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Dental Crowns |
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Crowns , also known as caps, restore damaged teeth and mimic the shape, size and color of the surrounding teeth and are indicated for cracked teeth and teeth with deep cavities; to protect teeth that have been filled by root-canal treatment; to provide extra support for bridges; and to cover poorly shaped or discolored teeth. It may be made of metal, porcelain, or newer restorative materials like metal free ceramics, plastic, ceramic or metal alloys and simulate the appearance of natural teeth.
The teeth to be crowned are prepared which involves reduction of the tooth size (usually under local anaesthesia) followed by an impression or mould of the prepared tooth. This trimming of the tooth is required to create space for the crown to be fitted. The mould taken is then sent to a laboratory where skilled technicians will fabricate the crown. In the meanwhile, a temporary crown is made and fitted onto the trimmed tooth.
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| Types of Dental Crowns
Dental crowns are made of metal, ceramic, or porcelain fused to metal. The type of crown utilized during your dental crown procedure will depend on your unique needs and goals, as well as the recommendation of your dentist.
Metal Crowns
Although their metallic color makes them a poor choice for highly visible teeth, dental crowns made of metal can be an ideal option for repairing decayed or damaged back teeth. They are extremely durable and can be applied with less removal of the natural tooth than all porcelain or ceramic crowns. Metal crowns may consist of various materials, including gold alloy, palladium, nickel alloy, or chromium alloy.
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| All Ceramic Crowns
A dental crown is needed when a tooth is badly broken down, ie large or worn-out fillings or a large amount of decay. With old technology, dental crowns were commonly made with a metal foundation: although these are strong, they can often look dull and lifeless and it is common for the metal to show as grey around the gumline. Today, we are able to offer all ceramic metal free crowns which are beautiful and natural looking: these are the treatment of choice for teeth which show in your smile. New bonding technology allows us to bond the crown to your tooth so that they become one unit: almost like an enamel replacement.
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Porcelain Crowns
Porcelain crowns or new reinforced resin are considered to be the most aesthetically pleasing, as it is so easily matched in color to the surrounding teeth. The thickness of the porcelain required for pleasing aesthetics also requires that more tooth structure needs to be removed. . All-porcelain crowns require a higher skill level from your dentist and lab.
Porcelain fused-to-metal crowns have a very natural appearance. They have a metal substructure and require an opaque below the porcelain.
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Why would I need a crown?
Crowns are an ideal restoration for teeth that have been broken, or have been weakened by decay or a very large filling. A crown could be used for a number of other reasons, for instance:
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You may have discoloured fillings and would like to improve the appearance of the tooth |
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You may have had a root filling which will need a crown to protect it |
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It may help hold a bridge or denture firmly in place. |
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What is a post crown?
In root-filled teeth it may be necessary to insert a post before placing a crown. A post provides support and helps the crown stay in place. The weakened crown of the tooth may be shortened to gum level. A post can be made of prefabricated stainless steel which the dentist can fit directly into the root canal, or a custom-made post can be constructed by the dental technician to accurately fit the shape of the prepared root canal. The post is placed into the root canal and cemented in position, ready for the crown to be attached. |
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Are there any alternatives to post crowns for root-filled teeth?
If a root-filled tooth is not completely broken down, it may be possible to build it up again using filling material. This ‘core’ is then prepared in the same way as a natural tooth and the impressions are taken |
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What is a crown made of?
Crowns can be made of a variety of different materials and new materials are continually being introduced. Some of the most popular options are listed below.
Porcelain bonded to precious metal: this is what most crowns are made from. A precious metal base is made and then porcelain is applied in layers over it.
Porcelain crowns: these crowns are made entirely out of porcelain and are not as strong as bonded crowns, but they can look very natural and are most often used for front teeth.
All-ceramic crowns: this modern technique offers a metal-free alternative, which can give the strength of a bonded crown and the appearance of a porcelain crown. Therefore it is suitable for use in all areas of the mouth.
