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Robert C. Clay, Jr., DDS, Ltd.

Frequently Asked Questions (FAQs): Crowns and Bridges

How can we help you?

If you’ve got questions, we’ve got answers. We know that most people have questions about their dental health, the services we offer, and dental insurance. We get asked questions about these topics, and many others, every single day. We welcome all of your questions, and it is an encouraging sign that you are taking interest in your oral healthcare. We would love the opportunity to help.

So, whether you have a dental question, an insurance question, or heck, if you can’t remember the lyrics to a song, we will do our best to help you get the answers you are looking for. We have a few of the more common questions compiled here, but please feel free to ask us if you have any other questions you need answered.

Crowns and Bridges

There are various reasons we do crowns as well as various processes involved.  Most of the time, after a tooth is prepared and an impression taken, we can have the crown ready to cement in two weeks.  Crowns on implants will often require an additional week to make as implant components must be ordered by the lab and custom parts fabricated.  Those additional steps require more time at the lab. 

 

There are other times that the time frame may differ for various reasons.  Sometimes we like to keep a temporary crown on, or even the permanent crown, using temporary cement for an extended period. We will do this when we have concerns about the health of the nerve in the tooth and we want additional time to evaluate it.  If we need the lab to make a post for the tooth, this will also require additional time and appointments. Other times, we will send you to the lab so the lab technician can see you for custom shading and tinting so the best esthetic result can be obtained.  Timing of that appointment and availability of the patient and lab technician may delay the final finish date accordingly.

 

Like so many things, we want them done right, not just fast.  We understand that patients want things done right away, but we want them done right. We will always go the extra mile to make sure you get the result you want and deserve. 

We offer a range of cosmetic dentistry services such as veneers, porcelain crowns, bonding using tooth-colored composite, and even orthodontic treatments like Invisalign. All our of dentistry is done with an eye toward aesthetics. We know that it's important that your teeth are both healthy and attractive. If you'd like to find out which of our services can help you meet your goals, call our office to schedule your consultation.

Having a missing tooth can be very stressful when considering esthetics, the treatment one needs to undergo to replace the tooth, or teeth, and the costs associated.  Since every patient has their own individual needs as well as financial constraints, it is not always up to us to decide what is “best” for you. We will always present all of the available options and weigh the pros and cons as far as optimal dental treatment goes.  Along with that, we will present the fees associated with all of these options.  Finally, we will present you with options for third party finance companies to help spread the costs over a longer period of time where costs are a concern.  We will try to find a way to allow you to get the best treatment, the treatment that you deserve, but also understand if the “best” treatment just isn’t feasible at this time.  We will then work to help you decide on one of the alternate options

When people have chipped or worn teeth, it can result in esthetic concerns as well as produce discomfort of the teeth or joints. While patients want things fixed quickly, our first challenge is to determine the cause of the problem.  We always want to know the cause because we want to prevent further breakdown of the teeth, as well as have long term success with any new restorations we may place.  Sometimes the fix can be as simple as a filling, a crown or a veneer,  while other times the optimal treatment may get more involved. We often see an underlying cause of tooth breakdown related to grinding or clenching teeth. When there is significant wear throughout, the restorative treatment to address this problem may involve a full rehabilitation of crowns on many, or even all teeth to re establish a normal alignment of the teeth.  Other times we see an underlying cause that is orthodontic in nature and we need to treat the patient with orthodontics such as braces or Invisalign prior to any restorations.  So, our “cosmetic” options will be determined by the problems we are presented with, and we will always show our patients X-rays, photos, and plaster models to explain our findings and recommendations prior to starting any treatment. If you have any concerns with chipping or wear, give us a call so we can see what options you may have to restore your optimal smile. 

A dental crown, also referred to as a cap, is a restorative option to restore a single tooth into function and also provide esthetics in the esthetic zone. There are many reasons to place a crown, but the basic process involves a dentist, or laboratory modifying and contouring a tooth, or implant component, so that a fake tooth (crown) can fit over it and glued into place.  I always compare it to placing a thimble over a finger.  Crowns can be made of esthetic materials to match adjacent teeth, or gold.  There are benefits to each material option and we will discuss this with our patients as we  are planning the restoration.  If you think you need a crown, we would be happy to discuss it with you further, so give us a call for a consultation. 

