What Are Crowns?
A crown is a
restoration that covers, or "caps," a tooth to restore it to its
normal shape and size, strengthening and improving the
appearance of a tooth. Prosthetic crowns are made of metal,
porcelain fused to metal substrates, or new all-white
restorative materials. Crowns are necessary when a tooth is
generally broken down and fillings won't solve the problem. If a
tooth is cracked, a crown holds the tooth together to seal the
cracks so the damage doesn't get worse. Crowns are also used to
support a large filling when there isn't enough of the tooth
remaining, attach a bridge, protect weak teeth from fracturing,
restore fractured teeth, cover badly shaped or discolored teeth
or protect a root-canal filled tooth with compromised strength.
How is a crown
The tooth is numbed
and prepared for the crown by removing any decay or weakened
areas. The remaining tooth structure is then reshaped to meet
proper crown preparation design. If necessary, a restorative
material, usually a composite resin, is added to the remaining
tooth structure to ensure that the prosthetic crown will have a
good foundation. This procedure is called a "build-up."
If the dental decay is found to have gone deep to an extent
where the living portion (dental pulp) is affected, root canal
procedures are essential prior to completion of the crown /
bridge procedures. This is to avoid complications from pulpal
infections after the procedures have been carried out.
After the tooth is prepared, impressions of teeth and gums are
made and sent to the dental laboratory for the crown
fabrication. On the next visit, the dentist cements the
permanent crown onto the tooth. During the second appointment,
the new crown is placed on the tooth. Adjustments may be
required to exact the perfect fit, so that the crown will feel
comfortable in the mouth and will conform to the bite. When the
crown fits seamlessly and contacts the neighboring teeth
correctly, the crown is cemented on the tooth.
Will it look
Yes. The dentist's
main goal is to create crowns that look like natural teeth. That
is why dentists take an impression. To achieve a certain look, a
number of factors are considered, such as the color, bite,
shape, and length of your natural teeth. Any one of these
factors alone can affect your appearance. If you have a certain
cosmetic look in mind for your crown, discuss it with your
dentist at your initial visit. When the procedure is complete,
your teeth will not only be stronger, but they may be more
attractive. Metal (vitallium) crowns will have a metallic
finish. However, it will resemble a normal tooth in shape and
What is the
difference between a cap and a crown?
There is no
difference between a cap and a crown.
How long do
Crowns should last
approximately 5-8 years. However, with good oral hygiene and
supervision most crowns will last for a much longer period of
time. Some damaging habits like grinding your teeth, chewing
ice, or fingernail biting may cause this period of time to
decrease significantly. The type of material used in crown
fabrication also affect the life of crowns.
How should I
take care of my crowns?
To prevent damaging
or fracturing the crowns, avoid chewing hard foods, ice or other
hard objects. You will also have to avoid teeth grinding.
Besides visiting your dentist and brushing in the correct manner
twice a day, cleaning between your teeth is vital with crowns.
Floss or interdental cleaners (specially shaped brushes and
sticks) are important tools to remove plaque from the crown area
where the gum meets the tooth. Plaque in that area can cause
dental decay and gum disease. Regularly scheduled examinations
and hygiene appointments must be adhered to, or the same
bacterial assault, which causes decay and makes dental care
necessary, may cause the restorations to fail.
What is a bridge?
A bridge is a
dental appliance, made up of multiple crowns. It generally helps
replace one or more natural missing teeth, thereby "bridging"
the space between two teeth. Bridges are cemented into place on
the "abutment" teeth i.e. the surrounding teeth on either side
of the space or span, from which the bridge takes support. Teeth
called “pontics” which connects the crowns on abutment teeth
together replace the missing teeth. Unlike removable partial
dentures, bridges cannot be taken out of the mouth by the
Who should get a
A person with
missing teeth and committed to maintaining good oral hygiene
practices, is a good candidate for a bridge. A bridge is the
most natural choice to fill the space in the mouth left by
missing teeth. If left unfilled, this space can cause the
surrounding teeth to drift out of position and can cause teeth
and gums to become more susceptible to tooth decay and gum
disease that can cause further tooth loss. Bridges not only
correct an altered bite, improve the chewing ability and speech,
but they also safeguard the appearance by preventing the
collapse of facial features that can cause premature wrinkles
and age lines.
