Crowns, Bridges, Dentures
If you want a smile that's your crowning glory, you may need a crown to cover a tooth and restore it to its normal shape and size. A crown can make your tooth stronger and improve its appearance.
It can cover and support a tooth with a large filling when there isn't enough tooth left. It can be used to attach a bridge, protect a weak tooth from breaking or restore one that's already broken. A crown is a good way to cover teeth that are discolored or badly shaped. It's also used to cover a dental implant.
If your dentist recommends a crown, it's probably to correct one of these conditions. Your dentist's primary concern, like yours, is helping you keep your teeth healthy and your smile bright - literally, your crowning glory.
Crowns and bridges can be made of different restorative materials, with all their advantages and disadvantages.
INDIRECT RESTORATIVE MATERIALS
Sometimes the best dental treatment for a tooth is to use a restoration that is made in a laboratory from a mold. These custom-made restorations, which require two or more visits, can be crowns, inlays or onlays. A crown covers the entire chewing surface and sides of the tooth. An inlay is smaller and fits within the contours of the tooth. An onlay is similar to an inlay, but it is larger and covers some or all chewing surfaces of the tooth. The cost of indirect restorations is generally higher due to the number and length of visits required, and the additional cost of having the restoration made in a dental laboratory. Materials used to fabricate these restorations are porcelain (ceramic), porcelain fused to metal, gold alloys and base metal alloys.
All-Porcelain (Ceramic) Dental Materials
All-porcelain (ceramic) dental materials include porcelain, ceramic or glasslike fillings and crowns. They are used as inlays, onlays, crowns and aesthetic veneers. A veneer is a very thin shell of porcelain that can replace or cover part of the enamel of the tooth. All-porcelain (ceramic) restorations are particularly desirable because their color and translucency mimic natural tooth enamel.
All-porcelain restorations require a minimum of two visits and possibly more. The restorations are prone to fracture when placed under tension or on impact. Their strength depends on an adequate thickness of porcelain and the ability to be bonded to the underlying tooth. They are highly resistant to wear but the porcelain can quickly wear opposing teeth if the porcelain surface becomes rough.
Another type of restoration is porcelain-fused-to-metal, which is used to provide strength to a crown or bridge. These restorations are very strong and durable.
The combination of porcelain and metal creates a stronger restoration than porcelain used alone. More of the existing tooth must be removed to accommodate the restoration. Although they are highly resistant to wear, porcelain restorations can wear opposing natural teeth if the porcelain becomes rough. There may be some initial discomfort to hot and cold. While porcelain-fused-to-metal restorations are highly biocompatible, some patients may show an allergic sensitivity to some types of metals used in the restoration.
Gold alloys contain gold, copper and other metals that result in a strong, effective filling, crown or a bridge. They are primarily used for inlays, onlays, crowns and fixed bridges. They are highly resistant to corrosion and tarnishing.
Gold alloys exhibit high strength and toughness that resists fracture and wear. This allows the dentist to remove the least amount of healthy tooth structure when preparing the tooth for the restoration. Gold alloys are also gentle to opposing teeth and are well tolerated by patients. However, their metal colors do not mimic natural teeth.
Base metal alloys
Base metal alloys are non-noble metals with a silver appearance. They are used in crowns, fixed bridges and partial dentures. They are highly resistant to corrosion and tarnishing. They also have high strength and toughness and are very resistant to fracture and wear. Some patients may show allergic sensitivity to base metals and there may be some initial discomfort from hot and cold. The metal color does not mimic natural teeth.
Crowns, inlays and onlays can be made in the laboratory from dental composites. These materials are similar to those used in direct fillings and are tooth colored. One advantage to indirect composites is that they do not excessively wear opposing teeth. Their strength and durability is not as high as porcelain or metal restorations and they are more prone to wear and discoloration.
If you're missing one or more teeth, you may notice a difference in chewing and speaking. There are options to help restore your smile. Bridges help maintain the shape of your face, as well as alleviating the stress in your bite by replacing missing teeth.
