Prosthodontics
A tooth is essentially made up of pulp and dentine which is encased in an extremely hard substance called enamel. This gives a tooth its strength.
Although teeth are difficult to break, trauma or tooth decay may severely damage a tooth. When this happens, a crown or bridge, sometimes in conjunction with root canal treament, may be the best way to save or replace the tooth.
Crowns and bridges can sometimes be fitted by your dentist, or you may be referred to a prosthodonist for treatment.
Crowns
When the strength of a a tooth is compromised, due to trauma, decay or as a result of root canal treatment, a crown can be the best way to save the tooth by strengthening and protecting it. A crown is an artifical tooth which is secured on top of the natural crown (the visible part of the tooth which sits above the gum line).
Crowns can be made of porcelain, gold alloy or both. While both materials are strong, porcelain would normally be used for the front teeth as it can be made it match the colour of your existing teeth, while gold alloy may be used for the back molars where strength and durability are most important for chewing.
Procedure
A crown will usually require multiple visits to the dentist. After an impression has been taken and a mould of your upper and lower teeth, the area will be numbed with local anaesthetic. The tooth is then reshaped using a dental drill, which will result in the tooth becoming smaller usually by one to two millimetres. After reshaping the tooth, another impression will be taken. The final impressions are then sent to a special technician who will make the custom-fit crown. To protect the tooth between treatments, a temporary crown will be fitted.
Once the permanent crown is ready to be fitted, the temporary crown will be removed and the permanent crown will be cemented over the original tooth. Once properly fitted, the new crown should feel comfortable in your mouth. You should advise your dentist if the crown is uncomfortable so that minor adjustments can be made.
Bridges
Bridges are similar to crowns except their primary purpose is to replace a missing tooth. A bridge is an artificial tooth attached to crowns which are anchored to the surrounding teeth. The artifical tooth then effectively fills the gap and replaces the missing tooth. If a tooth is lost as a result of trauma or decay, a bridge may be the most effective treatment, however implants may also be a treatment option. Your dentist can advise you on the best treatment option for your condition.
Procedure
Fitting a bridge is very similar to fitting a crown and may take several appointments. The teeth either side of the gap are reshaped in preparation for crowns. Temporary crowns will be used to protect the teeth in between treatments. A special technician will make the bridge based on your dentist's specifications. Once the bridge is made, the dentist will cement it in place.
Implants
If a tooth (the crown and the root) is extracted or lost from trauma or decay, an implant may be used to replace the tooth. An implant is an artifical tooth, designed to replace a natural one. It is made up of two parts, a steel post which is implanted into the jaw bone to which a crown which is then attached to. Implants can be an alternative to a bridge and your dentist can advise you on your best treatment option.
Procedure
Similar to a crown and bridge, an impression and mould will be taken of your upper and lower teeth. Your dentist will need to determine whether your existing bone structure is strong enough to support the implant. Oral surgery will then be required to integrate the implant into the jaw bone, where it will effectively replace the original tooth root. Once the implant site has healed, a crown or bridge can then be attached to the implant, effectively replacing the missing tooth with an artifical one.
Benefits of crowns, bridges and implants
Our teeth play an incredibly important role in our life. They help us eat and also improve the general appearance of our face. If a tooth is missing or severely damaged, it is important it is replaced for the following reasons:
› to maintain your natural bite and improve your chewing ability
› to help prevent damage to other teeth
› to help prevent other teeth from moving around a gap
For more information on which procedures are available at your local Primary Dental, please contact your local centre directly.
