Crowns are full coverage restorations that are used to cover a tooth that is likely to break or is too broken down to be restored with a filling. They are most commonly done after root canal treatment. Crowns ride over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a far more serious matter and much more difficult to treat. Crowns prevent this, as well as making for a nice smile.
It takes two appointments to restore a tooth with a crown. In the first appointment, any decay is removed from the tooth and it is shaped to accept the crown. Then an impression is made of the tooth for use in fabricating a crown. Between the two visits, the crown is made, usually of high-strength porcelain over gold alloy, all ceramic material, or gold. During this time a temporary crown is worn. In the second visit this temporary is removed then the permanent crown is adjusted as needed and then cemented in place.
Dentures / Partials
There are different types of dentures/partials. However, they share common functions. They replace teeth that have become loose or have been lost, due to bone loss and/or decay.
The entire mouth is examined and a determination is made as to which teeth will have to be removed, and which will remain. Partials are fitted to go over or around whatever teeth remain in the mouth. Dentures replace all teeth after they have been removed. There is an adjustment period after dentures/partials are placed. Once accustomed to the denture/partial, most normal functionality and appearance will return.
A dental implant is an option to replace a missing tooth. In this procedure, a small titanium shaft is surgically implanted into the bone and allowed to set. The bone grows around it forming a tight connection, which additionally slows or stops the bone loss that occurs when the root of a natural tooth is missing. Once the implant is firmly set in the mouth, the dentist then works to attach the replacement tooth onto the top of the shaft. This permanent solution has the advantages over bridge work that does not stress the surrounding teeth for support.
Often implants can be used to further stabilize dentures. Implants can also be used as support as part of an implant bridge. This is an alternative to partial dentures and has several advantages. First, there is no adjustment period to acclimatize the patient. Second, this slows the bone loss occasioned by missing teeth. Third, there is no discomfort or difficulty in eating.
Root Canal Treatment
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is left untreated. (Regular cleanings and checkups prevent and detect problems early) Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy. Once this occurs the pulp becomes infected, and can even extend through the root tip and begin to eat away at the surrounding bone (this is an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own. It can even weaken the entire immune system. This is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. Sometimes, however, no symptoms are apparent. This is why x-rays at routine dental check ups are strongly recommended.
Once the infection is removed, usually, a core build-up and crown is recommended for restoring a tooth that has had root canal therapy.
This is an option for filling a space created by a missing tooth. It is formed to look like the missing tooth. The sides of a bridge use the two surrounding teeth for support, hence the name. A bridge replaces the missing tooth, both functionally and cosmetically. Bridge work is as much an art as it is an exact science. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material. The choice of material depends on requirements for strength, wear, and/or esthetics.
It is important that a missing tooth is replaced as soon as possible for several reasons. If not treated the teeth surrounding the gap begin to shift inward. Teeth use their neighbors for support, and, with one missing, they start to “fall.” As this worsens the bite changes in response to the pressure. This can eventually result in problems with the entire jaw, e.g. TMJ. The surrounding teeth deteriorate and it is just a matter of time before they, too, are lost.
TMJ stands for temporal-mandibular joint. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in it’s where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Aside from the two bones that meet there, cartilage buffers them and five muscles are involved in the area.
Problems in this area can cause:
- Trouble/soreness in opening and closing the mouth
- Clicking or popping of the jaw
- Pain in the jaw muscles
- Soreness in the area, sometimes extending to the face
Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite, filling gaps between teeth, etc. There is no one solution that is right for all cases. Sometimes a plastic mouthpiece is used to prevent clenching or grinding that is contributing to the problem. If untreated and taken to extremes, surgery may be required to repair a badly damaged joint.