Crowns & Bridges
A crown, which is sometimes called a ‘cap’ is an artificial restoration that fits over the remaining part of a prepared tooth, making it strong and giving it theshape of a natural tooth. In cosmetic dentistry, a crown is made of porcelain. Sometimes gold is used in circumstances where appearance is less important.
Crowns may be indicated if a tooth has become weakened or broken due to trauma, tooth decay, large fillings, cracks, root canal treatment, or excessive wear and tear. They can also be used for front teeth, where veneers are not sufficient.
A bridge replaces one or more missing teeth. It consists of crowning teeth adjacent to a gap and suspending an artificial tooth or teeth between them. The whole unit is then cemented in place.
Bridges are becoming less common these days, as the benchmark treatment for replacing a missing tooth is now a dental implant.
At least two visits are required for a crown (or bridge) to be placed.
- the tooth/teeth to be crowned are shaved down to allow space for the crown to be fitted. An impression is taken and sent to a laboratory for crown construction, and a temporary crown is made for you to wear in between appointments.
- the temporary crown is removed, the colour and fit of the new crown is checked, and cemented in place permanently
Crowns and bridges should last for many years, although there is never a lifetime guarantee in dentistry. As with natural teeth, longevity depends on good hygiene and maintenance. Although they are the strongest way to restore a tooth, they are can still fracture or suffer decay of the underlying tooth. If there is a clenching or grinding habit a guard may be strongly recommended by your dentist to be worn at night, to minimise the risk of this kind of damage.
Possible complications of crown and bridge treatment are:
- tooth breakage during preparation
- infection or inflammation of the pulp (nerve). Approximately 4-8% of crowned teeth have an issue with the pulp at some stage, and will require root canal therapy
- failure/fracture of the crown or bridge – can happen in cases of grinding or trauma, or due to decay over a period of time
Dental implants are now the benchmark treatment for a missing tooth. A titanium implant is surgically paced into the jawbone where it forms a connection and acts as a new ‘root’ to which a crown can be connected. The implant forms a sold foundation in the mouth for the crown, which then looks and feels almost like a real tooth.
At Moore Street Dental we are happy to offer implants to all suitable patients. We refer to superb specialists for the surgical component of treatment, and once we know your implant has integrated with the surrounding bone, you return to us for your crown.
Usually the procedure takes 3-6months from extraction to crown placement, so if in an area that is visible, you may require a temporary tooth – usually on a denture or within a thin mouthguard.
Dental implants have many benefits:
- they help prevent bone loss in the jaw
- they provide a stable, great looking restoration
- they prevent the formation of hollowed or collapsed cheeks that can occur following tooth extraction
- they are usually surrounded by gum tissue just like natural teeth they are firmly secured in the jaw
- they are far better tolerated than dentures (plates)
- they allow patients to chew and speak properly, as well as increase comfort and self confidence.
As with any dental procedure, there can be complications. These include:
- failure of integration, where the titanium and bone don’t blend properly
- failure of the implant crown – internal screws can loosen and break
- gum disease around the implant – this can happen in the same way it can happen to teeth
There are some patients who are not good candidates for implants, but for most people they are the restoration of choice when a tooth is missing.