Crowns are full coverage restorations used to cover a tooth that is likely to break, or is too broken down to be restored with a filling. Crowns are recommended for teeth that have received root canal treatment, or when a large filling wears out. The greater the damage done by tooth decay, the more likely a crown will be needed. Even after a filling is put in a large cavity, a tooth is more likely to break. Because the jaw muscles are the strongest in the human body, teeth are subjected to tremendous pressures. Crowns completely cover teeth providing strength and protecting the tooth against fracture. Without the protection of a crown, suseptible teeth can crack or break and require extraction.
Like veneers, crowns can improve your smile. The shape and color of a crown is completely under your control. A crown can be made for a tooth in two appointments. During the first visit decay is removed from the tooth and it is shaped to accept the crown. An impression is made of the prepared tooth for use in fabricating the crown. A dental laboratory fabricates the crown from high-strength porcelain over gold alloy, all ceramic material, or gold. During this time a temporary crown is worn. In the second visit the temporary crown is removed and the permanent crown is adjusted as needed and cemented in place.
There are different types of dentures, but they share a common function. They replace teeth that have become loose or have been extracted due to bone loss. Dentures are also indicated if teeth have become too worn or damaged by decay to repair. Dentures can create a beautiful smile and restore proper speech.
A complete oral examination determines which teeth will have to be removed, and which will remain. A complete denture replaces all the teeth while a partial denture adapts to whatever teeth remain in the mouth. There is an adjustment period after dentures are placed in the mouth, and it can take some getting used to. Once accustomed to dentures, regular check ups are still necessary to evaluate function and esthetics. Implants can used to further stabilize the dentures and are strongly recommended for use in the lower jaw.
A dental implant is an option to replace a missing tooth. In this procedure, a small titanium cylinder is surgically implanted into the bone. The bone grows around the implant forming a tight connection known as osseointegration. Once the implant is osseointegrated, the dentist then attaches the replacement tooth onto the top of the cylinder. This treatment is excellent for replacing a single missing tooth because the adjacent teeth need not be crowned as is the case for conventional bridge work.
Implants can also be used as supports for a bridge as an alternative to partial dentures. There are several advantages to using dental implants. Becasue no part of the bridge presses directly on the tissue, there is no adjustment period for the patient. When the bridge is placed, it feels and functions like natural teeth. Unlike complete or partial dentures, implant bridges are fixed in the mouth.
Mini dental implants are also available for patients with severe bone loss. These implants are about half the diameter of traditional implants are used mainly to stabilize lower dentures. The cost is less than conventional dental implants.
ROOT CANAL TREATMENT
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is necessary when a cavity is allowed, through neglect, to reach all the way to this pulp. (Regular cleanings and checkups prevent and detect problems early.) Deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy. Once a pulp becomes infected the infection can extend through the root and into the bone causing an abscess. When a dental pulp is infected it cannot heal on its own and must be treated. Untreated, a dental abscess can affect the entire immune system. 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. Rarely, an abscessed tooth causes no symptoms. Routine examinations and complete radiographs can diagnose an asyptomatic abscess.
Root canal treatment cleans out the infected pulp tissue and disinfects the canals. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. A core build-up and crown is recommended for restoring a tooth that has had root canal therapy.
TOOTH SUPPORTED BRIDGES
This is an option for filling the space created by one or more missing teeth. Teeth on both sides of the missing tooth are crowned and the missing teeth are replaced by a pontic attached to the crowns. A bridge replaces missing teeth, both functionally and cosmetically. Bridge work is as much an art as it is an exact science to replace missing teeth while restoring both function and esthetics. 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 esthetics.
It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated the teeth on either side of the gap begin to shift inward. Teeth use their neighbors for “support.” With one missing, they start to “drift.” As this progresses the bite changes in response to changing pressure. This can eventually result in problems with the jaw joint (TMJ or TMD). The remaining teeth can break or cause gum disease resulting in their loss. The difficulty of correcting the problem increases the longer the neglect continues.
TMJ stands for temporomandibular joint. A cartilagenous disc separates the jaw bone from the temporal area of the skull. Five muscles stabilize the joint. Jaw joint pain may be caused by a misalignment of the teeth, trauma, or excess muscle tension.
Problems with the disc or the muscles in the TMJ 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 TMJ pain 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.