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Crowns and Bridges

Crowns
   
When larger fillings no longer serve their original purpose, it is a good idea to construct a crown. A crown will cover and protect a damaged tooth. Fillings may develop broken edges which will no longer properly seal the tooth. If the filling is small enough, a new filling can be used. But if the tooth has a large filling and there is not very much of the original tooth material to attach the filling to, a crown may be a better solution.
   
Dental crowns fit over your natural teeth after they have been shaped to accept the crown. You may need a crown to protect you tooth because of any of the following causes;

  •     Worn Fillings
  •     Cracked Tooth
  •     Failing Crown
  •     Large Cavity
  •     After Root Canal

Procedure
   
It takes two appointments to restore your tooth with a crown. This is because the crown must be custom hand-crafted in a dental laboratory to precisely fit your tooth and bite. These are the steps necessary to produce your new crown:

  •     Your tooth is numbed with topical and local anesthetic.
  •     Any decay is removed.
  •     The tooth is shaped with a handpiece.
  •     We take a precise impression of your teeth.
  •     You will be fitted with a temporary crown while the dental laboratory crafts your permanent crown. This usually takes one to two weeks.
  •     On your next visit to the dentist, your temporary crown is removed and your new permanent crown is fitted.
  •     When you and the dentist are satisfied with the fit and bite, the crown is permanently cemented in place.

Bridges
   
A bridge is a replacement for a missing tooth that is anchored in place by the adjacent teeth. A bridge can avert the chain-reaction of dental problems that can occur when a tooth is lost. These can include;

   




  • The tooth opposing the missing tooth can start to extrude from its socket.
  • The missing tooth can cause chewing problems.
  • Problems can develop with the TMJ.
  • It is much harder to clean the teeth that have shifted, and this may cause further tooth loss through the advancement of periodontal disease.

Procedure
   
It takes two appointments to restore your mouth with a bridge. This is because the bridge must be custom hand-crafted in a dental laboratory to precisely fit your bite and teeth.

  •     Your tooth is numbed with a topical or local anesthetic.
  •     Any decay is removed.
  •     The teeth are shaped with a handpiece.
  •     We take a precise impression of your teeth.
  •     You will be fitted with a temporary bridge while the dental laboratory crafts your permanent bridge. This usually takes two weeks.
  •     On your next visit to the dentist, your temporary bridge is removed and your new permanent bridge is fitted.
  •     When you and the dentist are satisfied with the fit and bite, the bridge is permanently cemented in place.

Dentures

Dentures are artificial replacements for your natural teeth. If disease or lack of dental care has left you with few healthy teeth or none at all, your dentist might suggest dentures to replace your missing teeth. Dentures will restore your smile and return some of the chewing power you once had.
   
Unlike permanent bridges, which can be supported by teeth or dental implants, dentures are removable. Dentures can replace all of your teeth, or they can just replace a few missing ones. Complete dentures are usually made of an acrylic resin, while partial dentures are made from a combination of acrylic resin and metal.

Who needs dentures?
   
Contrary to popular belief, dentures aren't inevitable as you age. If you brush and floss daily and see your dentist regularly, you should be able to keep your natural teeth for as long as you live. If you don't take good care of your teeth, tooth decay (dental caries) and gum disease (periodontitis) may necessitate that you have your teeth removed. Despite your best efforts to keep your teeth clean, some diseases and conditions can make you more prone to tooth problems, including:
   
Dry mouth (xerostomia) - Saliva cleans, disinfects and re-mineralizes your teeth. Cancer treatments, diseases such as Sjogren's syndrome, some medications and menopause can all cause dry mouth.
   
Diabetes - Diabetes, especially if it's poorly controlled, weakens your gums' resistance to infection.
   
Problems with self-care - Diseases that make it more difficult for you to care for yourself, such as Alzheimer's, and diseases that cause limited movement, such as arthritis, can make it harder to keep up with daily dental care.
   
Certain medications can put you at risk of gum disease because they can cause overgrowth and inflammation of your gums (gingival hyperplasia). Examples include:

  •     Phenytoin (Dilantin), an epilepsy drug
  •     Cyclosporine (Sandimmune, Neoral), a drug given after an organ transplant
  •     Calcium channel blockers used to treat heart disease or high blood pressure

    If you take any of these medications, talk to your dentist about ways you can keep your teeth and mouth healthy while continuing your medications.


Types of dentures
   
The type of denture your dentist prescribes is based on how many remaining natural teeth you have and your individual needs. Your dentist might recommend:
   
Complete dentures - These dentures cover your entire jaw and can be used in place of your upper teeth, lower teeth or both. Complete dentures consist of artificial teeth and gums. They rest directly on your gums and are used if you have no remaining natural teeth.
   
Partial dentures - These dentures fit around your remaining, healthy teeth. Partial dentures usually have artificial teeth and gum, connected by a metal framework. They're usually held in place by clasps that attach to your natural teeth.
   
Overdentures - These dentures fit over your few remaining teeth or dental implants. Your teeth or implants give the denture stability, so it's less likely to shift in your mouth. And keeping some of your natural teeth or having implants helps preserve your jawbone. To fit an overdenture, your natural teeth usually need to be reshaped to fit in the denture.

How dentures are fitted to your mouth

   
How your dentures are made for your mouth depends on whether you get your dentures as soon as your teeth are removed or later, after your gums have healed.

Immediate dentures
   
Immediate dentures are those that are inserted the same day you have your teeth removed. Your dentist will see you for a series of appointments before your teeth are removed in order to make molds of your jaws. Your teeth are then removed and your denture is inserted. Since your gums and your jawbone will shrink after your teeth are removed, your denture will need to be adjusted or replaced later.
   
You might consider an immediate denture if you're having the front teeth in your upper jaw removed. Having a denture right away can reduce some of the embarrassment you might feel about not having front teeth.
   
An immediate denture might not be possible if your diseased teeth can't withstand the process of making a mold (impression) of your teeth. In this case you'd need a conventional denture.

Conventional dentures
   
Conventional dentures are usually fitted after your teeth have been extracted and your gums have healed - usually about two months after tooth removal. Your dentist makes impressions of your mouth after removing your teeth so that the dentures will fit your gums. Because your diseased teeth have been removed, you can have trial fittings with your new dentures as your dentist works to make them fit just right.
   
Choosing conventional dentures means you'll be without teeth for a month or two while your gums and jawbone heal and your dentures are being made. This might make it difficult to eat, and it might make you self-conscious about your appearance. Conventional dentures, however, usually fit better in the long run.