Crowns and Bridgework
Dentistry is an art as well as a science; dental crowns offer a perfect example of this. 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 crown completely covers a tooth above the gum line. This is in contrast to a dental veneer, which only covers a tooth's front surface and needs 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 ceramics), crowns are virtually indistinguishable from natural teeth. They can even be designed to improve upon a tooth's original appearance.
There are other materials besides porcelain that we can use to make dental crowns, depending on what qualities are most important. For durability, cast gold can't be beat. 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 be happy to discuss the pros and cons of these various options with you.
Crowning or Capping a Tooth
Crowning or capping a tooth will usually take two to three visits. At the first visit, your tooth is prepared to receive 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 there is very little tooth structure left to begin with, 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 for the creation of a crown. The models will serve as guides to the highly skilled lab technicians, who will ensure that 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 special light source, or a type of permanent cement.
Creating a Bridge
Crowns can also be used to create a lifelike replacement for a missing tooth. This is done with 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 in between them; that third crown is referred to as a pontic. If more than one tooth is missing, more crowns will be needed to bridge the gap in 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, as well as where in the mouth the missing tooth is located. For example, if you have three missing teeth, four abutment teeth may be necessary, thereby creating a seven-tooth bridge. Engineering and designing of the bridge requires an understanding of how to replace teeth, as well as the biology of the supporting gum and bone tissue.
Caring for Your Crowns & 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 your investment.
Same Day Crowns
A CEREC restoration is a CAD/CAM (computer aided design & manufacturing) that is custom made for the patient right here in our office.
The advantages ae numerous, including:
-One visit dental restorations, which saves the patient travel time.
-An extremely strong and natural looking restoration that should last many years.
-No “temporary” restoration.
A crown is a restorative device to fully or partially cover and protect a tooth that has been damaged by:
-Decay (a bacterial infection)
-A large filling that should not be replaced with another filling to avoid future problems
-A bigger fracture/breakage of part of the tooth due to trauma, previous decay, unsupported previous fillings, or biting into a very hard object that cannot be partially covered due to the amount of tooth structure that is missing.
-A broken crown that cannot be repaired
It takes only one appointment to restore your tooth with a CEREC crown/bridge restoration. That is because the restoration is custom crafted with our CAD/CAM system right here in the office.
First Visit: We start with a digital X-ray of the tooth to make sure that no infection is at the end of the root before we construct the crown. Sometimes abscesses are in the tooth and the patient does not know it.
We, of course, will thoroughly “numb” you up with local anesthetic to make you comfortable. We use the “Dentalvibe” system, which helps block injection pain.
We then remove any restorative material, decay, chalky demineralized tooth so that we are at sound tooth structure.
The crown build up or core, if required, is next and is bonded physically and chemically to the tooth. This material strengthens the tooth, decreases sensitivity, and releases fluoride into the area to decrease the chance of new decay under the crown. The tooth is then shaped so that the restoration fits over/in/around the remaining tooth.
A final optical scan of the prepared tooth is taken. The restoration is then designed on the computer and this information is sent digitally to the milling unit in our in-house dental lab.
That same day we bond the restoration in your mouth with composite bonding technology.
Here at Dr. Wiest’s office, we care about our patients and want them to have a good experience with us. If for any reason the CEREC crown we made for you breaks or fractures we will replace it FREE of charge as long as we see you every 6 months for a preventative cleaning and check-up.
A CEREC crown/bridge is made out of a solid block of ideally manufactured porcelain and has been proven by over 20 years of clinical research to last many years.
Orthodontics - Six Month Smile
Six Month Smiles is for adults with crocked, spaced or misaligned teeth. Using clear braces to gently straighten and align teeth, the average time most people wear braces is just six months. It has quick results because they only move the teeth that show when you smile. Six months is the average treatment time. Most patients finish right around six months, but treatment times may range from 4-9 months. As with all orthodontic treatment, a retainer is necessary to maintain the new, straight position of your teeth. There are a variety of retainer options you can choose from depending on your personal preference and situation.
Many insurance plans will cover orthodontics. For those without insurance, Dr. Wiest’s office offers a 10% discount if paid in full at the beginning of service. We also offer monthly payment plans, with the final payment due at the time the bands are removed.
Everyone should be able to smile with confidence! For more information on crowns and bridges call our Provo, UT office at (801) 374-8205 today!
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Value Of Quality Care Are all crowns created equal? And why are some crowns more expensive than others? Crown fabrication costs depend upon the materials used and the time needed to create them, among other factors. Dear Doctor magazine examines these variables... Read Article
Fixed vs. Removable Bridgework For those patients who have lost all their teeth, but have not lost significant bone, a fixed bridge (permanent non-removable teeth) may be the treatment of choice. For those who have severe bone loss, an implant-supported overdenture offers significant advantages... Read Article