Framingham Cosmetic Dentistry - RESTORATIVE DENTISTRY: WHY CROWN & BRIDGE PRE-OPERATIVE INSTRUCTIONS & INFORMATION

Indications

Crown - When a tooth is heavily filled, have marginal break down, decay, or fracture, and there is substantial loss of tooth structure (inadequate tooth structure is life), then the filling is failing and the tooth is very prone to fracture and nerve damage. Therefore, the best treatment with a better longevity is: build-up (replacing of the decayed/lost tooth structure) followed with a coronal coverage in order for the biting pressure to get distributed evenly over the whole tooth.

Bridge - It is one of the treatment options for replacing a missing tooth. A bridge can restore function (another tooth to use) as your food needs to be fully chewed b fore swallowing and no extra work is left for your stomach. It also stops the opposing upper tooth from coming down beyond its plane and consequently causing changes on your bite, and provides cosmetic so that you are able to talk/smile without worrying about showing hole/s in your mouth. Moreover, it stops the neighboring teeth to bend downward which will cause gaps and food catching between your teeth, collapse of the bite, and premature facial wrinkles.

Learn More About Crowns and Bridges
	Crowns
	Crown Aesthetics
	Crown Types
	Crown Procedures
	Metal Crown
	Post and Crown
	Temporary Crown
	Bridges
	Fixed Bridge
	Video Library

Common Question & Answers:

Q - The last filling lasted over 20 years! Can’t you just fill it?

A - A simple filling on a very compromised and weak tooth is not strong enough and is just like placing a band-aid on a broken arm. The problem is not the filling. The problem is the tooth and replacing the filling does not fix the tooth. A tooth may be under a few hundred pounds of pressure when used for chewing (more so if the patient is a grinder/clencher), so either a filling, if placed, will fall off or the tooth itself will fracture which may cost the lost of the tooth itself.

Q - It is not broken, has no decay, feels fine and does not hurt! Why do anything?

A - Whether or not you experience any pain, your teeth is literally infused and needs to have a crown, a protective restoration, to protect biting surface, make the tooth as strong as possible, and avoid many future potential risks and consequences. When a tooth is broken. Just because a piece has not fallen yet does not mean it is not full of cracks. Just because there is no pain does not mean the nerve is healthy or going to stay healthy. If it breaks it is going to be worse and may need root canal of gum surgery, and the remaining tooth is permanently weakened and eventually lost, or has to be extracted.

Potential Risks & Consequences

A crown is like a cast that protects a broken bone, but unlike a broken bone, the crack and weakness in the tooth will never heal. Teeth with fillings flex more. Biting stresses force tooth apart and cause fractures (on the crown and or/root) and eventually part of the tooth breaks which may cause nerve injury or tooth loss. A crown is the best attempt (optimal treatment) to make a tooth a strong as possible, to prevent future damage. Yet, whether or not the tooth has caused Andy previous discomfort, the tooth and its never might have been damaged by years of work/usage (wear and tear), cracks and fractures, decays and cavities, which cannot be ignored and may not be repaired by a crown alone, a conservative and optimistic treatment. When a crown is placed after a tooth is badly damaged or severely compromised, the tooth may have a poor prognosis (no certain/predictable ideal outcome). This means the nerve may start to cause sensitivity or pain, even right after the crown is placed. This is unavoidable and unpredictable. Additional procedures may need to be done, such as root canal therapy, at any time symptoms start to appear.

Procedure

The First visit is relatively lengthy during which the tooth is prepared (reduced) for a laboratory-made customized crown. Then, a cord is packed under the gum and around the tooth, and an impressions/molding of the tooth is taken. Your tooth will be covered with a temporary crown for about 2 weeks. Also, a proper color is selected for your crown. During the second visit, the proper fit, an even biting pressure, and the esthetics of the permanent crown/bridge is evaluated, prior to the final cementation.

Below are before and after shots of Bridge work and the resulting difference: