Restorative Dentistry FAQ

What is a crown?

A crown is a covering that surrounds the tooth restoring form and function. A crown is needed in many circumstances but its main purpose is to keep the tooth around in the mouth when it has been compromised beyond when just a restoration or filling is needed. A crown can be needed when a fracture or cracked tooth is present. A crown is indicated when decay gets deep and destroys much of the tooth and more support is needed. When a tooth needs a root canal a crown is required or when a large existing filling is present with in a tooth and needs replacement, a crown is often indicated to hold the small remaining parts of the tooth together.

What materials can a crown be made of and which is better?

Crowns can be made of gold, porcelain or a combination of the two. Crowns made of gold are the most durable and kindest to opposing tooth structure however they are the least aesthetic. A combination or porcelain fused to metal crown has the advantages of a hard core of gold alloy and is covered with a porcelain material to hide the metal. An all porcelain crown has several categories, those that have a strong core and those that do not. Of all the options, all porcelain crowns look the most natural but can have limitations to them. When needing a crown it is best to discuss with your dentist which option is best for the tooth being crowned.

What is a cracked tooth and why do I need a crown to fix it?

A cracked tooth is one that has been compromised from wear and tear. It can be from grinding or chewing harder items like ice for a while. Whatever the cause once a fracture is present in the tooth the process has to be stopped before getting too deep and into the nerve or even worse splitting the tooth in parts. A crown acts as a covering and holds the portions of the tooth on either side of the fractures and prevents the propagation of the fractures any deeper. Once the cracks get to the nerve a root canal will be needed to remove the nerve. In some circumstances a crack can get so deep it can split the tooth at which time the only treatment that can be done is to have the tooth removed. Caught early enough a crown can cover a tooth and hold the cracks together preventing the need for a root canal or possible extraction (tooth removal).

What is an abscess?

An abscess is a term used to describe a tooth that has been infected for a period of time and sometimes shows signs on the x-rays. For whatever the reason, decay or fractures close to or into the nerve, the nerve will start to die off. This process called necrosis is the process of the nerve of the tooth dying and the body’s reaction to this is the resultant infection. The process of the nerve dying off can be very painful due to the nerve being contained within the confines of the tooth. When something gets infected in swells and gets inflamed and inside a tooth that pressure has nowhere to go, resulting in a pain some view to be the worst pain one can experience. Once this occurs the only treatment option left is to remove the nerve. The most common and most advised way is by root canal therapy.

Why a root canal, and what is it exactly?

A root canal is where the nerve of the tooth is removed leaving the tooth in the mouth so it can still be used for many more years to come. Usually when a tooth is infected a course of antibiotics is used to aide the body in ridding itself of the infection. This by itself will only temporarily resolve the problem. Without removing the source of infection, the nerve, the infection will come back. You see, the infection is just the body’s way of not recognizing the nerve of the tooth any longer and so rejecting it. Cells in our body are responsible for removing foreign objects and once the nerve starts to die off it is now foreign material and so is rejected. A root canal removes the necrotic nerve tissue replacing it with a rubbery matrix filling material called gutta percha. Once the root canal is performed a crown is usually indicated for the tooth to help prevent breakage and help support the remaining tooth structure.

What options for tooth replacement do I have?

There are many options all of which center around being fixed or removable. Removable options include dentures and removable partial dentures Fixed options include implants or bridges (fixed partial dentures).

Why should I save a tooth, can’t I just pull it out?

There are many options all of which center around being fixed or removable. Removable options include dentures and removable partial dentures It is almost always the best option if you can save a tooth to do it. It is almost always more time consuming and more costly to replace a tooth than it is to save it. Depending on the situation it is most favorable to save the tooth as the best option. A tooth can always be pulled (extracted) out, however if a replacement is not inserted in a timely matter then tooth movement, shifting, and bite changes can occur which are permanent alterations which can have harmful effects.

What is a dental implant?

There are many options all of which center around being fixed or removable. Removable options include dentures and removable partial dentures A dental implant( to replace a single tooth) is designed to permanently replace missing teeth in a fixed non-removable fashion. A specially designed root formed titanium alloy “screw” is placed within the jawbone to act just like a natural tooth would. It can function and mimic a natural tooth to make a very pleasing smile and tooth replacement. An implant can replace a single tooth, multiple teeth or can support bridges, partials and dentures. By supporting removable options they can make the fit and function multiple times better for chewing and biting efficiency. Once the dental implant is placed a tooth is designed from an imprint or impression and is either cemented or screwed to place. Dental implants are by far the best way to stabilize and replace the natural dentition if the circumstances allow.

