The Ultimate Guide to Crowns and Bridges: Everything You Need to Know
Are you considering getting dental crowns or bridges? These restorative dental treatments can offer many benefits for people who want to improve their smile’s function and appearance. But before going ahead with these procedures, it’s important to understand what they are, how they work, and what to expect.
In this comprehensive guide, we’ll cover everything you need to know about dental crowns and bridges, including their purpose, types, materials, preparation, and aftercare. We’ll also discuss the benefits and risks of these treatments, as well as their cost and insurance coverage. Whether you’re new to the world of dental restorations or looking to refresh your knowledge, this guide has something for you.
What are dental crowns and bridges?
Dental crowns and bridges are dental restorations that are used to repair damaged, weakened, or missing teeth. Both crowns and bridges are fixed, meaning they are cemented onto existing teeth or implants and cannot be removed.
A dental crown is a cap that fully encases a tooth that has been severely damaged or weakened by decay, trauma, or root canal treatment. The crown protects the tooth from further damage and restores its shape, size, and function. Crowns can also be used to improve the appearance of teeth that are discolored, misshapen, or otherwise unappealing.
A dental bridge is a prosthetic device that is used to replace one or more missing teeth. The bridge consists of two or more dental crowns that are attached to the remaining teeth on either side of the gap, with an artificial tooth or teeth (pontic) in between. The bridge fills the space left by the missing teeth, restores the bite, and prevents the remaining teeth from shifting or tilting.
Types of dental crowns and bridges
There are several types of dental crowns and bridges, each with its own advantages, disadvantages, and suitability for different cases. The main types of crowns and bridges are:
Porcelain fused to metal (PFM) crowns: PFM crowns are the most common type of crowns used today. They consist of a metal substructure that is covered with a layer of tooth-colored porcelain. These crowns offer good strength and durability, but their metal base can sometimes show through the porcelain and cause a dark line at the gum line.
All-ceramic crowns: All-ceramic crowns are made entirely of dental ceramics, such as zirconia or lithium disilicate. These crowns offer superior esthetics and translucency, and their color can be customized to match the natural teeth. However, they are less strong than PFM crowns and can chip or fracture under heavy biting forces.
Gold crowns: Gold crowns are made of a gold alloy and offer excellent strength and biocompatibility. They are less esthetic than other types of crowns but are often used for molars or back teeth that require extra durability and chewing power.
Cantilever bridges: Cantilever bridges are used when there are teeth on only one side of the missing tooth or teeth. The bridge is anchored to one or more adjacent teeth on the same side, creating a “floating” pontic. Cantilever bridges are less stable than conventional bridges and can put more stress on the supporting teeth.
Maryland bridges: Maryland bridges, also called resin-bonded bridges, are similar to cantilever bridges but are more conservative and less invasive. They use a metal or porcelain “wing” that is bonded to the back of the adjacent teeth instead of crowns. Maryland bridges are ideal for replacing front teeth or for people who want to preserve as much natural tooth structure as possible.
Materials used in dental crowns and bridges
The choice of materials for dental crowns and bridges depends on several factors, such as the location, function, and esthetic requirements of the affected teeth, as well as the patient’s budget and preferences. Here are some of the most common materials used in crowns and bridges:
Metal alloys: Metal alloys, such as gold, palladium, and nickel-chromium, offer excellent strength, durability, and biocompatibility. They are ideal for molars or back teeth that require extra chewing power or for people with metal allergies. However, they are less esthetic than other materials and can cause dark lines around the gums in some cases.
Ceramics: Dental ceramics, such as porcelain, zirconia, and lithium disilicate, are favored for their esthetic properties, biocompatibility, and natural-looking translucency. They can be color-matched to the surrounding teeth and can be used for anterior or posterior restorations. However, they are more prone to chipping or cracking than metal, and their strength can vary depending on the type and thickness of the ceramic used.
