CROWNS AND BRIDGES


What are crowns and bridges?
Crowns are fixed prosthetics used to restore a damage tooth by covering the tooth completely to protect it from further damage as well as to improve its overall appearance.
Bridges are fixed prosthetics that consist of a group of interconnecting crowns used to replace one or more missing teeth by spanning the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space, called abutments, which serve as anchors for the bridge.


When are crowns necessary?

Crowns are necessary when there is a need to
  • Replace a large filling when there isn't enough tooth remaining
  • Protect a weak tooth from fracturing
  • Restore a fractured tooth
  • Attach a bridge
  • Cover a dental implant
  • Cover a discolored or poorly shaped tooth
  • Cover a tooth that has had root canal treatment
When are bridges necessary?
Bridges are necessary when
  • Missing teeth affects the aesthetic appearance of the person
  • The teeth begin to drift out of position due to missing teeth resulting in
      a change in the bite
      loss of additional teeth
     -  tooth decay
      gum disease
      migraine headaches


Who are the ideal candidates?
Crown
Candidates who have a tooth that is beyond repair with a filling, inlay or onlay

Bridge
Candidates who have a tooth missing
 

What are the different types of crowns and bridges?

  • Porcelain or ceramic crowns
  • Gold and metal alloys
  • Acrylic and ceramic
  • Porcelain bonded to a metal shell


What are the risks and complications associated with fixing of crowns and bridges?

  • Breakage of fixture
  • Exposure of the pulp (nerve) of the tooth during shaping of the tooth for a crown or bridge requiring a root canal treatment


What are the pre-treatment procedures?

  • During the initial consultation, a thorough discussion on the expectations of the patient is understood
  • The dental history, complete medical history and x rays are taken
  • A thorough oral examination and medical consultation is done by the dental team
  • Photographs are taken for further comparison after procedure.
  • The dentist discusses and advises on options of treatment, type of facilities, risks, anaesthesia, limitations and cost with the patient.
  • The patient may be given an antimicrobial mouth rinse, anti-inflammatory medication and/or antibiotics before the surgery.
  • The patient must inform the dentist if he/she has high blood pressure or knows that they have problems with epinephrine in local anaesthetics
  • The patient must arrange for transportation and assistance to leave for home after the surgery.


How is the procedure done?

Crowns and bridges require two appointments to complete the procedure
First appointment
  • The patient is administered local anaesthesia
  • The teeth to be crowned or to which the bridge is to be attached is reduced by removing 1-2 millimeters of the teeth structure in order to receive the crown or crown ends of the bridge.
  • Impressions are taken of the reduced tooth/teeth and a temporary crown or bridge is cemented in place.
  • The procedure takes 1 hour to complete
Second appointment
The impression is used to create a custom made crown or bridge which takes around 2-3 weeks
  • The temporary crown/ bridge is removed
  • The area is cleaned and the custom made crown/ bridge is cemented or bonded into place.
The procedure takes around 45 minutes to complete.


What are the post treatment symptoms and procedures?

Loosening of the temporary crown may occur in some cases. If so, the patient must place the crown back on the tooth immediately and call for an appointment to have the temporary crown refitted. Recovery is quick, with teeth feeling back to normal within a day or two. The teeth may be sensitive for a day or two and some pain may occur. Medication is prescribed for any such discomfort.


What are the recuperative guidelines to be followed?

  • The patient must contact the dentist if the teeth remain sensitive for even after two days and  there is pain that cannot be controlled by medication
  • The patient must brush, floss, and have regular visits to the dentist after a bridge has been placed in the mouth.
  • As the false tooth and the crown are a single, the patient will need to use a special flossing tool called a floss threader to go under the false tooth and keep this area of the gum healthy.
  • The patient must meet the dentist at the earliest if any damage is noticed to the structure of the crown or bridge in order to avoid further damage due to the weakened structure.
  • Crowns and bridges last 5 - 15 years when under proper care


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