What is a bridge?

There are many options all of which center around being fixed or removable. Removable options include dentures and removable partial dentures A dental implant( to replace a single tooth) is designed to permanently replace missing teeth in a fixed non-removable fashion. A specially designed root formed titanium alloy “screw” is placed within the jawbone to act just like a natural tooth would. It can function and mimic a natural tooth to make a very pleasing smile and tooth replacement. An implant can replace a single tooth, multiple teeth or can support bridges, partials and dentures. By supporting removable options they can make the fit and function multiple times better for chewing and biting efficiency. A bridge or fixed partial denture is also a fixed appliance meaning it cannot be removed. It is most commonly to replace one or two missing teeth and is attached to the natural teeth. Your teeth act as the peirs of the bridge and where the missing teeth are acts as the bridge space or “pontic” space. There are pros and cons to each option, be sure to discuss with your dentist the option that is right for you.

What is a removable partial denture?

There are many options all of which center around being fixed or removable. Removable options include dentures and removable partial dentures A dental implant( to replace a single tooth) is designed to permanently replace missing teeth in a fixed non-removable fashion. A specially designed root formed titanium alloy “screw” is placed within the jawbone to act just like a natural tooth would. It can function and mimic a natural tooth to make a very pleasing smile and tooth replacement. An implant can replace a single tooth, multiple teeth or can support bridges, partials and dentures. By supporting removable options they can make the fit and function multiple times better for chewing and biting efficiency. A removable partial denture or RPD is an appliance that can be removed by the patient and is attached to the remaining teeth by way of attachments. These attachments are usually made of metal and hold on to the existing teeth to help support and steady the appliance.

What is a denture?

There are many options all of which center around being fixed or removable. Removable options include dentures and removable partial dentures A dental implant( to replace a single tooth) is designed to permanently replace missing teeth in a fixed non-removable fashion. A specially designed root formed titanium alloy “screw” is placed within the jawbone to act just like a natural tooth would. It can function and mimic a natural tooth to make a very pleasing smile and tooth replacement. An implant can replace a single tooth, multiple teeth or can support bridges, partials and dentures. By supporting removable options they can make the fit and function multiple times better for chewing and biting efficiency. A denture is needed when you are missing all of your teeth. It is removable and is recommended not to sleep in them due to tissues needing rest from forces applied while chewing. The upper denture can stay in place quite well depending on the amount of bony ridge left over upon tooth extraction or removal. You see, our bone in our jaws has one purpose and that is to hold and support our teeth, once all the teeth are removed the bone starts to atrophy. This atrophy over time is why dentures need to be relined and adjusted on a regular basis. Lower dentures move around quite frequently due to the muscles of the tongue and cheek that have their attachments along where the borders of the dentures sit.

A denture depends on suction to hold it in and can be aided by attaching them to dental implants. By the addition of dental implants, dentures are now very predictable and there is no longer and reason why they should come out and be limited by certain foods. The higher the number of implants supporting a denture the more stable it can become. 

What exactly is an implant-supported denture?

There are many options all of which center around being fixed or removable. Removable options include dentures and removable partial dentures A dental implant( to replace a single tooth) is designed to permanently replace missing teeth in a fixed non-removable fashion. A specially designed root formed titanium alloy “screw” is placed within the jawbone to act just like a natural tooth would. It can function and mimic a natural tooth to make a very pleasing smile and tooth replacement. An implant can replace a single tooth, multiple teeth or can support bridges, partials and dentures. By supporting removable options they can make the fit and function multiple times better for chewing and biting efficiency. An implant-supported denture is one that is attached or supported by a number of implants. At least two and most likely 3-4 implants are placed and attachments are connected to the bottom side of the denture. Think of a nylon snap, one part being on the implant and the corresponding connector on the underbelly of the denture. By this method a denture can click or snap to place and be help firm and steady while normal chewing functions. Implants can also support a denture by 4 implants making it non removable. It will be fastened to place and can only be removed by a dentist training in this sort of care.

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