Sometimes called a fixed partial denture, a bridge replaces missing teeth with artificial teeth, looks great, and literally bridges the gap where one or more teeth may have been. The restoration can be made from gold, alloys, porcelain or a combination of these materials and is bonded onto surrounding teeth for support. Unlike a removable bridge, which you can take out and clean, a fixed bridge can only be removed by a dentist.
An implant bridge attaches artificial teeth directly to the jaw or under the gum tissue. Depending on which type of bridge your dentist recommends, its success depends on its foundation. So it's very important to keep your remaining teeth healthy and strong.
GETTING YOUR SMILE BACK
Dentures have been around for a very long time. Many people have heard the stories about George Washington's dentures. Today's, dentures are of better quality and are more comfortable than ever before.
An important step in maintaining a healthy smile is to replace missing teeth. When teeth are missing, the remaining ones can change position, drifting into the surrounding space. Teeth that are out of position can damage tissues in the mouth. In addition, it may be difficult to clean thoroughly between crooked teeth. As a result, you run the risk of tooth decay and periodontal (gum) disease, which can lead to the loss of additional teeth.
Replacing missing teeth is important for maintaining good health and appearance. A full denture is a prosthetic appliance that replaces all the natural teeth. People who have no teeth usually show the effects of age more then people who have healthy natural teeth. A denture also has benefits with the way a person can eat and speak. A full denture support the the facial muscles and gives a natural appearance and smile.
A full or Complete Denture is a removable appliance that replace all the natural teeth.
A Partial Denture is a removable appliance that fills the spaces that happen when teeth are lost.
A full denture can be immediate. The denture is constructed before the teeth are removed, the teeth are removed and the denture is immediately placed in the mouth. The advantage is that a person is never without teeth during the healing period. An Immediate Denture will always require a reline because the tissues of the mouth will change as healing occurs.
An Overdenture uses roots if they have adequate bone, or implants that hold the denture in place in the mouth with the help of special attachments. This holds the denture firmly in place.
A good and exam and x-rays are essential when constructing a denture. There are many steps and try ins that are necessary for a denture to fit and function correctly and have a natural appearance. It is essential to record proper jaw relationships and make accurate copies of the mouth.
New dentures are seldom without problems. There is an adjustment period to learn how to chew and use them correctly. New Dentures will usually develop sore spots and the dentist will need to adjust the denture until if is comfortable. Like with anything new dentures will require a learning period. You will need to learn how to use the muscles of your mouth and tongue to hold the lower denture in place.
It is best not to leave the dental office and plan on a steak dinner. Start slowly with softer foods that are easier to chew. It may also take some time to learn how to speak correctly.
Because a denture is made out of plastic it can break if dropped. Your denture should be cleaned on a daily basis. In the case of a partial denture, It should be removed before brushing your teeth and cleaned before placing it back into your mouth. When the denture is not in your mouth it should be soaked so that it will not dry out and warp.
It is usually recommended to remove a denture at night to let the tissues of the mouth rest and breath. Many patients do sleep with their teeth for "social" reasons. Like anything else, a denture will wear out over time. Rebasing and relining a denture can extend it's life. Eventually depending on various factors the teeth will wear out and the entire denture will need to be replaced.
MYTHS ABOUT DENTURES
There are many common myths and misconceptions regarding dentures that are accepted as fact. As with any other myth it is important to set the matter straight.
FICTION: "Dentures last forever!"
FACT: Dentures are long lasting but like anything man made do wear out. They are made from plastic and dropping them can cause them to break. Depending on the individual the teeth wear out and the mouth changes.
FICTION: "Once you have dentures, you don't need to see a dentist anymore."
FACT: The mouth changes constantly. Dentures that become looose and do not fit as well as they should will require a reline. People with dentures can still develop oral cancer and should be examined regularly by a dentist. If your dentures become loose you may need to see the dentist for a reline.
FICTION:"Everyone can tell when you're wearing dentures."
FACT: Well fitting dentures made with meticulos care and attention to detail are difficult to recognize as dentures. They should provide a natural appearance and function well. You should be able to eat and speak normally. Dentures that fit well should not require adhesives to hold them in place.
