What is a crown?
Crowns are an ideal way to rebuild teeth which have been broken, or have bee weakened by decay or a very large filling.
The crown fits right over the remaining part of the tooth, making it strong and giving it shape and contour of a natural tooth. Crowns are sometimes known as ‘caps’. An ‘Anterior Crown’ is a crown fitted to the front eight teeth.
Why would I need a crown?
There are a number of reasons. For instance:
- The tooth may have been weakened by having a very large filling.
- You may have a disc0loured fillings and would like to improve the appearance of the tooth.
- You may have had a root filling which will need a crown to protect it.
- You may have had an accident and damaged the tooth.
- It may help hold a bridge or denture firmly in place.
What are crowns made of ?
Crowns are made of a variety of materials and new materials are being introduced all the time. Here are some options avaliable at present:
- Porcelain fused to metal: this is what most crowns are made from. A metal base is made and layers of porcelain are then applied over it.
- Porcelain crowns: The crown is completely made of porcelain with no metal base. We offer two options:
- IPS e.max® Lithium Disilicate crowns
- AmannGirrbach Zirconia crowns
- Precious metal (gold and palladium): There crowns are very strong and hard-wearing , but are not usually used at the front of the mouth, where they are highly visible.
How is a tooth prepared for a crown?
The dentist will prepare the tooth to the ideal shape for the crown. This will mean removing most of the outer surface, and leaving a stronger inner ‘core’. The amount of the tooth removed will be the same as the thickness of the crown to be fitted. Once the tooth is shaped, the dentist will take an impression of the prepared tooth, one of the opposite jaw and possibly another to mark the way you bite together. The impression will be given to the technician, along with any other information they need to make the crown.
Who makes the crown?
The impression and information about the shade of your teeth will be given to our dental technician who will be skilled in making crowns. They will make models of your mouth and make the crown on these to be sure that the crown fits perfectly.
Will the crown be noticeable?
No. The crown will be made to match your other teeth exactly. The shade of the neighboring teeth will be recorded, to make sure the colour looks natural and matches the surrounding teeth. A temporary crown, usually made in plastic, will be fitted at the end of the first appointment to last until the permanent one is ready. These temporary crowns may be more noticeable, but they are only in place for about a week.
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.
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 local anaesthetic may not be needed.
Are post crowns different?
Post crowns may be used when the tooth has been root filled. The weakened crown to the tooth drilled off at the level of the gum. The dentist makes a double-ended ‘post’ to fit into the root canal. This can be either prefabricated titanium or custom made metal. One end of the post is cemented into the root canal, and the other end holds the crown firmly in place.
Are there any alternatives to post crowns for root-filled teeth?
If root filled teeth 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.
How long will a crown last?
The life of a crown will depend on how well it is looked after. The crown itself cannot decay, but decay can start where the edge of the crown joins the tooth. It is important to keep the area as clean as your other teeth, or decay could endanger the crown. Properly cared for crowns will last for many years – your dentist will be able to tell you how long.
How are crowns fixed to teeth?
Once the fit and the appearance of the crown has been checked – and approved by you – it will be cemented in place with special dental cement. The cement also forms a seal to help hold it firmly in place.
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 it feels higher than the surrounding teeth. If it is at all uncomfortable ask your dentist to check and adjust it.
Is there an alternative to a crown?
A veneer can be an alternative to having an anterior crown. Your dentist will advise you of any suitable alternatives.
What are dental implants?
A dental implant is a titanium metal rod which is placed into the jawbone. It is used to support one or more false teeth.
In practice, both the false teeth and their supporting rod are known as ‘implants’.
Are implant safe? How long will they last?
Implant are a well-established, tried-and-tested treatment. 90 % of modern implants last for at least 15 years.
I have some of my own teeth. Can I still have implants?
Yes, You can have any number of teeth replaced with implants – from one single tooth to a complete set.
Can implants always be used to replace missing teeth?
