Crowns and Bridges Blog

29 September 2016

Crowns and Bridges

Most people have heard the terms “crown” and “bridge” when speaking in dental terms. Most would even say that they have a crown or bridge, but aren’t quite sure what they are, or why their dentist recommended it for them. A good dentist will remain committed to making sure that our patients know all of their options, as well as what they are. Continue reading on more information on crowns and bridges.

Crowns

A crown is essentially a cap that is placed over a natural tooth to ensure its strength and resistance to decay. They are recommended by dentists when the prognosis of a filling is guarded or poor, and the filling is likely to fall out or fail due to its size. A crown is a preventative measure that prevents further decay of the tooth. In some cases, the use of a crown can be purely cosmetic, as the shade, size, and shape of a crown can all be customized as per the patient and the doctor’s needs and wants. While some people opt for the less-expensive metal crowns, most choose crowns made with porcelain fused to metal for a natural looking crown that will be indistinguishable from a natural tooth.

The process of making a crown:

  1. An impression is taken of the tooth and surrounding teeth
  2. A resin material is placed into the crevice representing the tooth that will be prepared for the crown
  3. The resin material hardens and is trimmed to become the “temporary crown”, which the patient leaves with on that same day to cover the prepared tooth until the “permanent crown” is ready to be cemented, usually in about two weeks.
  4. The natural tooth is shaved down to a smaller version of itself. In some cases, a post is placed inside the tooth to ensure the stability and integrity of the tooth.
  5. A final impression is taken. This impression is wrapped up and sent out to a lab, where the permanent crown is fabricated.
  6. The temporary crown is cemented.
  7. In two weeks’ time, the permanent crown arrives back at the dental office. The temporary crown is removed, and the permanent crown is cemented in.

Bridges

Bridges may seem like a bit of a complicated concept, but they are really just a multi-unit crown, that can cover a number of teeth, usually three, but possibly more, depending on what is recommended by the dentist. Bridges are usually used to replace a missing tooth or even multiple teeth by using the two teeth on either side of the gap as anchors. The result is often a very natural looking replacement for missing teeth.

The process of preparing the teeth for a bridge is much like that of a crown:

  1. An impression is taken of the teeth that are to be prepared for the bridge
  2. A resin material is placed into the reservoir which represents the two teeth which will be the anchors for the bridge in order to fabricate the temporary bridge.
  3. The anchor teeth are shaved down to smaller versions of themselves.
  4. A final impression is taken. This impression is wrapped up and sent out to a lab, where the bridge will be fabricated.
  5. The temporary bridge is cemented.
  6. In two weeks’ time, the permanent bridge is cemented.

It can only be hoped that reading through this post has helped you better understand the use of crowns and bridges. These terms may seem frightening at first, but are really simple procedures when fully understood.

Covid-19 and your care

We have now received clear guidance as to what dental procedures we can safely carry out and at what stages during the pandemic.

Below is a summary of the guidance as we understand it, although this may modify over the next few days as some small inconsistencies are clarified.

The government has set five different risk levels for the pandemic 1-5 (low to high), although this changes on a daily basis.

The treatments that we can carry out safely in dental practice will change with the risk level.

Treatments are significantly limited at level 4.

During the next few weeks, we will attempt to contact each patient that has contacted us with a significant dental problem during lockdown, and we hope to book an assessment appointment for those patients in the week commencing 8th June.

Practice doors will be locked at level 3, 4 and 5. Entry to the practice will be limited to pre-booked appointments.

There will be very clear criteria provided in due course as what is required before arriving at the practice, and what the procedure will be upon arrival. We will endeavour to ensure that each person knows exactly what to expect at their visit as this will be quite different to what you have been used to.

The appointment diary will be structured to take into consideration those patients who are shielding, may have underlying medical issues and so on.

The first week is expected to be a slow start as we ensure that the new protocols are working effectively for everyone’s safety. These protocols will be audited and modified until required.

At level 4 we should be able to carry out the following:

Dental assessment (initially restricted to patients who have current urgent need, or did and contacted us during lockdown).

X rays but only for patients who tolerate them well.

TEMPORARY re cementation of crowns. (We cannot dry the tooth effectively enough to cement a crown permanently with the restrictions we face).

Fabrication or repair of removable dentures.

Simple dental extractions. If a tooth breaks, it is probable we will have to leave the roots in place until we are at a lower level of risk. Naturally, we will assess the risk very carefully prior to treatment.

Tightening of loose dental implants if possible, without using a high-speed handpiece (drill).

Temporary fillings.

Draining of a swelling/abscess.

Provision of antibiotics.

Trimming of sharp orthodontic wires (not reliable re cementation of loose brackets, or replacement of missing brackets).

Treatment is only to be offered after careful assessment.

Cosmetic orthodontics

Cheshire Dental Centre provide many of these treatments. We may now be able to progress some of our Quick Straight Teeth cases. We will be in touch with each patient shortly, but please allow us to contact you; we hope that it is understandable that we will be prioritising patients with urgent dental need.

The PPE (personal protective equipment) requirements for the above are not too onerous, and we will not look too different to normal. As you are aware, the cross-infection control at Cheshire Dental Centre has always been exemplary and one of our top priorities.

Although we have been organised with the new PPE guidelines well in advance there may be the occasional time where we are awaiting stock. All practices are attempting to source the necessary PPE we need to keep you and us safe, but supplies are scarce and consequently very expensive.