Dentists are continually handling cases of missing teeth, cracks from tooth decay, and fractures from trauma, overcrowding and other teeth problems. The American Dental Association noted that average adults between 20 – 64 years have at least three missing or decayed teeth. Large spaces between teeth can adversely impact how you eat and speak, bone loss may follow, and the remaining teeth may shift. Installing crowns and bridges are some of the plausible solutions, and Encino Dentist is here to help you install new crowns and bridges as well as recommend other alternative options.
What are Crowns and Bridges?
Crowns and bridges are fixed prosthetic devices that are cemented on top of existing teeth or implants to protect what is underneath. Unlike other removable devices like dentures, crowns and bridges can only be removed by dentists. The choice of crowns and bridges vary depending on the issues pinpointed during a consultation.
Crown restoration is one of the most common dental procedures alongside treatments for toothaches, fractured teeth, lost filling, chipped or broken veneers. Unfortunately, dental crowns are often misunderstood and evoke fear in many patients, which should not be the case as you will see here.
A dental crown or a tooth-shaped "cap" is a covering that is attached over a damaged, rotten, or unappealing tooth and, in some cases, replaces a tooth as part of dental bridgework. Therefore, crowns must be tailor-made to fit over each tooth perfectly. They also look like natural teeth, so they are not conspicuous or look odd in the mouth.
What Materials are Crowns Made Of?
Dental crowns are made from durable and resilient materials so they can endure the trauma of chewing. They are designed to operate like natural teeth so don't be wary of damaging them any more than your regular teeth.
Thanks to emerging technologies, the market avails crowns from porcelains (dental ceramics) that resemble natural teeth. For extra durability, you can opt for cast gold, but these are not suitable for front teeth where aesthetic beauty is a top priority.
Porcelain-fused-to-metal crowns (PFM) have a metal interior which reinforces their strength and a porcelain exterior, so they appear natural. Porcelain crowns that are coated with zirconia are highly recommended for their durability. Other materials for crowns include stainless steel (they are ideal for children too) and all-resin crowns, which are less expensive but more susceptible to fractures.
Reasons for Getting Dental Crowns
- The main reason for getting crowns is to restore the shape, size, and strength of teeth. They prevent cracked teeth from breaking further by holding them together and shielding them from external pressures. If a cracked tooth is left unattended, more problems will ensue such as contracting infections that could spread to the head and neck.
- Crowns also come in handy by supporting teeth that have large fillings such that there is barely any tooth left. People with dental bridges can get crowns installed to support structures that can no longer work on their own.
- Having a proper bite is vital and crowns aid in maintaining the structural integrity of your mouth and bite. A bad bite or malocclusion occurs when the maxillary (upper) teeth and mandibular (lower) teeth fail to fit together correctly. Bad bites occur in cases of crowded teeth, open bite, crossbite, overbite, underbite, etc. Scientific studies also show a correlation between dental occlusion (contact between teeth) and control of posture and balance.
- The cosmetic modification of teeth is another reason for installing crowns. If you have crooked, cracked, or broken teeth, you may need crowns to restore the appearance and alignment of such teeth. After installing the crowns, you will have the confidence to smile, and social interactions will be much easier to navigate.
- You can also have crowns installed to cover dental implants. Alternatively, crowns can be mounted to save teeth that are rotten beyond repair, where fillings are not an option.
- Tooth decay among children is a real problem, and it is characterized by white spots on the affected areas, which is a warning sign of enamel wearing off. If your child has a high risk of decay, crowns can salvage their teeth especially if oral hygiene is failing.
How are Crowns Different from Veneers?
Crowns are different from veneers in that they cover the entire tooth above the gum line whereas veneers only cover the front part. Some crowns may extend down to the root surface depending on the patient's needs. More so, veneers depend on the tooth's natural structure for support, but crowns can be used to fill gaps left by fallen teeth.