It depends on the state of the bone in your jaw. Your dentist will arrange for a number of special tests to assess the amount of bone still there. If there is not enough, or if it isn’t healthy enough, it may not be possible to place implants without grafting bone into the area first.
Do implant hurt?
Placing the implant requires a small operation. This can be carried out under local anaesthetic. You will not feel any pain at the time but you may feel some discomfort during the week following the surgery. This is usually due to having stitches in place, and the normal healing process.
Can I have new teeth straight away?
No. The implant need to bond (integrate) with the bone after they have been placed. This takes at least 2-3 months. If you are having one, two or three teeth replaced, you will have a temporary restoration in the meantime. If you have complete dentures, then you can wear them throughout the healing period once they have been adjusted after the surgery.
How long does treatment take?
It takes about 3-4 months. A lot depends on how complicated your treatment is. Your dentist will be able to give you a timetable once the surgery has been done.
Are the teeth difficult to clean?
Cleaning around the teeth attached to the implants is no more difficult than cleaning natural teeth. However, there may be areas that give you problems and you’ll be shown methods to help.
If I had gum disease when I had my own teeth, will I get it with the teeth attached to the implants?
Yes, if you don’t care for them well enough. If you keep them clean, and don’t smoke, then you should not have any problems.
Can I take the teeth out if they are fixed to implants?
Most artificial teeth attached to implants can only be placed and removed by the dentist. However, if you have complete dentures fixed to the implants by attachments, then you’ll be able to take them out for cleaning.
Do implants show?
Your dentist will make sure that the implants won’t show during all normal movements of the mouth and lips. You will need to be able to see them, so that you can clean them properly.
Do I have an implant for each missing tooth?
No, unless you’re only having a single tooth replaced. Normally, five or six implants are used to replace all the teeth in one jaw, as each implant can usually support two teeth. For a few missing teeth, two or three implants may be used.
What if I get hit in the face?
Implants and the teeth they support can be damaged by an accident in the same way that natural teeth can. However, if the false teeth are damaged and the remnants are left in the bone then they may be more difficult to remove than natural teeth would be. After healing, false teeth can then be placed alongside the fragments.
What happens if the implant does not bond (integrate) with the bone?
This happens very rarely. If the implant becomes loose during the healing period or just after, then it is easily removed and healing takes place in the normal way. Once the jaw has healed, another implant can be placed there. Or, the dentist can make a bridge, using the implanted false teeth that have ‘taken’.
Is the treatment expensive?
Unfortunately, yes. However, in the many situations, the cost of the treatment is only a little more than the cost of more conventional treatment with crowns and bridges.
There are advantages to it, too. An implant to replace a single tooth avoids the need to cut down the teeth either side for crowns to support a bridge. Normal dentures often mean you can’t eat or speak well, due to the denture moving about. But teeth attached to an implant don’t cause this problem.
Where do I get this treatment?
Talk to your dentist, so we can make an assessment and treatment plan. Your dentist may already carry out some or all of this type of treatment and will give you the advice you need.
Why should I replace missing teeth?
Your appearance is one reason. Another is that the gap left by a missing tooth can mean greater strain on the teeth on either side. A gap can also mean you ‘bite’ is affected, because the teeth next to the space can lean into the gap and alter the way the upper and lower teeth bit together. This can lead to food getting packed into the gap? which causes both decay and gum disease.
How are missing teeth replaced?
This depends on the number of teeth missing and on where they are in the mouth. The condition of the other teeth also affects the decision.
There are two main ways to replace the missing teeth. The first is with a removable false tooth or teeth – a partial denture. The second is with a fixed bridge. A bridge is usually used where there are fewer teeth to replace, or when the missing teeth are only on one side of the mouth.
Can I always have a bridge to replace missing teeth?
Yes, if you have enough strong teeth with good bone support. Your dentist will help you decide the best way of replacing your missing teeth.