Porcelain and composite: porcelain and composite resin materials can sometimes look the most natural. However, these crowns are not as strong as bonded metal crowns.
Glass: these crowns look very natural and are used on both front and back teeth.Gold alloy crowns: gold is one of the oldest filling materials. Today it is used with other metal alloys to increase its strength, which makes it a very hardwearing restoration. These crowns are white or gold in colour. |
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How is a crown prepared?
The dentist will prepare the tooth to the ideal shape for the crown. This will involve removing most of the outer surface, and leaving a strong inner core. The amount of the tooth removed will be the same as the thickness of the crown.
Once the tooth is shaped, the dentist will take an impression (mould) of the prepared tooth, one of the opposite jaw and possibly another to mark the way you bite together.
The impressions will then be given to the dental technician, along with an appropriate shade and other information needed for the crown to be made. |
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What will happen between visits?
A temporary crown will be made so that you can use the tooth while you wait for the crown to be made. This crown may be more noticeable but is only a temporary measure.
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How is the crown fitted?
When the dentist is happy with the fit and appearance of the new crown it will be fixed in place with special dental cement or adhesive. The cement forms a seal to hold the crown in place. |
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How long does the treatment take?
You will need to have at least two visits: the first for the preparation, impression, shade taking and fitting the temporary crown; and the second to fit the permanent crown. There will usually be about 1 to 2 weeks in between appointments. |
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| Does it hurt to have a tooth prepared for a crown?
No. A local anaesthetic is used and the preparation should feel no different from a filling. If the tooth does not have a nerve, and a post crown is being prepared, then a local anaesthetic may not be needed. |
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Will the crown be noticeable?
No. The crown will be made to match your other teeth exactly. The shade of the neighbouring teeth will be recorded, to make sure that the colour looks natural and matches the surrounding teeth. |
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Will the crown feel different?
Because the shape of the crown will be slightly different from the shape of your tooth before it was crowned, you may be aware of it to begin with. Within a few days it should feel fine, and you will not notice it. The crown may need some adjustment if your bite does not feel comfortable, so you should ask your dentist to check and adjust it.
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Are crowns available on the NHS?
Crowns are provided under the NHS if there is a clinical need. However, tooth-coloured crowns are not available on back biting teeth. If you would like to have a crown for cosmetic reasons and you do not have a clinical need, a dentist will be able to carry out the procedure privately. It is advisable to get a written estimate and treatment plan before beginning your dental treatment. |
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How do I care for my crown?
How long your crown lasts depends on how well you look after it. The crown itself cannot decay, but decay can start where the edge of the crown joins the tooth. Therefore, it is important to keep this area just as clean as you would your natural teeth in order to prevent decay affecting the crown. |
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How long will the crown last?
Properly cared for crowns should last for many years. Your dentist will be able to tell you how long the crown may be expected to last.
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Veneers |
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Dental veneers are custom-designed shells of tooth-like ceramic material that, when applied over the surface of a tooth, can cover worn tooth enamel, uneven tooth alignment, or spacing and chips or cracks. Dental veneers fall into the category of cosmetic dentistry because they create a bright, white smile with beautifully aligned, shapely teeth. Even better, the translucent ceramic quality of today's veneers provides a more natural look than what’s been available in the past.
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| Types of Tooth Veneer Procedures:
There are two tooth veneers procedures available that correct discoloration of the teeth by removing the brown and yellow staining. While each work effectively, there are advantages and disadvantages to each procedure dependent upon your objectives and commitment to the processes. The type of procedures available should be discussed with your cosmetic dentist, and a they will recommend the most appropriate tooth veneers procedure.
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Composite Veneer Procedure:
Composite (direct) veneers are usually performed in a single visit to your cosmetic dentist. The procedure is an application of a bond and enamel directly to the tooth's surface.
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Porcelain Veneer Procedure:
Porcelain (indirect) veneers are a very thin porcelain material. Usually porcelain veneers require two visits and also require a dental laboratory to create the final tooth restoration piece.
