Crowns are a mainstay of cosmetic dentistry used to improve your smile’s appearance in a variety of situations. Not all crowns are alike, though — and the differences could affect your cost.
Crowns or caps are needed to cover remaining tooth structure which was previously damaged. Tooth decay and trauma are the major reasons for damage or loss of tooth structure that make crowns necessary. After preparing the remaining healthy tooth to fit into the new crown, we then make an impression mold of the tooth for a dental technician to use to create the new crown. It’s at this point where the road to your new smile can take different paths, both in construction and how much artistry goes in to your crown’s formation.
Porcelain crown construction falls into two general categories. The first category involves life-like porcelain fused to an inner core of metal. Because many older types of porcelain tend to be brittle and subject to breaking under pressure, metals are used to strengthen the crown. A fused crown can thus provide both durability and a life-like appearance.
In recent years, though, new dental materials have made the second category — all porcelain crowns — a viable option. Either lithium disilicate or zirconium oxide account for nearly two-thirds of crowns made today. Although research on their durability is relatively new, initial results have been encouraging, showing advanced all-ceramic crowns can tolerate forces comparable to porcelain fused to metal (PFM) crowns used in bridges.
On the downside, these newer materials may be more expensive than PFM crowns. Costs for manufacturing may also increase depending on how life-like the matching of color with other teeth you desire your crown to be. For example, individual teeth aren’t a uniform color — there are gradations of color that can vary from the tip of the tooth to the root. To capture these gradations in an individual crown requires a high level of artistry and time by the dental technician, which increases the final cost.
If you’re in need of a crown, it’s best to first make an appointment for a consultation to review your options, and to consider both your expectations and financial ability. Together we can determine what it will take to create a new look for your teeth that fits your expectations and your budget.
It might seem that supermodels have a fairly easy life — except for the fact that they are expected to look perfect whenever they’re in front of a camera. Sometimes that’s easy — but other times, it can be pretty difficult. Just ask Chrissy Teigen: Recently, she was in Bangkok, Thailand, filming a restaurant scene for the TV travel series The Getaway, when some temporary restorations (bonding) on her teeth ended up in her food.
As she recounted in an interview, “I was… like, ‘Oh my god, is my tooth going to fall out on camera?’ This is going to be horrible.” Yet despite the mishap, Teigen managed to finish the scene — and to keep looking flawless. What caused her dental dilemma? “I had chipped my front tooth so I had temporaries in,” she explained. “I’m a grinder. I grind like crazy at night time. I had temporary teeth in that I actually ground off on the flight to Thailand.”
Like stress, teeth grinding is a problem that can affect anyone, supermodel or not. In fact, the two conditions are often related. Sometimes, the habit of bruxism (teeth clenching and grinding) occurs during the day, when you’re trying to cope with a stressful situation. Other times, it can occur at night — even while you’re asleep, so you retain no memory of it in the morning. Either way, it’s a behavior that can seriously damage your teeth.
When teeth are constantly subjected to the extreme forces produced by clenching and grinding, their hard outer covering (enamel) can quickly start to wear away. In time, teeth can become chipped, worn down — even loose! Any dental work on those teeth, such as fillings, bonded areas and crowns, may also be damaged, start to crumble or fall out. Your teeth may become extremely sensitive to hot and cold because of the lack of sufficient enamel. Bruxism can also result in headaches and jaw pain, due in part to the stress placed on muscles of the jaw and face.
You may not be aware of your own teeth-grinding behavior — but if you notice these symptoms, you might have a grinding problem. Likewise, after your routine dental exam, we may alert you to the possibility that you’re a “bruxer.” So what can you do about teeth clenching and grinding?
We can suggest a number of treatments, ranging from lifestyle changes to dental appliances or procedures. Becoming aware of the behavior is a good first step; in some cases, that may be all that’s needed to start controlling the habit. Finding healthy ways to relieve stress — meditation, relaxation, a warm bath and a soothing environment — may also help. If nighttime grinding keeps occurring, an “occlusal guard” (nightguard) may be recommended. This comfortable device is worn in the mouth at night, to protect teeth from damage. If a minor bite problem exists, it can sometimes be remedied with a simple procedure; in more complex situations, orthodontic work might be recommended.
Teeth grinding at night can damage your smile — but you don’t have to take it lying down! If you have questions about bruxism, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Stress & Tooth Habits” and “When Children Grind Their Teeth.”
Implant-supported fixed bridges are growing in popularity because they offer superior support to traditional bridges or dentures. They can also improve bone health thanks to the affinity between bone cells and the implants' titanium posts.
Even so, you'll still need to stay alert to the threat of periodontal (gum) disease. This bacterial infection usually triggered by dental plaque could ultimately infect the underlying bone and cause it to deteriorate. As a result the implants could loosen and cause you to lose your bridgework.
To avoid this you'll need to be as diligent with removing plaque from around your implants as you would with natural teeth. The best means for doing this is to floss around each implant post between the bridgework and the natural gums.