What are bridges made of?
Bridges are usually made of a precious metal or a high-quality zirconia base. If the bridge will show, the non-metal base will provide superior aesthetics.
Are bridges expensive?
Although a bridge may seem expensive it will last many years. It will also improve your appearance and bite. A bridge uses the considerable skill of the dentist and technician, and in this way, it’s similar to ordering a piece of hand made jewellery. The materials are also expensive so it’s fair to say a bridge will not be the cheapest treatment you have ever had.
How do I look after my bridge?
You need to clean your bridge every day, to prevent problems such as bad breath and gum disease. You also have to clean under the false tooth every day. Your dentist or hygienist will show you how to use a special floss, as a normal toothbrush cannot reach.
Are there other methods for fixing false teeth?
There are other methods, such as using a combination of crowns and partial dentures that can keep the retaining clips out of sight.
These are quite specialised dentures, so you should ask your dentist about them. You can also have teeth implanted, ask your dentist for more information.
Remember that it is as important to care for your remaining teeth as it is to replace the missing ones.
Are there different types of bridges?
Yes, there are different types of bridges which use different fixing methods. Your dentist will chose the most effective and conservative bridge for your personal situation.
What is a Veneer?
A Veneer is a thin layer of porcelain made to fir over the front surface of a tooth, just like a false fingernail fits over a nail.
Sometimes a natural color composite material is used instead of porcelain.
What are the advantages of veneers?
Veneers make teeth look natural and healthy, and because they are very thin and held in place by a special strong bond (rather like super-glue) very little preparation of the tooth is needed.
When would I need a veneer?
Veneers can improve the colour, shape and position of teeth. A precise shade of porcelain can be chosen to give the right colour to improve a single discoloured or stained tooth or to lighten front teeth generally. A veneer can make a chipped tooth look intact again. The porcelain covers the whole of the front of the tooth with a thicker section replacing the broken part. Veneers can also be used to close small gaps, when orthodontics (braces) are not suitable. If one tooth is slightly out of position, a veneer can sometimes be fitted to bring it into line with the others.
What about alternatives?
A natural-coloured filling material can be used for minor repairs to front teeth. This is excellent where the tooth supports the filling, but may not work so well for broken tooth corners. There will always be a join between the tooth and the filling material.
Crowns are used for teeth that need to be strengthened – either because they have broken, have been weakened by a very large filling, or have had root canal treatment.
How long will a veneer last?
Veneers should last for many years, but they can chip or break, just as your own teeth can. Your dentist will tell you how long each individual veneer should last. Small chips can be repaired, or a new veneers fitted if necessary.
How are teeth prepared for a veneer?
Some of the shiny outer enamel surface of the tooth may be removed, to make sure that the veneer can be bonded definitively in place later. The amount of enamel removed is tiny and will be the same as the thickness of the veneer to be fitted, so that the tooth stays the same size. A local anesthetic (injection) may be used to make sure that there is no discomfort, but often this is not necessary.
Once the tooth has been prepared, the dentist will take an ‘impression’. This will be given to the dental technician, along with any other information needed to make the veneer. The colour of the surrounding teeth is matched on the shade guide to make sure that the veneer will look entirely natural.
How long will it take?
A veneer take at least two visits; the first to prepare the tooth and to match the shade, and the second to fit it. Before bonding it in place, your dentist will show you the veneer on your tooth to make sure you are happy with it. Bonding a veneer in place is done with a special adhesive, which holds it firmly on the tooth.
Will I need a temporary veneer between visits?
Because the preparation of the tooth is so slight you will probably not need a temporary veneer. The tooth will look very much the same after preparation, but will feel slightly less smooth.
What happens after the veneer is fitted?
Only minor adjustments can be made to the veneer after it is fitted. It is usually best to wait a little while to get used to it before any changes are made. Your dentist will probably want to check and polish it a week or so after it is fitted, and to make sure that you are happy with it.
