Dental FAQ's Crowns & Bridges FAQ's

A Crown is a restoration that covers the entire tooth like a cap. It can be made of porcelain or acrylic. Crowns are used to restore teeth that are discolored, have multiple decays or are fractured.

A Bridge is a prosthetic appliance that replaces missing teeth by permanently getting attached to the adjacent remaining teeth.

The metallic FPD can be given an acrylic or porcelain facing over the areas that are visible to the exterior so as to make them esthetically acceptable.

Earlier pure gold was used in the fabrication of FPDs. The higher cost of gold and its softness led to the introduction of the gold alloys, which have some % of gold along with other metals such as platinum, palladium, silver, copper, zinc, etc. These additions to the gold made the alloy cheaper and also improved its mechanical properties. A number of different gold-based alloys are available with differing contents of gold that are used for different dental applications.

The maximum number of teeth that can be replaced by a Bridge is two to three. Much depends upon the health of the remaining teeth and in which area the teeth are missing.

Unlike a normal Bridge that is attached to teeth on both sides, a cantilever Bridge is one that is attached only on one side to the remaining teeth. The other side is free or unattached. These cantilever Bridges are indicated when the tooth to be replaced is the last one and does not have remaining teeth beyond it. These Bridges have poor prognosis in the long run.

The resin bonded Fixed Partial Dentures are those that are bonded to adjacent teeth using acrylic resins. Unlike the conventional Bridges these resin bonded ones need less reduction of the adjacent remaining teeth and are therefore more conservative.

Sometimes we come across patients who have some roots remaining. These roots can be used to give support for prosthesis. These roots are first endodontically treated and then strengthened by inserting a post into their root canals. Over these posts a core is built up and this core can be used to give support for the prosthesis. These are called post and cores.

You have just experienced one of a number of common misunderstandings we see in dentistry today. Terminology used in dentistry is not 100% uniform throughout our profession. Both dentists were probably "correct". The word "cap" as used in dentistry by different dentists can refer to a number of different things. A pulp cap refers to a calcium containing dressing placed under a deep filling to stimulate healing. A full Crown, made by a dental laboratory which completely covers the outside of your tooth is frequently called a cap. A partly broken tooth may be built up by your dentist in the office with a bonded filling material. This is called a cap or "capping" by some dentists. This sounds like what you probably had done. Visit Crowns & Bridges Section for further details

Preparing a tooth for a Crown usually requires two visits to the dentist, the first step involves examining and preparing the tooth, the second visit involves placement of the permanent Crown. /

  • First Visit: Examining and preparing the tooth. At the first visit in preparation for a Crown, your dentist may take a few X-rays to check the roots of the tooth receiving the Crown and surrounding bone. If the tooth has extensive decay or if there is a risk of infection or injury to the tooth pulp, a root canal treatment may first be performed. Before the process of making your Crown is begun, your dentist will anesthetize (numb) your tooth and the gum tissue around the tooth. Next, the tooth receiving the Crown is filed down along the chewing surface and sides to make room for the Crown. The amount removed depends on the type of Crown used (for instance, all-metal Crowns are thinner, requiring less tooth structure removal than all-porcelain or porcelain-fused-to-metal ones). If, on the other hand, a large area of the tooth is missing (due to decay or damage), your dentist will use filling material to "build up" the tooth to support the Crown. After reshaping the tooth, your dentist will use impression paste or putty to make an impression of the tooth to receive the Crown. Impressions of the teeth above and below the tooth to receive the dental Crown will also be made to make sure that the Crown will not affect your bite. The impressions are sent to a dental laboratory where the Crown will be manufactured. The Crown is usually returned to your dentist office in 2 to 3 weeks. If your Crown is made of porcelain, your dentist will also select the shade that most closely matches the color of the neighboring teeth. During this first office visit your dentist will make a temporary Crown to cover and protect the prepared tooth while the Crown is being made. Temporary Crowns usually are made of acrylic and are held in place using temporary cement.
  • Second Visit: Receiving the permanent dental Crown. At your second visit, your dentist will remove your temporary Crown and check the fit and color of the permanent Crown. If everything is acceptable, a local anesthetic will be used to numb the tooth and the new Crown is permanently cemented in place.

