Crowns and Bridges
Crown
Sometimes referred to as a “cap,” a crown is a restoration that completely covers a damaged tooth and “hugs” all the pieces together when biting pressure is applied. Regular dental fillings (white or silver) are placed inside tooth structure rather than around it. When biting pressure is applied to a tooth with a filling, the filling material does not help hold the pieces of original tooth structure together. The biting pressure creates prying forces on the remaining tooth structure which can eventually lead to fractures.
Crowns come in either porcelain (tooth colour) or gold. Porcelain-coloured crowns blend nicely with existing teeth but can be hard on their opposing chewing partners. Gold crowns are more visible but the soft properties of the metal are gentle on the remaining natural teeth. Gold crowns tend to have a longer lifespan than porcelain.
When It Is Recommended
When teeth have had large fillings or fractures, traditional “fillings” are not sufficient to ensure a good long-term prognosis. When a tooth has been damaged by decay or large fillings, the remaining tooth structure may not be enough to withstand the separating forces caused by chewing over time. These teeth are more prone to cracking and breaking, which can lead to the tooth needing to be extracted. To prevent such catastrophic fractures, we use dental crowns in the place of a traditional filling. A crown goes around a damaged tooth and “hugs” the pieces together ensuring the best long-term prognosis for the tooth.
Other Indications: Root Canal Treatment
Root canals significantly weaken molar teeth (see explanation of root canal treatment below). It is advisable to place crowns on posterior teeth that have had root canals in order to protect them and provide them with the best possible long-term prognosis.
The Process
To have a tooth crowned is a two-appointment process. For this restoration, if there is any question that there may be decay in the tooth, we remove the old fillings and any associated decay. The tooth is then reduced in size to accommodate the thickness of the crown material and an impression is taken and sent to a dental lab that will make the crown. In the meantime we fabricate a plastic or soft metal temporary crown to keep the tooth healthy while we are waiting for the final crown to come back from the dental lab. At the second appointment, approximately two weeks later, the temporary crown is removed and the final crown is permanently cemented in its place. The end result is a tooth protected from fracture for the long-term.
Bridge
A dental bridge is a restoration that is used to replace a missing tooth. It is a fixed (non-removable) solution that looks like your natural teeth. There are different options to replace a missing tooth and the dental bridge is a tried, tested, and true method that has been used for a very long time in dentistry. If taken care of properly, a bridge can last decades.
When It Is Recommended
Dental bridges are used when a patient wishes to have a tooth replaced and meet the following criteria:
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the space to be replaced has a tooth on either side of it,
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these “anchor” teeth are structurally sound and able to support the load of a bridge, and
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the teeth opposing the space to be replaced allow for enough room for the bridge.
All of these factors are assessed by your dentist as needed.
Ideal cases for bridges are when the teeth on either side of a space could benefit from, or already have, dental crowns.
The Process
The final bridge will crown the teeth on either side of the space to be filled and a replacement tooth will “bridge” the gap between the two crowns. Each of these teeth are reduced in size and an impression is taken and sent to the dental lab to have the bridge made. In the meantime, a plastic temporary bridge is made to keep the newly modified teeth healthy until the final bridge can be delivered. This temporary bridge fills the gap left by the missing tooth. Once the final bridge is back from the lab, the temporary bridge is removed and the permanent bridge is cemented in place. This final bridge completely covers the teeth on either side of the space to be filled and feels like your natural teeth to your tongue.
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