Crowns & Bridges
Crowns, or “caps” as they are commonly referred to, are restorations that completely cover the tooth. There are many indications for a crown to be placed. Common needs are if a tooth has had a root canal treatment, as this causes the tooth to become brittle and may unrestorably fracture if it is not supported by a crown. When a vital tooth breaks to the point where there isn’t enough healthy tooth structure to support a basic filling, a crown is the treatment of choice. In some cosmetic cases, a full crown is needed when a veneer isn’t possible. Crowns are also placed on implants.
There are three basic types of crowns. Full porcelain crowns are the most aesthetic, full gold crowns are the most durable, and a combination (porcelain fused to a metal substructure) is also sometimes the best option. Material decisions can be made, with the pros and cons of each always discussed in detail.
The crown process is similar to that for veneers and bridges: two appointments with a temporary crown worn while the lab fabricates your case. Local anesthetic is usually only needed at the first appointment when the teeth are prepared.
A bridge is a common solution for replacing a missing tooth or teeth where there is a healthy tooth on either side of the space. The teeth on either side of the space, called abutments, are prepared similarly as to how they would be for a crown. The replacement tooth/teeth in the middle, called pontics, are attached in one piece with the abutments. This bridge is cemented permanently to the abutment teeth, with the pontic tooth attached to nothing underneath but to the adjacent abutments, and the pontic made to look as if it is emerging from the gums.