THE COMPLETE DENTURE EXAM
The successful Denture starts with a Complete Denture Examination. It is important to determine if a person actually needs a denture and whether an overdenture is indicated. Because of advances in Dentistry it is often possible to return the mouth to health without the construction of a denture. It is always the best choice to KEEP your teeth or at least some of them. A successful denture can be made but is always a compromise.
As with a patient that has teeth, It is important that a proper exam be performed before a denture is constructed on someone who has worn a denture for many years. It is important to check for changes in the mouth and to determine if the dental arches can be enhanced by ridge enhancement surgery, before the new denture is constructed. If any pathology is present, it is important not to construct a new denture over active disease.
A complete clinical examination of the mouth is used to determine the condition of the soft tissues and the size and shape of the dental arches. The relationship of the upper and lower jaws can also be determined. A panoramic or intraoral x-ray will show all the bony areas, and along with a clinical exam can uncover any hidden problems and allow for a proper diagnosis. Some of the things we look for in a denture exam are:
- Retained tooth roots
- Hard and soft tissue lesions
- Hyperplastic (loose tissue)
- Size of the ridges
- Jaw relationship
- Oral Cancer
If only a few roots can be saved, an Overdenture, which is a denture which attaches to a couple of roots anchored in the jaw can be constructed. For patients wanting to maintain some teeth while a denture is constructed an Immediate Denture can be constructed. Implants may be placed in the jaw to anchor a denture when a patient is unable to wear a denture successfully.
This is what your mouth would look like if you lose all your lower teeth. It is always the best choice to KEEP your teeth or at least some of them. As you can see there is nothing to hold a lower denture down while you chew.
A successful denture can be made but is always a compromise. As with other types of dentistry, if proper time, care, skill and judgement are exercised, a denture that functions well and looks natural, can be constructed. As with a patient that has teeth, It is important that a Denture Exam be performed before a denture is constructed.
Dentures need to be checked regularly by the dentist because the mouth changes and the denture may not fit as well as it should and may require a reline. Unfortunately there are many "Myths about Dentures", many of these common misconceptions about dentures have prevented people from achieving their best health, appearance and self-confidence. Patients often have many questions about how dentures are made and how they should be worn. It is important for a person receiving a new denture to go through a period of adjustment.
An immediate denture is constructed before teeth are removed so that you will not be without any teeth. Constructing immediate dentures involves taking impressions (making copies) of your mouth before the teeth are removed. When your remaining teeth are removed the denture can be inserted immediately.
Because the denture is placed over the new extraction sites it will actually prevent swelling. The denture should not be removed for 24 hours and only by the dentist the day after you receive your new denture.
Post operative visits will be required to check the extraction sites and make required adjustments to the dentures. Because the mouth will change after it heals, your dentures will need to be evaluated at 3 month intervals and will need to relined to fit the changes that have occurred in your mouth.
An Overdenture is a denture that uses precision dental attachments to hold the denture down. The overdenture attachment can be placed in tooth roots that have been saved, or placed into dental implants which have been placed to receive them.
A removable partial denture fills in the space created by missing teeth and fills out your smile. A denture helps you to properly chew food, a difficult task when you are missing teeth. In addition, a denture may improve speech and prevent a sagging face by providing support for lips and cheeks. A partial denture is a removable dental appliance that replaces multiple missing teeth. It can be attached to the teeth with clasps (clasp or conventional partial) or it can be attached to the teeth with crowns with precision attachments (hidden clasps). Both types have a metal framework and plastic teeth and gum areas.
Precision attachments or claps?
Your decision means more than a pretty smile.
FAQ ABOUT REMOVABLE DENTURES
How do you wear a removable partial denture?
Removable partial dentures usually consist of replacement teeth attached to pink or gum-colored plastic bases, which are connected by metal framework. Removable partial dentures attach to your natural teeth with metal clasps or devices called precision attachments. Precision attachments are generally more esthetic than metal clasps and they are nearly invisible. Crowns on your natural teeth may improve the fit of a removable partial denture and they are usually required with attachments. Dentures with precision attachments generally cost more than those with metal clasps. Consult with your dentist to find out which type is right for you.
