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Tooth Replacement

Missing teeth can be replaced in a variety of ways


Crowns are an ideal restoration for teeth, which have been broken, or have been weakened by decay or a very large filling. The crown fits right over the remaining part of the tooth, making it strong and giving it the shape and contour of a natural tooth. Crowns are sometimes also known as 'caps'.
There are a number of reasons. For Instance:
1. the tooth may have been weakened by having a very large filling
2. you may have discoloured fillings and would like to improve the appearance of the tooth.
3. you may have had a root filling which will require a crown to protect it.
Crowns are made of a variety of materials, and new materials are continually being introduced. Here are some of the options available at present:
1. Porcelain bonded to precious metal: This is what the majority of crowns are made from. A precious metal base is made and porcelain is then applied in layers over it.
2. Porcelain: These crowns are not as strong as bonded crowns but they can look very natural and are most often used for front teeth.
3. Porcelain and composite: Porcelain and composite resin materials can sometimes look the most natural. However, these crowns are not as strong as bonded metal crowns.
4. Precious metal (gold and palladium): These crowns are very strong and hard wearing, but are usually used at the back of the mouth, where they are not visible.
The dentist will prepare the tooth to the ideal shape for the crown. This will involve removing most of the outer surface, and leaving a strong inner 'core'. The amount of the tooth removed will be the same as the thickness of the crown to be fitted. Once the tooth is shaped, the dentist will take an impression of the prepared tooth, one of the opposite jaw and possibly another to mark the way you bite together. The impressions will be given to the technician, along with any other information needed to make the crown.
The impression and shade information will be given to a Dental Technician who will be skilled in making crowns. Models will be made of your mouth and the crown will be constructed on these in order to ensure that the crown fits perfectly.
No. The crown will be made to match your other teeth exactly. The shade of the neighbouring teeth will be recorded, to make sure that the colour looks natural and matches the surrounding teeth. A temporary crown, usually made in plastic, will be fitted at the end of the first appointment to last until the permanent one is ready. These temporary crowns may be more noticeable, but they are only a temporary measure.
At least two visits are needed, the first for the preparation, impression, shade taking and fitting the temporary crown, and the second to fit the permanent crown.
No. A local anaesthetic is used and the preparation should feel no different to that of a filling. If the tooth does not have a nerve, and a post crown is being prepared, then local anaesthetic may not be needed.
Post crowns may be used when the tooth has been root filled. The weakened crown of the tooth is drilled off at the level of the gum. The dentist makes a double-ended 'post' to fit into the root canal. This can be either prefabricated Stainless Steel or custom made of gold. One end of the post is cemented into the root canal, and the other end holds the crown firmly in place.
If a root-filled tooth is not completely broken down, it may be possible to build it up again using filling material. This 'core' is then prepared in the same wayas a natural tooth and the impressions are taken.
The life of a crown will depend on how well it is looked after. The crown itself cannot decay, but decay can start where the edge of the crown joins the tooth. It is very important to keep this area as clean as your other teeth, or decay may occur which could endanger the crown. Properly cared for crowns will last for many years - your dentist will be able to advise you how long.
Once the fit and appearance of the crown has been checked - and approved by you - it will be cemented in place with special dental cement. The cement also forms a seal to help hold it firmly in place.
Because the shape of the crown will be slightly different from the shape of the tooth before it was crowned, you may be somewhat aware of it to begin with. Within a few days it should feel fine, and you will become unaware of it. The crown may need some adjustment if it feels proud of the surrounding teeth. If it is at all uncomfortable you should ask your dentist to check and adjust it.