Because temporary dental Crowns are just that -- a temporary fix until a permanent Crown is ready, most dentists suggest that a few precautions be taken with your temporary Crown. These include:

  • Avoid sticky, chewy foods (for example, chewing gum, caramel), which have the potential of grabbing and pulling off the Crown.
  • Minimize use of the side of your mouth with the temporary Crown. Shift the bulk of your chewing to the other side of your mouth.
  • Avoid chewing hard foods (such as raw vegetables), which could dislodge or break the Crown.
  • Slide flossing material out-rather than lifting out-when cleaning your teeth. Lifting the floss out, as you normally would, might pull off the temporary Crown.

Following Problems may develop with a Crown:

  • Discomfort or sensitivity: Your newly Crowned tooth may be sensitive immediately after the procedure as the anesthesia begins to wear off. If the tooth that has been Crowned still has a nerve in it, you may experience some heat and cold sensitivity. Your dentist may recommend that you brush your teeth with toothpaste designed for sensitive teeth. Pain or sensitivity that occurs when you bite down usually means that the Crown is too high on the tooth. If this is the case, call your dentist. He or she can easily fix this problem.
  • Chipped Crown. Crowns made of all porcelain can sometimes chip. If the chip is small, a composite resin can be used to repair the chip with the Crown remaining in your mouth. If the chipping is extensive, the Crown may need to be replaced.
  • Loose Crown. Sometimes the cement washes out from under the Crown. Not only does this allow the Crown to become loose, it allows bacteria to leak in and cause decay to the tooth that remains. If your Crown feels loose, contact your dentist office.
  • Crown falls off. Sometimes Crowns fall off. Usually this is due to an improper fit or a lack of cement. If this happens, clean the Crown and the front of your tooth. You can replace the Crown temporarily using dental adhesive or temporary tooth cement that is sold in stores for this purpose. Contact your dentist office immediately. He or she will give you specific instructions on how to care for your tooth and Crown for the day or so until you can be seen for an evaluation. Your dentist may be able to re-cement your Crown in place; if not, a new Crown will need to be made.
  • Allergic reaction. Because the metals used to make Crowns are usually a mixture of metals, an allergic reaction to the metals or porcelain used in Crowns can occur, but this is extremely rare.
  • Dark line on Crowned tooth next to the gum line. A dark line next to the gum line of your Crowned tooth is normal, particularly if you have a porcelain-fused-to-metal Crown. This dark line is simply the metal of the Crown showing through.

Onlays and 3/4 Crowns are variations on the technique of dental Crowns. The difference between these Crowns and the Crowns discussed previously is their coverage of the underlying tooth. The "traditional" Crown covers the entire tooth; onlays and 3/4 Crowns cover the underlying tooth to a lesser extent.

On average, dental Crowns last between 5 and 15 years. The life span of a Crown depends on the amount of "wear and tear" the Crown is exposed to, how well you follow good oral hygiene practices, and your personal mouth-related habits (you should avoid such habits as grinding or clenching your teeth also known as Bruxism, chewing ice, biting your fingernails and using your teeth to open packaging).

While a crowned tooth does not require any special care, remember that simply because a tooth is crowned does not mean the underlying tooth is protected from decay or gum disease. Therefore, continue to follow good oral hygiene practices, including brushing your teeth at least twice a day and flossing once a day-especially around the Crown area where the gum meets the tooth.

Costs of Crowns vary depending on what part of the country you live in and on the type of Crown selected (for example, porcelain Crowns are typically more expensive than gold Crowns, which are typically more expensive than porcelain-fused-to-metal Crowns). Generally, Crowns can range in cost from ` 1000 to 15000 or more per Crown.

Patients today have an array of options for replacing missing teeth. Dental bridges, dentures and dental implants all have their advantages and disadvantages, though modern cosmetic and restorative dentistry has come to favor dental implants because they look and function just like real teeth and require no special care. If you have lost a tooth or several teeth, we urge you to seek treatment. Adjacent teeth can shift into the gap left by a lost tooth; in addition, a missing tooth can lead to bone loss, hygiene problems, difficulties with speaking and eating, and much more. Today's dental restorations are better than ever, and they can give you a strong bite and a beautiful smile.

Visit Crowns & Bridges Section for further details
Visit Downloads Section for downloading informative files