Crowns, Bridges, and Veneers
If you have a damaged or decayed tooth or if you miss a tooth, we can help you choose the best solution. Crowns and bridges are custom-fittedfixed prosthetics that function and look like natural teeth. Veneers are a less invasive alternative, but may only be a solution for those with slight tooth damage or discoloration.
Crowns
A dental crown is a "cap" that is placed over a tooth to restore its shape and size, strength, and improve its appearance.
The crowns, when cemented into place, fully encase the entire visible portion of a tooth that lies at and above the gum line.
Why Is a Dental Crown Needed?
A dental crown may be needed in the following situations:
To protect a weak tooth (for instance, from decay) from breaking or to hold together parts of a cracked tooth
To restore an already broken tooth or a tooth that has been severely worn down
To cover and support a tooth with a large filling when there isn't a lot of tooth structure left
To hold a dental bridge in place
To cover misshapened or severely discolored teeth
To cover a dental implant
To make a cosmetic modification
Types of crowns
Most common permanent crowns are porcelain-fused-to-metal, all ceramic or zirconia.
Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth. These crowns can be a good choice for anterior or posterior teeth as well as long bridges where the metal is needed for strength.
All-ceramic or all-porcelain dental crowns provide better natural color match than any other crown type and may be more suitable for people with metal allergies. All-ceramic crowns can be used for anterior and posterior teeth.
Zirconia dental crowns are very popular because of their advantages: strength, longevity, biocompatibility and sometimes could be same day procedures. The shade may be hard to match the natural tooth color.
Temporary versus permanent. Temporary crowns can be made in the dentist's office, whereas most permanent crowns are typically made in a dental laboratory. Typically, temporary crowns are made of an acrylic-based material and can be used as a temporary restoration until a permanent crown is constructed by a lab.
The Procedure
Preparing a tooth for a crown usually requires two visits to the dentist - the first step involves examining and preparing the tooth, the second visit involves placement of the permanent crown.
First visit: Examining and preparing the tooth
At the first visit for crown preparation, we may take a few X-rays to check the roots of the tooth receiving the crown and surrounding bone. If the tooth has extensive decay or if there is a risk of infection or injury to the tooth's pulp, root canal treatment may first be indicated.
Before the process of making a crown begins, we will anesthetize (numb) the tooth and the gum tissue around the tooth. Next, the tooth receiving the crown is reshaped along the chewing surface and sides to make room for the crown. The amount removed depends on the type of crown used. If, on the other hand, a large area of the tooth is missing (due to decay or damage), we will use filling material to "build up" the tooth to support the crown.
After reshaping the tooth, we typically will use a paste or putty to make an impression of the tooth to receive the crown. Sometimes, though, impressions are made with a digital scanner. Impressions of the teeth above and below the tooth to receive the dental crown will also be made to make sure that the crown will not affect your bite.
The impressions or scans are sent to a dental lab where the crown will be manufactured. The crown is usually returned in two to three weeks.
Second visit: Receiving the permanent dental crown
At the second visit, your dentist will remove the temporary crown and check the fit and color of the permanent crown. If everything is acceptable the new crown is permanently cemented in place.
How Should I Care for My Temporary Dental Crown?
Because temporary dental crowns are just a temporary fix until a permanent crown is ready, we suggest to take the following precautions:
Avoid sticky, chewy foods (for example, chewing gum, caramel), which have the potential of pulling off the crown.
Minimize use of the side of your mouth with the temporary crown. Please chew on the other side of the mouth.
Avoid chewing hard foods (such as raw vegetables), which could dislodge or break the crown.
Slide rather than lift out dental floss when cleaning between your teeth to avoid pulling off the temporary crown.
Bridges
To replace a missing tooth that has neighboring teeth with decay and/or large fillings, or a tooth that has been missing for a long time, bridges have been for a long time the only fixed solution until implants came along.
Why is a dental bridge needed?
A dental bridge can replace one or more missing teeth, therefore:
restoring your smile
restoring the ability to properly chew
restoring speech and pronunciation if anterior teeth are missing
maintaining the shape of your face
re-adjusting your bite to properly distribute the force when you chew
preventing your remaining teeth from moving out of the correct position
Types of Bridges:
There are three main types of dental bridges:
traditional
cantilever
Maryland
Traditional dental bridge
A traditional dental bridge consists of a false tooth or teeth being held in place by dental crowns that have been cemented onto each of the abutment teeth. A traditional bridge is the most popular type of dental bridge and can be used when you have natural teeth on both sides of the gap created by your missing tooth.
Cantilever dental bridge
Although similar to a traditional bridge, the pontic in a cantilever dental bridge is held in place by a dental crown that is cemented to only one abutment tooth. For a cantilever bridge, you only need one natural tooth next to the missing tooth gap.
Maryland dental bridge
Similar to a traditional bridge, Maryland dental bridges need two natural abutment teeth, one on each side of the gap. However, while a traditional bridge uses dental crowns on the abutment teeth, a Maryland bridge uses a framework of either metal or porcelain that is bonded onto the backs of the abutment teeth. Like a traditional bridge, a Maryland bridge can only be used when you have a natural tooth on each side of the gap caused by the missing tooth or teeth.
The Procedure
The bridge procedure is identical with preparing a tooth for a crown and consists of two visits to the dentist -- the first step involves examining, preparing the tooth and taking an impression and the second visit involves placement and cementation of the bridge.
Veneers
To enhance the appearance of one or more anterior teeth with minimal removal of tooth structure, we suggest veneers. They are very thin, porcelain or resin shells that you can customize in color and shape. They are non-invasive and are resistant to future stains.
Why are dental veneers needed?
The biggest benefit to veneers is improving the appearance of anterior teeth, giving you a close to perfect smile. Dental veneers are often used in the following situations:
broken or chipped anterior teeth
discoloration or uneven coloring that can’t be fixed with whitening
small spaces or minimally misaligned teeth
smaller or misshaped teeth
The Procedure
Before you get your veneers, you’ll have a preliminary appointment to discuss which options are right for you and how many veneers you want to have placed. In some cases, if teeth are crooked or uneven, you may need to have braces before we can place the veneers. We will often take X-rays at this stage to evaluate your teeth’s health and to look for signs of tooth decay, gum disease, or the need for root canals. If you have any of these conditions, you may not be a candidate for veneers.
Preparing a tooth for a veneer usually requires two visits -- the first step involves preparing the tooth and taking the impression, the second visit involves placement of the permanent veneer.
First visit: Examining and preparing the tooth
To get accurate sizing for your veneers, at the next appointment, the teeth are trimmed down before a mold (impression) is taken. This mold is then sent off to the lab for the creation of your veneers.
Second visit: Receiving the permanent veneer
It typically takes between one and two weeks between the first and second appointment. Once the veneers are in, you can schedule an appointment to have them placed. At this appointment, we will evaluate the fit, shape, and color of the veneers to make sure they fit well. After the tooth surface is carefully cleaned and prepped we use a dental cement to bind the veneer to the tooth.
To assure the best long term lifespan for your veneers, few precautions must be taken:
Don’t chew on hard objects like pens, ice, or your finger nails.
Never use your teeth to open packaging or condiment packages.
Try not to chew with your front teeth. Eat harder foods with your back teeth only; cut up hard foods like chocolate bars so that this is possible.
If you grind or clench your teeth at night, get a splint or retainer to protect your veneers.
If playing sports, you must wear a mouth guard.