Question 1

When is a crown needed?

Accepted Answer

A crown is considered when a tooth is too damaged for a simple filling: a large cavity, a fracture, an extensive old restoration, a root-treated tooth or a significant cosmetic need. A crown is a cap that covers the entire visible part of the tooth. It restores the shape, strength and appearance of the tooth when the remaining structure is no longer enough to hold a conventional filling. The most frequent situations are an extensive cavity, a cracked or broken tooth, a weakened root-treated tooth, a large old filling that is breaking down, or a heavily discoloured or misshapen tooth. A crown is also used as the visible part on an implant, or as a support for a bridge that replaces a missing tooth. When the loss of tooth structure is more limited, more conservative solutions exist, such as an inlay, an onlay or a veneer. The dentist chooses with you the option that preserves the most natural tooth while providing a lasting restoration.

Question 2

What materials are crowns made of?

Accepted Answer

Mainly ceramic, with different types depending on the tooth and its use, or ceramic on a metal base. The choice takes into account appearance, strength and your situation. All-ceramic crowns are widely used today. Some ceramics favour translucency and appearance, which makes them ideal for front teeth. Others, which are stronger, suit back teeth that bear heavy pressure. Porcelain-fused-to-metal crowns combine a metal framework covered with ceramic. They remain a proven solution in certain situations, but the metal base can sometimes show as a thin grey line at the edge of the gum. The choice depends on the position of the tooth, the space available, the colour of the underlying tooth, your habits such as clenching, and your cosmetic expectations. All crowns are made by a dental laboratory from an impression. The dentist explains the material recommended in your case and states this choice on the written estimate.

Question 3

How is a crown fitted and how long does it last?

Accepted Answer

Generally two appointments or more: preparing the tooth, impression and temporary crown, then fitting the crown. Well maintained, it can last for many years, with no fixed lifespan. At the first appointment, under local anaesthesia, the dentist prepares the tooth by giving it a suitable shape, then takes an impression. The shade is chosen with you. A temporary crown is fitted to protect the tooth while the final crown is made. The dental laboratory then makes the crown. At the next appointment, the dentist removes the temporary crown, checks the fit, the contact with the neighbouring teeth and your bite, then fixes the crown permanently. How long a crown lasts depends on hygiene, the health of the gums, the quality of the underlying tooth and your habits. The tooth under the crown can still decay at the edge if plaque builds up there. Careful brushing, cleaning between the teeth and regular check-ups help it last a long time. No lifespan is guaranteed, but attentive follow-up makes it possible to spot any problem early.

Question 4

How does a dental bridge work?

Accepted Answer

A bridge replaces one or more missing teeth with a fixed prosthesis supported by the neighbouring teeth or by implants. It is not removed by the patient. A bridge consists of crowns placed on the teeth on either side of the gap, called abutments, joined to one or more artificial teeth in the middle. The whole unit is fixed permanently in the mouth. On natural teeth, the abutments have to be reshaped to receive the crowns. This solution is particularly worthwhile when these teeth are already crowned or heavily restored. A bridge can also rest on implants, which avoids touching the neighbouring teeth. Cleaning requires a little attention: you need to pass under the artificial tooth with a special floss or interdental brushes, because plaque can build up there. The dentist shows you how when the bridge is fitted. A bridge is generally made over two appointments or more, as with a crown, with a temporary bridge in between. The dentist explains whether a bridge, an implant or another solution suits your situation more closely.

Question 5

When should a removable denture be considered?

Accepted Answer

A removable denture replaces several teeth or a whole arch and comes out for cleaning. It can be partial or complete, and is sometimes stabilised by implants. A partial removable denture replaces several missing teeth by resting on the remaining teeth and on the gum, often with the help of clasps. A complete denture replaces all the teeth in an arch and rests on the gum and the bone. It may be proposed when several teeth are missing in different places, when the remaining teeth cannot support a bridge, or as a temporary solution while waiting for implant treatment. The first few weeks require a period of adjustment: speaking and chewing with a denture are learnt gradually. Small adjustments are often needed to remove sore spots. When the stability of a complete denture is a problem, particularly in the lower jaw, a few implants can be used to hold it in place. The dentist presents the different options, with their advantages and their limits, at the consultation.

Crowns, bridges and dentures

Crowns, bridges and dentures

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