How long will it take to get used to wearing a partial denture?
For the first few weeks, your new partial denture may feel awkward or bulky. However, your mouth will eventually become accustomed to wearing it. Inserting and removing the denture will require some practice. Follow all instructions given by your dentist. Your denture should fit into place with relative ease. Never force the partial denture into position by biting down. This could bend or break the clasps.
How long should I wear the partial denture?
We will give you specific instruction about how long the partial denture should be worn and when it should be removed. Initially, you may be asked to wear your partial denture all the time. Although this may be temporarily uncomfortable, it is the quickest way to identify those denture parts that may need adjustment. If the denture puts too much pressure on a particular area, that spot will become sore. Your dentist will adjust the denture to fit more comfortably. After making adjustments, your dentist will probably recommend that you take the denture out of your mouth before going to bed and replace it in the morning.
Will it be difficult to eat with a partial denture?
Replacing missing teeth should make eating a more pleasant experience. Start out by eating soft foods that are cut into small pieces. Chew on both sides of the mouth to keep even pressure on the denture. Avoid foods that are extremely sticky or hard. You may want to avoid chewing gum while you adjust to the denture.
Will the partial denture change how I speak?
It can be difficult to speak clearly when you are missing teeth. Consequently, wearing a partial denture may help. If you find it difficult to pronounce certain words with your new denture, practice reading out loud. Repeat the words that give you trouble. With time, you will become accustomed to speaking properly with your denture.
How do I take care of my partial denture?
Handling a partial denture requires care. It's a good idea to stand over a folded towel or a sink of water just in case you accidentally drop the denture. Brush the denture each day to remove food deposits and plaque. Brushing your denture helps prevent the appliance from becoming permanently stained. It's best to use a brush that is designed for cleaning dentures. A denture brush has bristles that are arranged to fit the shape of the denture. A regular, soft-bristled toothbrush is also acceptable. Avoid using a brush with hard bristles, which can damage the denture. Some people use hand soap or mild dishwashing liquid to clean their dentures, which are both acceptable. Other types of household cleaners and many toothpastes are too abrasive and should not be used for cleaning dentures.
Clean your dentures by thoroughly rinsing off loose food particles. Moisten the brush and apply the denture cleaner. Brush all denture surfaces gently to avoid damaging the plastic or bending the attachments. A denture could lose its proper shape if it is not kept moist. At night, the denture should be placed in soaking solution or water. However, if the appliance has metal attachments, they could be tarnished if placed in soaking solution. Your dentist can recommend the proper method for keeping your dentures in good shape.
Will my partial denture need adjusting?
Over time, adjusting the partial denture may be necessary. As you age, your mouth naturally changes, which can affect the fit of the denture. Your bone and gum ridges can recede or shrink, resulting in a loose-fitting denture. Partial Dentures that do not fit properly should be adjusted by your dentist. Loose partialdentures can cause various problems, including sores or infections. See your dentist promptly if your denture becomes loose.
Can I make minor adjustments or repairs to my partial denture?
You can do serious harm to your partial denture and to your health by trying to adjust or repair your denture. A denture that is not made to fit precisely by a dentist can cause irritation and sores. Using a do-it-yourself kit can damage the appliance beyond repair. Glues sold over-the-counter often contain harmful chemicals and should not be used on a denture.
If your denture no longer fits properly, if it breaks, cracks or chips, or if one of the teeth becomes loose, see your dentist immediately. In many cases, dentists can make necessary adjustments or repairs, often on the same day. Complicated repairs may require that the denture be sent to a special dental laboratory.
Must I do anything special to take care of my mouth?
Brushing twice a day and cleaning between your teeth daily help prevent tooth decay and gum disease that can lead to tooth loss. Pay special attention to cleaning teeth that fit under the denture's metal clasps. Plaque that becomes trapped under the clasps will increase the risk of tooth decay. We will demonstrate how to properly brush and clean between teeth. Selecting a balanced diet for proper nutrition is also important.