Crowns, often called caps, and bridges are ways to restore teeth into function.  Crowns are restorations placed on a single tooth or implant to return it into function.  A bridge, on the other hand is used to replace a missing tooth or teeth by “bridging” the space that is missing teeth using artificially fabricated teeth. We do this by fabricating a restoration that has several teeth connected together and we anchor this restoration, also known as a “bridge,” to existing teeth that are modified to act as anchors.   The most common materials used for these restorations are either gold, porcelain, lithium disilicate, or zirconia.  There are other materials available, but these are the ones we most commonly use. There are benefits and drawbacks of each material option and we always weigh esthetics and strength as deciding factors when selecting materials for our patients. If you feel you need a crown or bridge, contact us so we can give you an evaluation and see what your options may be.   

When patients talk about “cosmetic dentistry” we are always interested to hear what people think that means.  To us, dentistry has evolved to the point that we feel most services could be considered “cosmetic” as we use tooth colored filling material for almost everything.  That said, many people consider cosmetic dentistry to include the use of porcelain crowns, porcelain veneers, bonded white fillings on front teeth, tooth whitening or bleaching, and white fillings on back teeth.  And yes, we routinely perform all of these procedures.  We also utilize Invisalign to help straighten your teeth,  and dental implant restorations to restore a single tooth, multiple teeth, or even all of your teeth.  In fact, we even feel the conventional dentures and removable partials we fabricate also fall into the cosmetic category as we not only use top labs and materials, but also take every extra step to ensure they look as realistic as possible.  So yes, we do perform all of these cosmetic dental services, and we will discuss them with you, as well as present options and risks of treatment before we start your treatment. Give us a call to set up a consultation so we can see what can be done.

We make every effort to select the best materials for your restorative needs. There are many options available for crowning teeth.  While gold teeth are often considered an older, not so esthetic option, they are still one of the best materials that can be used in dentistry. 

 

That said, most patients prefer the white crowns that look like real teeth.  The traditional Porcelain Fused to Metal (PFM) crowns have been widely used with great success in dentistry.  These PFM crowns can be made to look very realistic in most cases, but they are what we call “feldspathic porcelain” and this material’s biggest drawback is its low fracture toughness,  essentially, it can crack and chip easily. It also requires quite a bit of tooth to be cut away in order to use as directed. 

 

Lithium disilicate crowns are a newer option that is also highly esthetic.  This material has no metal substructure to hide and it also has a much higher fracture toughness than the PFM crowns.  This material also requires aggressive tooth prepping to use properly.

 

Zirconia is a newer material that is our strongest yet.  It is extremely strong and ther is no metal to hide.  Another benefit is the conservative tooth preparation that can be done to use this material.  The downside is that it is not as pretty of a material.  I looks good, but not great.  The manufacturers have developed even newer versions of this material that are starting to look much more like the other materials as far as esthetics, but the strength drops greatly with these options; however it is still much stronger than the traditional PFM crowns.

 

We choose the material we use based on needs.  Location plays a big role as back teeth do more work and would benefit from more strength, while front teeth don’t do as much of a chewing load, but are required to look good.  As fear as strength goes, the flexural strength (force to break the material) of a PFM is 90 MPa (MegaPascals), lithium disilicate is 400 MPa, and the strongest. Zirconia is 1465 MPa. You don’t have to understand the physics behind flexural strength or megapascals, but it is easy to understand that 1465 is more than 90. Since MPa is a unit of force needed to break the material,  zirconia is exponentially stronger for back teeth and is often used as we like the braun over the beauty. Lithium disilicate or PFM crowns are used more in front for beauty.  We also use labs that can custom tint crowns to get your shade as exact as possible.  We will make sure you are happy with the result you get.

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