Crowns and Bridges Carnegie

Dental Crowns

Crowns are a cosmetic restoration used to strengthen a tooth or improve its shape and colour. Crowns are most often used for teeth that are broken, worn, or partially destroyed by tooth decay.  Crowns are "cemented" onto an existing tooth and fully cover the portion of your tooth above the gum line or at the gum line. In effect, the crown becomes your tooth's new outer surface. 

Crowns can be made of porcelain, metal, or both. Porcelain crowns are most often preferred because they mimic the translucency of natural teeth and are very strong and aesthetic.  

Crowns or onlays (partial crowns) are needed when there is insufficient tooth strength remaining to hold a filling. Unlike fillings which apply the restorative material directly into your mouth, a crown is fabricated outside of your mouth. Your crown is then sculpted just for you so that your bite and jaw movements function normally once the crown is placed.  

Bridges  

A bridge may be used to replace missing teeth, help maintain the shape of your face, and alleviate stress on your bite.  A bridge replaces missing teeth with artificial teeth, looks great, and literally bridges the gap where one or more teeth may have been. Your bridge can be made from gold, alloys, porcelain, or a combination of these materials, and is bonded onto surrounding teeth for support.  The success of any bridge depends on its foundation — the other teeth, gums, or bone to which it is attached. Therefore, it's very important to keep your existing teeth, gums, and jaw healthy and strong.

What is a dental crown?  

A dental crown is a tooth-shaped custom made “cap” that is placed over a tooth — covering the tooth to restore its shape and size, strength, and/or to improve its appearance. The crowns, when cemented into place, fully enclose the entire visible portion of a tooth that lies at and above the gum line. 

Why is a crown needed?  

A dental crown may be needed in the following situations: 

• To protect a weakened tooth (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 left 
• To hold a dental bridge in place in the mouth
• To cover mis-shapen or severely stained teeth 
• To cover a dental implant  

What types of dental crowns are available?  

Permanent crowns can be made from all metal, porcelain-fused-to-metal, all resin, or all ceramic/porcelain.  

• Metals used in crowns include gold alloy, other alloys (for example, palladium) or a base-metal alloy (for example, nickel or chromium). Compared with other crown types, less tooth structure needs to be removed with metal crowns, and tooth wear to opposing teeth is kept to a minimum. Metal crowns withstand biting and chewing forces well and probably last the longest in terms of wear down. Also, metal crowns rarely chip or break. The metallic color is the main drawback. Metal crowns are a good choice for out-of-sight molars.  
• Porcelain-fused-to-metal dental crowns can be color matched to your adjacent teeth (unlike the metallic crowns). However, more wearing to the opposing teeth occurs with this crown type compared with metal or resin crowns. The crown’s porcelain portion can also chip or break off. Next to all-ceramic crowns, porcelain-fused-to-metal crowns look most like normal teeth. However, sometimes the metal underlying the crown’s porcelain can show through as a dark line, especially at the gum line and even more so if your gums recede. These crowns can be a good choice for front or back teeth.   
• All-ceramic or all-porcelain dental crowns provide the best natural color match than any other crown type and may be more suitable for people with metal allergies. However, they 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.   •Temporary versus permanent. Temporary crowns can be made in your dentist’s office whereas permanent crowns are made in a dental laboratory. Temporary crowns are made of acrylic or stainless steel and can be used as a temporary restoration until a permanent crown is constructed by the dental laboratory.   

What steps are involved in preparing a tooth for a crown?  

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.  

How should I care for my temporary dental crown?  

Because temporary dental crowns are just that — a temporary fix until a permanent crown is ready, most dentists suggest that a few precautions be taken with your temporary crown. 

These include:

• Avoid sticky, chewy foods (for example, chewing gum, caramel), which have the potential of grabbing and pulling off the crown. 
• Minimize use of the side of your mouth with the temporary crown. Shift the bulk of your chewing to the other side of your mouth.
• Avoid chewing hard foods (such as raw vegetables), which could dislodge or break the crown. 
• Slide flossing material out-rather than lifting out-when cleaning your teeth. Lifting the floss out, as you normally would, might pull off the temporary crown.  What problems could develop with a dental crown?  
• Discomfort or sensitivity. Your newly crowned tooth may be sensitive immediately after the procedure as the anesthesia 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. Your dentist may recommend that you brush your teeth with toothpaste designed for sensitive teeth. 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, call your dentist. He or she can easily fix this problem.   
• Chipped crown. Crowns made of all porcelain can sometimes chip. If the chip is small, a composite resin can be used to repair the chip with the crown remaining in your mouth. If the chipping is extensive, the crown may need to be replaced completely.   
• Loose crown. Sometimes the cement washes out from under the crown. Not only does this allow the crown to become loose, it allows bacteria to leak in and cause decay to the tooth that remains. If your crown feels loose, contact your dentist’s office.   
• Crown falls off. Sometimes crowns fall off. Usually this is due to an improper fit or a lack of cement. If this happens, clean the crown and the front of your tooth. You can replace the crown temporarily using dental adhesive or temporary tooth cement that is sold in stores for this purpose. Contact your dentist’s office immediately. He or she will give you specific instructions on how to care for your tooth and crown for the day or so until you can be seen for an evaluation. Your dentist may be able to re-cement your crown in place; if not, a new crown will need to be made.   
• Allergic reaction. Because the metals used to make crowns are usually a mixture of metals, an allergic reaction to the metals or porcelain used in crowns can occur, but this is extremely rare.  
• Dark line on crowned tooth next to the gum line. A dark line next to the gum line of your crowned tooth is normal, particularly if you have a porcelain-fused-to-metal crown. This dark line is simply the metal of the crown showing through.   

How long do dental crowns last?  

On average, dental crowns last between 7 and 10 years. The life span of a crown depends on the amount of “wear and tear” the crown is exposed to, how well you follow good oral hygiene practices, including flossing, and your personal mouth-related habits (you should avoid such habits as grinding or clenching your teeth, chewing ice, biting your fingernails and using your teeth to open packaging).  

Does a crowned tooth require special care?

While a crowned tooth does not require any special care, remember that simply because a tooth is crowned does not mean the underlying tooth is protected from decay or gum disease. Therefore, continue to follow good oral hygiene practices, including brushing your teeth at least twice a day and flossing once a day-especially around the crown area where the gum meets the tooth.  

Contact our office today to schedule an appointment!