Dentistry is an art as well as a science; dental crowns are a perfect example. A dental crown or “cap” is a covering that fits over a damaged, decayed, or unattractive tooth. It can even replace a tooth entirely as part of dental bridgework.
A crowns and Bridgework cover a tooth above the gum line. This contrasts with a dental veneer, which only covers a tooth’s front surface and needs a natural tooth structure to support it.
Therefore, if a tooth is missing a significant amount of structure above the gum line, a crown would be the restoration of choice.
Crowns strengthen damaged teeth, allowing them to function normally again. When crafted from today’s high-tech porcelains (dental implants), crowns are virtually indistinguishable from natural teeth.
Dental crowns can even be designed to improve a tooth’s original appearance. Depending on the qualities that matter most, we can use other materials besides porcelain to make dental crowns. For durability, cast gold can’t be beaten.
However, this is not always the most aesthetic choice — especially towards the front of the mouth.
Other possibilities include porcelain-fused-to-metal crowns (PFM), which have a metal interior for strength and a porcelain exterior for a more natural appearance, and all-porcelain crowns with zirconia, representing the strongest ceramic. We would happily discuss the pros and cons of these options with you.
Crowns and Bridgework or Capping a Tooth
Crowning or capping a tooth usually requires two to three visits. At the first visit, your tooth is prepared for its new crown.
First, it is shaped to fit inside the new covering. This will involve some drilling to give the tooth a uniform shape. The tooth and the surrounding area will be numbed beforehand.
If very little tooth structure is left, the tooth may have to be built up with filling material rather than filed down to support the crown.
After the tooth is prepared, impressions of your teeth are taken, either digitally or with reliable, putty-like impression materials, and sent to the dental laboratory.
There, the impressions will be used to make models of your teeth to create a crown. The models will guide the highly skilled lab technicians, ensuring your new crown is designed to enhance your smile and function well within your bite.
Before you leave the office, a temporary crown will be attached to your tooth to protect it until the permanent crown is ready.
At the second visit, your permanent crown will be attached to your tooth with either a resin that hardens when exposed to a particular light source or a type of permanent cement.
Creating a Bridge
Crowns can also create a lifelike replacement for a missing tooth. This is done with Crowns and Bridgework, which spans the space of the missing tooth and requires at least three crowns.
Two of those crowns will be placed over healthy teeth on either side of the missing tooth; these healthy teeth are referred to as abutment teeth. The two crowned abutment teeth become supports for a third crown placed between them; that third crown is called a pontic.
If more than one tooth is missing, more crowns will be needed to bridge the gap between the abutment teeth.
The number of abutment teeth necessary to replace missing teeth is influenced by the number of missing teeth, the size and length of the abutment tooth roots, the amount of bone support each abutment tooth has, and where the missing tooth is located in the mouth.
For example, if you have three missing teeth, four abutment teeth may be necessary, creating a seven-tooth bridge. Engineering and designing the bridge requires an understanding of how to replace teeth and the biology of the supporting gum and bone tissue.
Caring for Your Crowns and Bridgework
Crowns and bridgework require the same conscientious care as your natural teeth. Be sure to brush and floss between all of your teeth — restored and natural — every day to reduce the buildup of dental plaque.
When you have crowns, it is even more important to maintain your regular schedule of cleanings at the dental office. Avoid using your teeth as tools (to open packages, for example). If you have a grinding habit, wearing a nightguard would be a good idea to protect your teeth and investment.