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Lumineer Porcelain Veneer Procedure:
Made of Cerinate porcelain, Lumineers are a new type of porcelain veneers. They are contact lens-thin, roughly .2 mm thick. Little to no tooth reduction in most cases is necessary with this type of veneer and anesthetics or numbing shots are not needed.
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When are Veneers Appropriate?
Bonding often serves as an inexpensive and effective restoration for small chips and cracks in the teeth. Such minor problems may be functionally and cosmetically repaired with a composite "white filling." A composite resin material is bonded to the tooth in order to fill in the chip or crack and better protect the surrounding tooth structure. |
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Veneers or Whitening?
Teeth whitening may provide a white smile for mildly discolored teeth, and lasers may be used to treat specific discoloration spots on a tooth. Some people who are interested in veneers will find that their cosmetic dentist will steer them to the simpler alternative of whitening, perhaps combined with some simple orthodontic alignment. The placement of dental veneers requires the “shaping” or “prepping” of all teeth being fitted with the custom-designed shells.
If you have a severe case of dull or discolored teeth, you may have to opt for dental veneers. Veneers do have the added benefits of longevity and a proven ability to enhance the appearance of the mouth, smile, and possibly other areas of an aged face that would be better supported by properly shaped teeth. Although veneers require a much larger commitment than teeth whitening, the results are typically well worth it. |
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A Restorative Benefit to Veneers
In addition to being esthetically pleasing, dental veneers can also serve a functional purpose by protecting the surface of a damaged tooth. In some cases, veneers may replace the need for a dental crown, eliminating the need for more invasive tooth preparation.
Because dental veneers are so thin, they might require little-to-no tooth reshaping when bonded onto the tooth. They are incredibly strong and may last up to 15 years, assuming they are properly maintained through regular brushing and checkups.
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Dental Bridge |
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A bridgestabilizes the bite of a patient who is missing one or more teeth and prevents the surrounding teeth from moving or shifting in the mouth. A missing tooth that is not replaced may cause surrounding teeth to become unstable and require removal, compromising oral health or change the shape of the face. Unlike partial dentures, bridges are permanent; patients need not remove them. The missing tooth is replaced with an artificial tooth connected between two crowns (caps), which are permanently cemented or bonded on the adjacent teeth.
Bridges can be used to replace a small number of missing teeth if the neighboring teeth are sufficiently strong. The number of missing teeth, condition of the neighboring teeth, condition of the supporting gums and bone are all important factors which need to be assessed prior to making a bridge. |
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Tooth Colored Restorations:
Glass crystal epoxy resins have revolutionized cosmetic dentistry over the past two decades. Also known as composite resin fillings, these tooth-colored restorations (or "composites") are so durably esthetic that they have surpassed amalgams in popularity in many offices nationwide.Patients are asking for tooth-colored fillings in increasing numbers because of the advantages they offer. Not only do composites look like your real teeth, they are chemically bonded directly to the tooth and create a better seal; they are light-cured which makes them harden instantly; they resist temperature conduction, making them ideal for people with teeth that are sensitive to hot and cold; and, thanks to new advances in adhesive science, composite resins have excellent strength for small to medium sized fillings
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Teeth Whitening |
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Discoloured teeth can be whitened/bleached by the use of a dental chemical agent which lightens the external appearance of teeth by about 4-5 shades. The teeth that can be whitened are those which have accumulated stains by external colorants such as wine, chocolates, nicotine, coffee, tea, turmeric, spices.
Internal staining due to tetracyclines or hemorrhaging can be treated differently.
Either take home kits can be made for the patient to perform the procedure in the convenience of his/her home over a period of 10 days or an in -office procedure can be followed where in the dentist performs the procedure in the chair and the patient goes home with visibly whiter teeth in an hour.
Thereafter, the patient can do touch-ups every 8 months as per re-staining
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