What types of bridges are there?
bridges, another popular design is the resin bonded or
"Maryland" bridge, primarily used for the front teeth. This is
usually the most economical choice when the abutment teeth are
healthy and don't contain large fillings. The pontic is fused to
metal bands that can be bonded to the abutment teeth with a
resin cement and hidden from view, reducing the amount of
preparation on the adjacent teeth.
A cantilever bridge may be used if there are teeth on only one
side of the span. This involves anchoring the pontic to one side
over one or more natural, adjacent teeth. If there are no
adjacent teeth to act as anchors,an implant is recommended--a
metal post that is surgically embedded into the bone and capped
with a crown as an abutment. In some cases where the span is
large, a removable partial denture is recommended or even an
What is the
procedure of its fabrication?
For a traditional fixed bridge, the first appointment consists
of the dentist reducing the adjacent abutment teeth that will
act as anchors. Impressions are made, from which a metal
framework, including the pontic, is created. By the second
appointment, the final bridge is fitted over the teeth. The
total treatment time is usually around one week, depending on
the type of bridge. However, because it is often difficult to
match the natural shade of your teeth, the treatment time may be
How do I care
for a bridge?
With a bridge, it is more important than ever to brush, floss
and see the dentist regularly. If buildup of food debris and
plaque -the sticky film of bacteria formed from food acids-is
not controlled, the teeth and gums can become infected,
requiring further treatment and resulting in possible loss of
the bridge.We recommend using floss threaders that help remove
bacteria from hard to reach spaces between the bridge and
adjacent teeth and gums. Crowns on the bridge cover most of the
exposed portion of your tooth and decay does not affect a bridge
since it is made of metal and /or porcelain. However, where the
natural tooth meets the crown of the bridge can become decayed.
If optimal oral hygiene care is maintained,a bridge can last for
Adjustment period: It is ok for the bridge to feel a
little out of place for a few days after cementing. This is
because the teeth around this area are adjusting to new forces
both in between the teeth and upon biting.
Procedures: To provide optimum longevity for your
restorations and to prevent future decay and supporting-tissue
breakdown, please use the following home care tips:
Brush after eating and before bedtime around the bridge with a
soft toothbrush, especially where the crown or bridge meets the
gum line (margin). At this margin area harmful bacteria can be
harbored to cause decay and gum disease. An electric toothbrush
is highly recommended over manual to help you keep this area
Floss at least once to twice a day. Use the proxy brush, floss
threader or automatic flosser to remove plaque under and around
these areas to maintain good oral hygiene. On a bridge you must
clean �under� as well as around the bridge. If you do not
control the buildup of food debris and plaque your teeth and
gums can become infected.
Water Pik� can be used with an antibacterial, alcohol free
mouthwash at the gum line and under the bridge to keep this area
Fluoride rinse is to be used before bed. Swish the fluoride
rinse vigorously in your mouth for at least one minute. Do not
swallow any of the rinse and do not eat or drink anything for 30
Use a proxybrush (interdental brush) to clean around the area
after each meal
not chew hard foods on the restorations for 24 hours from the
time they were cemented � to attain optimum strength, the cement
must mature for approximately 24 hours Also avoid eating or
chewing on hard objects, food or ice
Limit snacks, if high in sugar brush this area or swish with
Do not worry about mild sensitivity to hot or cold foods. This
sensitivity will disappear gradually over a few weeks.
Infrequently, sensitivity last longer than six weeks.
Inadequate return for examination is the most significant reason
for prostheses failure. Visit us at regular six-month
examination periods. Often problems that are developing around
the restorations can be found at an early stage where they can
be corrected easily and will be more affordable. Waiting for a
longer time may require re-doing the entire restoration.
Call us immediately if any one of these conditions occurs: If
the tooth is the first tooth to hit when you bite down after a
couple of days, contact us for an adjustment; a feeling of
movement or looseness in the restoration; sensitivity to sweet
foods; a peculiar taste from the restoration site; breakage of a
piece of material from the restoration or sensitivity to
The "bridge" prior to placement.
Compiled by Pramod Clinic Team