Fixed restorations
Crowns and Bridges
Fixed restorations that cover a damaged tooth or span a gap, cemented in place rather than taken in and out.
The difference between them
A crown covers a single tooth completely, like a cap over what is left of it. It is used where too much tooth structure has gone for a filling to be reliable: after a large cavity, a fracture, or a root canal that has hollowed out the centre of the tooth. The crown takes the chewing load and holds the remaining tooth together.
A bridge replaces a missing tooth by joining to the teeth on either side. Those neighbouring teeth are prepared in the same way as for a crown and carry the replacement tooth between them. Because it is cemented, a bridge is not removed for cleaning, which is convenient but means cleaning underneath the replacement tooth has to be done in place with floss threaders or interdental brushes.
At the appointment
The tooth or teeth are numbed and reduced in shape so there is room for the thickness of the restoration. An impression or a digital scan records the prepared shape and how the jaws meet. Shade is chosen against the neighbouring teeth, which is best done in good light and before the teeth dry out, since teeth lighten as they dry.
A temporary crown or bridge is fitted to protect the prepared teeth while the permanent one is made. At the fitting appointment the temporary comes off, the permanent restoration is tried in, the fit, the contact with the neighbouring teeth and the bite are checked, and then it is cemented. Timelines vary depending on how the restoration is made and what it is made from.
Visits, Recovery and When to Call
Visits and timing
Commonly two appointments, one to prepare and one to fit, with laboratory time between them. Longer bridges and cases where the bite is being changed can take more visits, and a tooth needing a root canal first adds that treatment in front.
Afterwards
The prepared tooth can be sensitive while it has a temporary on it. Avoid hard and sticky food on that side so the temporary is not pulled off. After cementation the bite is checked, but chewing at home is a better test than tapping in the chair, so report anything that feels high.
Call sooner if
A temporary comes off, the bite feels uneven after a few days, there is a persistent ache or throbbing in the tooth under a new crown, or the gum around the margin stays sore. A crowned tooth can still develop decay at the edge and can still need a root canal later.
How long they last
Crowns and bridges are not permanent in the way people hope. They fail at the margin, where the restoration meets the tooth, usually from decay or from the cement washing out over years. That is one of the things a routine examination is checking. Grinding at night shortens the life of any fixed restoration considerably, so if you grind, ask about it while the crown is being planned rather than after it cracks.
Keep reading
Questions About Crowns and Bridges?
Describe the problem on the phone. That conversation is usually enough to work out the first appointment. Mandarin, Taiwanese, English and Japanese are spoken.