Porcelain fused to metal: PFM crowns and bridges combine the strength of metal with the esthetics of porcelain. The metal substructure provides a strong and stable support for the porcelain layer, which can be color-matched to the natural teeth. However, the metal can sometimes show through the porcelain and cause a grayish appearance, and the porcelain layer can wear down over time, exposing the metal underneath.
Preparation for dental crowns and bridges
Getting dental crowns or bridges usually requires two or more appointments spread over several weeks. The first appointment involves preparing the affected teeth, taking impressions, and placing temporary restorations. Here’s what to expect during the preparation phase:
Examination: The dentist will examine the affected teeth, gums, and surrounding structures, and check for any signs of decay, infection, or other issues that may affect the treatment. They may also take x-rays or other diagnostic tests to assess the condition of the teeth and roots.
Tooth preparation: If a dental crown is required, the dentist will first numb the affected tooth and surrounding tissues with a local anesthetic. They will then remove any decayed or damaged parts of the tooth and shape it to accommodate the crown. The amount of tooth structure removed will depend on the extent of the damage and the type of crown used. If a dental bridge is required, the adjacent teeth will also be prepared to receive the abutment crowns.
Impressions: After the teeth have been prepared, the dentist will take an impression or mold of the affected teeth, along with the surrounding tissues and opposite arch. This impression will be sent to a dental laboratory, where the permanent restorations will be custom-fabricated. In some cases, the dentist may use digital scanning or CAD/CAM technology to create a digital impression and design the restorations “in-house.”
Temporary restorations: Before you leave the office, the dentist will place temporary crowns or bridges over the prepared teeth. These temporary restorations will protect the teeth, prevent sensitivity, and maintain the bite and esthetics while the permanent restorations are being made. Temporary restorations are usually made of acrylic or composite resin and are not as durable as the permanent ones. You will be advised to avoid sticky or hard foods and to brush and floss gently around the temporary restorations.
Aftercare for dental crowns and bridges
Taking care of your dental crowns and bridges is essential to their durability, longevity, and esthetics. Here are some tips to help you maintain your restorations:
Brush and floss regularly: Brush your teeth at least twice a day with fluoride toothpaste and floss daily to remove plaque and bacteria from around the restorations. Use an interdental brush or water flosser to clean between the teeth and bridges. Avoid using abrasive or whitening toothpaste, as they can scratch or dull the porcelain surface.
Avoid hard and sticky foods: Chewing on hard foods, such as ice, popcorn kernels, or hard candy, can cause the porcelain or metal to chip or crack. Sticky or gummy foods, such as caramel or taffy, can dislodge the temporary restorations or pull off the permanent ones. Try to stick to softer foods or cut them into small pieces.
Avoid chewing on non-food objects: Some people have a habit of biting on pencils, pens, or fingernails, which can damage the teeth and restorations. Avoid using your teeth as tools or biting on non-food objects, and wear a mouthguard if you play contact sports or grind your teeth at night.
Avoid tobacco and alcohol: Smoking or using tobacco products can stain the teeth and increase the risk of gum disease, which can weaken the supporting structures of the teeth and bridges. Alcohol can also dry out the mouth and increase the acidity level, which can erode the enamel and cause decay.
Benefits of dental crowns and bridges
Dental crowns and bridges offer many benefits for people who have damaged, weakened, or missing teeth, including:
Restoration of function: Crowns and bridges can restore the bite force, chewing ability, and speech clarity of affected teeth, thus improving the overall quality of life. They can also prevent further damage or decay from occurring.
Improved esthetics: Crowns and bridges can improve the color, shape, size, and alignment of affected teeth, making them look more attractive and natural. They can also correct gaps, cracks, or other cosmetic issues.
Preservation of natural tooth structure: Crowns and bridges can preserve and strengthen the existing tooth structure, instead of requiring extraction or implantation. This can save time, money, and discomfort in the long run.
Longevity: Crowns and bridges can last for many years, with proper care and maintenance. Some types of crowns, such as gold, can last a lifetime.