This type of flossing is quite different than with natural teeth where you work the floss in between each tooth. With your bridgework you'll need to thread the floss between it and the gums with the help of a floss threader, a small handheld device with a loop on one end and a stiff flat edge on the other.
To use it you'll first pull off about 18" of dental floss and thread it through the loop. You'll then gently work the sharper end between the gums and bridge from the cheek side toward the tongue. Once through to the tongue side, you'll hold one end of the floss and pull the floss threader away with the other until the floss is now underneath the bridge.
You'll then loop each end of the floss around your fingers on each hand and work the floss up and down the sides of the nearest tooth or implant. You'll then release one hand from the floss and pull the floss out from beneath the bridge. Rethread it in the threader and move to the next section of the bridge and clean those implants.
You can also use other methods like specialized floss with stiffened ends for threading, an oral irrigator (or "water flosser") that emits a pressurized spray of water to loosen plaque, or an interproximal brush that can reach into narrow spaces. If you choose an interproximal brush, however, be sure it's not made with metal wire, which can scratch the implant and create microscopic crevices for plaque.
Use the method you and your dentist think best to keep your implants plaque-free. Doing so will help reduce your risk of a gum infection that could endanger your implant-supported bridgework.
If you would like more information on implant-supported bridges, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Hygiene for Fixed Bridgework.”
Accidents can happen to your mouth, especially if you have an active lifestyle. For example, a sudden blow to the jaw while playing sports or exercising could result in a chipped tooth. And, while the internal tooth structure may be fine, the effect on your appearance can be disheartening.
Fortunately, we have techniques and materials to restore your smile after an injury. Bonding with composite resin is one such procedure: it’s ideal for mild to moderate chipping, especially in highly visible front teeth.
Composite resin is a dental material made of various substances mixed to match the color and texture of natural teeth. The composite is usually made of inorganic glass filler blended with a plastic-based matrix and joined together with a chemical “coupling” agent. The ratio of filler to matrix will depend on the type of tooth and damage — for example, back teeth, which encounter higher biting forces, require a composite with more filler for added strength.
To begin the procedure, we first prepare the damaged tooth by applying microscopic etchings (often with a chemical solution) that create tiny depressions or “undercuts”: these help create a seamless bond between the composite and the natural tooth. We then apply the composite in layers with a bonding agent, building up layer upon layer until we’ve achieved the desired shape for the tooth involved.
Bonding with composite resins doesn’t require much tooth preparation, can be placed quickly and is relatively inexpensive. Because of the wide spectrum of color possibilities, composite resins are superior to traditional amalgam (metal) restorations in creating a more life-like appearance. Its application, however, can be limited by the amount of tooth structure needing to be replaced: because it isn’t as strong as the tooth structure it replaces, the more tooth structure the bonded composite resin attempts to replace the less likely it can stand up over time to normal bite forces.
Still, composite resins are ideal for mild to moderate damage or disfigurement. If you’ve suffered such an injury, be sure to visit us to see if bonding with life-like composites is the right solution for restoring your smile.
If you would like more information on bonding with composite resins, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Repairing Chipped Teeth.”
If you’ve ever heard your dentist or hygienist talk about “calculus,” they’re not referring to a higher branch of mathematics. The calculus on your teeth is something altogether different.
Calculus, also called tartar, is dental plaque that’s become hardened or “calcified” on tooth surfaces. Plaque begins as soft food particles and bacteria that accumulate on the teeth, and more so if you don’t properly clean your teeth every day. This built-up plaque becomes both home and food source for bacteria that can cause tooth decay or periodontal (gum) disease.
Because of this direct link between plaque and/or calculus and dental disease, we encourage everyone to perform two important oral hygiene tasks every day. The first is to floss between your teeth to remove plaque as you are unable to effectively reach those areas with a toothbrush. Once you loosen all the plaque, the other really important task is a thorough brushing of all of the tooth surfaces to remove any plaque that may have accumulated since the last brushing. Doing so every day will catch most of the softer plaque before it becomes calcified.
Once it forms, calculus is impossible to remove by brushing and flossing alone. That’s why you should have regular cleanings performed by a dental professional. Dentists and hygienists have special tools called scalers that allow them to manually remove plaque and calculus, as well as ultrasonic equipment that can vibrate it loose to be flushed away with water.
In fact, you should undergo dental cleanings at least twice a year (or as often as your dentist recommends) even if you religiously brush and floss daily. Calculus forms so easily that it’s nearly inevitable you’ll accumulate some even if you have an effective hygiene regimen. Your dental team can remove hardened deposits of calculus that may have gotten past your own hygiene efforts.
If you haven’t been consistently practicing this kind of daily hygiene, see your dentist to get a fresh start. Not only will they be able to check for any emerging problems, they can clean your teeth of any plaque and calculus buildup so that you’ll be able to start with a “clean” slate.
Calculus can be tenacious, but it not impossible to remove. Don’t let it set you up for an unhealthy experience with your teeth and gums.
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