The Process of Installing Crowns
- The first step in installing dental crowns is applying an anesthetic to numb the tooth in question and the adjacent gum tissue
- Removal of the tooth's outer surface including the top and sides follows to make room for the crown. This procedure is done with a dental drill and an abrasive bur
- In some cases, the damage is so severe that there is not enough tooth left on which the crown will sit; so the dentist will need to establish a firm foundation by adding a crown buildup
- The next step is creating the tooth's impression using dental impression paste, a digital scanner, or putty. This resulting imprint is then sent to a dental laboratory to make the crown, and this process takes about three weeks
- Meanwhile, the dentist will install an impermanent crown to avoid leaving the tooth exposed. Depending on what caused the problem, things could get worse during this waiting period
- Once the permanent crown is ready, the dentist will call for a return visit for the installation process. First, they will remove the impermanent crown then adjust the new one to match your tooth and bite. A special kind of cement is then applied and left to cure for a while before attaching the crown firmly onto the tooth.
A dental bridge is a fixed dental prosthesis or restoration that is used to replace one or more missing teeth by linking an artificial tooth to adjacent tooth or implant for support. These two or more anchoring teeth are referred to as abutment teeth. There are different materials for making false teeth or pontics: gold, porcelain, alloys, or a combination of these materials.
What are the Benefits of Dental Bridges?
Missing teeth draw unwanted attention that can reduce your self-esteem and interfere with proper functioning of remaining teeth. Having bridges is advantageous in the following ways:
- Restoring your natural smile
- Bring back the ability to chew and speak properly when the anterior teeth are in proper alignment
- Preserve the shape of your face (prevents hollowing of the cheeks)
- Distribute the forces in your bite as it should be
- Stop the surviving teeth from drifting out of position
Types of Dental Bridges
There are various kinds of bridges to choose from:
- Traditional Dental Bridges
These are the most common bridges, and they comprise one or more fake teeth (pontics) that are held firmly together by dental crowns, also known as abutments. As explained above, crowns are cemented onto the teeth neighboring the missing tooth.
If you have a missing molar, traditional bridges are strong enough to replace them so you can resume chewing food as usual. The only disadvantage of these bridges is the extra work of removing enamel on adjacent teeth to prepare them for crown installation. This outer covering does not grow back so such teeth will always need crown protection.
- Maryland Bridges
Maryland bridges are most preferred by people who opt out of traditional bridges and want a more conservative solution. These bridges have fake teeth that are held together by a porcelain or metal framework which is bonded on the backs teeth adjacent to the gap. There is no need for crowns and therefore no filing of surrounding teeth to remove enamel.
Maryland bridges are reinforced by resin that keeps it in place, but their strength is challenged where great biting force is conventional such as the molars. If too much pressure is exerted, the bridge may shift, thus, necessitating a dentist's intervention to restore it. In addition, the framework may interfere with your bite and even hurt the gums.
- Cantilever Bridges
These bridges resemble traditional bridges but differ in that a dental crown supports the pontic or false tooth only on one end of the prosthesis without supporting the other. The downside of cantilever bridges is that the distinctive arrangement of the abutments and pontic create a class I lever system. When the cantilevered pontic is in use during biting and chewing, force is exerted on the abutments, and this can trigger complications. For instance, the adjacent teeth may fracture or loosen the crown. However, studies derive that difficulties with cantilever bridges are not always attributed to clinical failure as they are a reflection of substandard care by the patient.
- Implant-Supported Bridges
Implant-supported bridges are suitable when multiple teeth are missing. Dental implants are used to support the bridges as opposed to crowns or metal frameworks. One implant is set at each gap, and these series of implants are what keeps the bridge in place. If having one implant per missing tooth is not feasible, the dentist may install pontics suspended between two crowns supported by crowns.
Using implants gives these bridges a significant advantage as they are comfortable and securely held in place. On the downside, this option calls for two surgeries: the first round to place the implants then a second surgery to set the bridge. This whole process takes roughly five months which admittedly is a bit much for patients who are pressed for time. If you still wish to explore this option, careful planning is desirable.
- Fixed-Movable Bridge
With this kind of bridge, the pontic is firmly attached to a retainer at one end of the chief retainer then connected to a minor retainer by way of a movable joint at the other end. The movable joint can accommodate the angulation differences in the anchoring teeth along an axis. This way, the path of insertion is not dictated by the alignment of the anchoring tooth, and there is no need of making abutments parallel to one and other before installation.