Risks of dental crowns and bridges
While dental crowns and bridges are generally safe and effective, they do carry some risks and limitations, such as:
Sensitivity: After getting a crown or bridge, some people may experience sensitivity to hot or cold temperatures, especially if the tooth was severely damaged or the nerve was exposed. This sensitivity usually subsides within a few days or weeks, but in some cases, it may persist.
Discomfort: Some people may experience mild discomfort or soreness around the prepared teeth or gums, especially after the anesthesia wears off. This discomfort can usually be managed with over-the-counter pain relievers or a cold compress.
Allergic reactions: People who are allergic to certain metals or dental materials may experience an allergic reaction to the crowns or bridges. This can cause swelling, redness, itching, or other symptoms and may require removal of the restoration.
Fracture or dislodgement: Crowns and bridges can fracture, chip, or dislodge if subjected to excessive forces or trauma, such as biting on hard objects or receiving a blow to the face. If this happens, the restoration may need to be repaired or replaced.
Cost of dental crowns and bridges
The cost of dental crowns and bridges can vary depending on several factors, such as the type, material, size, location, and complexity of the restoration, as well as the dentist’s experience and location. Here are some average costs for different types of crowns and bridges:
Porcelain fused to metal crown: $800-$1,500 per tooth
All-ceramic crown: $1,000-$3,000 per tooth
Gold crown: $1,000-$1,500 per tooth
Cantilever bridge: $2,000-$5,000 per unit
Maryland bridge: $1,500-$2,500 per unit
It’s important to note that dental insurance may partially or fully cover the cost of certain types of crowns and bridges, depending on the plan and the reason for the restoration. Some insurance plans may also have waiting periods, deductibles, or annual caps on benefits.
Frequently asked questions about dental crowns and bridges
Q: How long do dental crowns and bridges last?
A: Dental crowns and bridges can last for many years, with proper care and maintenance. The lifespan of a crown or bridge depends on several factors, such as the type, material, location, and oral hygiene of the patient. On average, a dental crown can last 10-15 years or more, while a dental bridge can last 5-15 years or more.
Q: How long does it take to get a dental crown or bridge?
A: Getting a dental crown or bridge usually requires two or more appointments spread over several weeks. The first appointment involves preparing the teeth, taking impressions, and placing temporary restorations. The second or subsequent appointments involve delivering and adjusting the permanent restorations, which are custom-fabricated by a dental laboratory. The exact timeline may vary depending on the complexity of the case and the availability of the laboratory.
Q: Is getting a dental crown or bridge painful?
A: Getting a dental crown or bridge should not be painful, as the affected area will be numbed with a local anesthetic. However, some people may experience mild discomfort or soreness, especially after the anesthesia wears off. This discomfort can usually be managed with over-the-counter pain relievers or a cold compress.
Q: Can I eat normally with dental crowns or bridges?
A: After getting dental crowns or bridges, you should avoid hard or sticky foods for a few days or until the temporary restorations are replaced with the permanent ones. Once the permanent restorations are in place, you should be able to eat normally, although you should still avoid biting on hard objects or chewing on non-food items.
Q: Can dental crowns or bridges be removed?
A: Dental crowns and bridges are fixed restorations, meaning they are cemented onto existing teeth or implants and cannot be easily removed. However, if a crown or bridge becomes loose, damaged, or infected, the dentist may need to remove it and replace it with a new one. This process may require additional tooth preparation or implant placement, depending on the case.
Dental crowns and bridges are valuable tools for restoring damaged or missing teeth, improving esthetics and function, and preserving natural tooth structure. However, getting these restorations requires careful preparation, attention to aftercare, and consideration of the types and materials available. By reading this guide, you should have a better understanding of what dental crowns and bridges involve, how they work, and what to expect. If you’re considering getting a dental crown or bridge, consult with your dentist to see which option is best for your needs and goals.