Who needs dental crowns?

For people with broken, cracked, decayed or irregular sized teeth, a dental crown can be a great treatment option. Crowns are essentially full tooth caps that are placed over the top of natural teeth after the natural teeth have been filed down and shaped into stumps. Crowns typically last for 15-25 years although they can last a lifetime with proper care and regular brushing.
Breaking a tooth can be an embarrassing problem which can also cause pain and difficulty chewing. The idea of a crown is to restore broken or damaged teeth so that they function properly and look as natural as possible. Crowns can be made for all types of teeth whether incisors, canines, molars or pre-molars and can be made to match the colour and contours of the natural teeth perfectly. Often crowns are made in a laboratory by a technician after the dentist has prepared and filed down the affected natural tooth. The lab technician uses moulds of the patient’s teeth provided by the dentist which can be used to design and create the crown based on the missing teeth marks present in the moulds. Typically, a lab will take around two weeks to complete crown work although this does not mean the patient will be without a tooth during this time as temporary crowns will be made and fitted by the dentist, usually out of composite resin.
If the dentist has a CEREC machine however, crowns can be designed, made and fitted for the patient in one single appointment that takes around one hour per tooth. CEREC is a CAD/CAM machine that comprises of a computer system and a computerised milling unit. The dentist will prepare the damaged tooth, removing any excess material and if necessary, clearing out any decay and then can scan an image of the damaged tooth and the corresponding teeth around it onto the computer system. The dentist can then use the computer software to design the perfect restoration for the patient taking into account things such as, bite, similarity with the natural teeth, shape and size. Once designed, the restoration can be sculpted out of a block of solid ceramic by the milling machine. Once fully milled out, the restoration is then stained and glazed in order to achieve a completely natural look that blends in perfectly with the patient’s natural teeth.
CEREC crowns and lab crowns are both very similar in quality and price although it is a huge benefit for patients undergoing crown treatment with CEREC that they do not need moulds, temporaries or long waits. Instead, they can get their tooth fixed on the day it gets damaged and will be able to chew with it immediately after the crown has been bonded on. CEREC also allows for less of the natural tooth to be removed than traditional lab based work as the computer system can design crowns to fit perfectly over any shape, not just a square stump.

Crowns, whether CEREC or lab based, should feel and look completely natural and as such need to be looked after in the same way as natural teeth. Brushing twice a day and taking care not to bite down too aggressively on hard foods like toffee greatly improves the life span of crowns.
Traditionally, many crowns were made of gold or silver metal, due to the price of gold this is now very rare and the benefits of a ceramic crown as far as aesthetics, longevity, hardness and toxicity greatly outweigh those of silver metal crowns.

Think about Dental Implants?

Teeth can be lost due to poor oral hygiene, gum disease, illness, infection or because of accidents. The best way to replace missing teeth is undoubtedly by using a dental implant.
Dental implants are essentially replacement tooth roots made from titanium alloy. They are implanted into the jaw bone in the place of a missing tooth which created a very strong fixture for a crown to be attached to.
Titanium alloy is used for dental implants due to its unique osseointegration properties. Basically this means that the titanium alloy fully adheres to bone creating a secure and tight fixture which allows the attached crown to function completely like a natural tooth.
Dental implants require rather extensive dentistry and not all dentist offer them due to the complexity of fitting them. They also take rather a long time, 4-6 months usually, to be completed. This is because once the jaw bone has had the implant placed; it needs a good few weeks for the bone to osseointergrate and heal over the implant.
Once the implant has fully adhered to the bone, the gum can be opened up and the implant exposed. A post called an abutment can then be attached to the implant and the gum is then left to heal for a further few weeks. Once the gum has fully healed, a mould of the exposed abutment can be taken and from this, a ceramic crown can be created to fit perfectly onto the abutment and with the teeth around it.
Once the crown is fitted, the implant will feel, look and function just like a natural tooth! Many patients forget they even have an implant, which demonstrates how natural they are!
Not everyone is suitable for implants though. If bone levels in the jaw are not high enough for example, an implant will not be able to be fitted. In case like this sometime bone grafting can be undertaken in order to build up a suitable amount of bone. This is extremely extensive dentistry however, and not all cosmetic dentists will be able to do this. Another reason why someone may not be suitable for a dental implant is if they have very bad oral hygiene. In cases like this, cosmetic dentists would not go ahead with implant work as there is a large risk of infection and other problems arising if the patient does not clean their teeth properly.
It is often necessary to take full mouth x-rays to check bone levels before implant work is carried out. Other tests may be used as well such a resting lip pattern tests, smile line tests etc which help the cosmetic dentist to design an extremely natural and aesthetically pleasing tooth for the patient.
Expect to pay around £2000 to £4000 per complete dental implant (including the implant, crown, and abutment). As implant dentistry is complex, time consuming and rather specialist, the price is high. It is however a much better treatment for missing teeth then the alternative, dentures.

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