- Hybrid Bridge
A hybrid bridge is yet another excellent option for the more discerning patient. This solution is beloved as it incorporates elements of both traditional and adhesive bridge designs. It can be fitted to replace an arch of fallen teeth, an entire section of teeth coupled with damaged gum tissue, or even a mouth where all teeth have been extracted. Hybrid bridges fill the affected areas with a natural look, feel, and functioning. In the end, you will enjoy a healthy smile with only minimal discomfort.
What are the Steps to Installing Dental Bridges?
- The first step is preparing the abutment teeth by recontouring, which is done by removing some enamel to create room for crown placement.
- The next step is making impressions of the teeth which will serve as a mock-up for developing the bridge, pontic, and crowns by a dental lab.
- Meanwhile, your dentist will create an impermanent bridge that you will wear to protect the exposed teeth and gums.
- In the second visit, the dentist will remove the impermanent bridge then inspect the new metal or porcelain bridge and make adjustments until finding a proper fit. Some cases require more than one visit to find the right fit of bite and framework.
- If you opt for a fixed dental bridge, the dentist may cement it in place for just a few weeks to ensure that it fits as desired. If things go as planned, the bridge is then cemented into place permanently.
Dental Bridge Failures and their Causes
In spite of selecting the most suitable bridges and adhering to due process from preparation to installation, bridges may sometimes fail to function as desired.
- Poor oral hygiene: this leads to building up of plaque around the bridge bearing in mind that bridge surfaces are more retentive of plaque that may trigger gingival inflammation.
- Mechanical failures: this foundering happens due to loss of retention of the bridge if cementation was not done well or the construction or preparation of the bridge was flawed. Fracture of metal pontic can also cause this problem.
- Biological failures: this is mainly linked to caries or dental cavities in the concerned tooth or severe injury. The abutment or anchoring teeth may fracture, or periodontal disease can exert undue pressure on the adjacent tissues.
- Aesthetic failures: these mishaps happen during cementation, and they include roughness margins, wrong contouring, and colors not matching. More causative factors include wearing off over time, gingival recession, or teeth drifting apart.
Caring for Dental Crowns and Bridgework
After having solved issues that have been plaguing your teeth for a while, the next important step is establishing a sound oral care regimen. Just like your natural teeth, crowns and bridges need conscientious care to keep them functioning optimally.
Adequate care means brushing at least twice per day and daily flossing between all teeth to stop plaque from building up. If you have crowns, make a point of going for regular cleaning at the dentist. Don't skip swishing around an antiseptic mouthwash to ward off tooth decay and gum-related illnesses that could expose you to further tooth loss.
If your oral hygiene has been suspect up to this point, ask your dentist to demonstrate what comprises of acceptable oral hygiene practices. It is expedient that you revisit the proper way of brushing teeth and flossing techniques to avoid spreading infections. Observing dental appointments helps in detecting problems early on when the prognosis of treatment is still good. If you grind your teeth at night or otherwise, safeguard your teeth and investment by wearing a nightguard.
You may take time getting accustomed to eating with a dental bridge in place, but this transition should not alarm you. Focus on eating soft foods that are precut to smaller pieces to reduce the amount of work your teeth are required to do. Mindfully select a balanced diet of nutrient-dense foods to boost your overall health.
Keeping the remaining teeth healthy is vital as the success of the bridge that is hinged upon it. Of course, other factors like the type of bridge cannot be downplayed. In essence, the anchoring teeth must provide a solid foundation for the bridge. Also, refrain from using your teeth to open packages or other forceful tasks as this could exacerbate problems.
Dental bridges typically last in the spectrum of five to fifteen years. The critical determinants of durability are maintaining an excellent oral hygiene regimen and regular checkups. If you follow these rules, the lifespan of a fixed bridge can extend beyond ten years.
Contact a Crowns and Bridges Dentist Near Me
Missing teeth, fractures and cracks, tooth decay and other teeth related issues are very common, and if ignored, they can pave the way for many health issues. Moreover, nagging teeth problems negatively impact your self-esteem.
Crowns and bridges are proven solutions that restore your teeth to optimum functionality in a short time. Do not postpone that dental visit any further as procrastination is not doing you any favors. If you reside in Encino, California, please reach out to the Encino Dentist at 818-650-0429 to start this all-too-important process.