bridge
Along with restoring your smile, dental bridges restore your ability to chew also. Without a dental bridge, there is a chance for other teeth to slowly shift out of their natural position. Placing a dental bridge can make you bite more equal across all your teeth and helps to distribute the biting force equally when you eat.

Is dental bridge a painful procedure
Since this procedure is done under anaesthesia, you should not worry about the pain. Doctor will choose the appropriate anaesthesia for each patient and which will ease your discomfort during the process.

Will it weaken the supporting teeth
When a tooth is missing, the neighbouring tooth can shift since it relies on surrounding teeth for support. The jaw can also lack support and contribute to gum disease. A dental bridge corrects it by connecting the teeth on either side of the gap and restores its functionality. If an appropriate number of teeth are selected for support it may not weaken the supporting teeth.

Can everyone go for a dental bridge
There is no age limit or condition for dental bride treatment as long as the patient is healthy to attend the procedure at the clinic. If the tooth condition is very bad, your doctor may opt for better treatment procedures.