Crowns are full coverage restorations that are used to cover a tooth that is likely to break, or is too broken down to be restored with a filling. They are most commonly done after root canal treatment, or when a large filling breaks down. The larger the hole made by a cavity or faulty filling, the more likely a crown will be recommended. A tooth restored with a large filling is also at risk of breakage. The jaw muscles are the strongest in the human body, so the teeth are subjected to tremendous pressures. Crowns cover the weakened tooth, providing strength and protection against breakage. A broken or cracked tooth is a more serious problem and can be difficult to treat.
It takes two appointments to restore a tooth with a crown. In the first appointment all decay and/or defective filling is removed from the tooth and it is shaped to accept the crown. The dentist will then take an impression of the tooth. This impression is sent to the lab and is used to fabricate the crown. A temporary crown is made during this visit to protect the tooth. The crown is made of high-strength porcelain over gold alloy, all ceramic material, or gold alloy. In the second visit the temporary is removed and the area is cleaned and prepared for delivery. The permanent crown is evaluated for proper alignment and esthetic. The crown is then cemented over the tooth.
There are different types of dentures, but they share a common function. They replace teeth that have been removed due to bone loss or traumatic injury. When bone loss around the roots of teeth is extensive and no further treatment is available, the teeth must be removed. Similarly, a tooth broken to the bone level may not be restorable and may require removal.
The entire mouth is examined and a determination is made as to which teeth will have to be removed, and which will remain. The loose teeth are then extracted. Dentures are fitted to go over or around the supporting teeth that remain, depending on design. There are two types of dentures. A full denture is recommended when all the teeth must be removed. A full denture fits over the supporting bone and soft tissue. A partial denture is fabricated to replace selected missing teeth and is supported by the remaining teeth. Both full dentures and partial dentures are removable. An adjustment period is expected after delivery of any denture. The goal of a denture is to return the patient to proper function and acceptable esthetic.
A dental implant is an option to replace a missing tooth. In this procedure, a small titanium post is surgically implanted into the bone and allowed to heal. The bone grows around it to form a tight connection. The placement of an implant will slow the bone loss that occurs when the root of a natural tooth is missing. Once the implant is firmly set in the mouth, the dentist then designs the replacement tooth to anchor on the implant. This permanent solution has several advantages over bridge work. Some of the benefits include the preservation of the adjacent teeth, the fixed attachment and the natural feel of a completed implant supported crown.
Implants can also be used as support for a multiple tooth implant bridge. This is an alternative to a removable partial denture. Some of the advantages of an implant supported bridge include a more natural appearance, less bulk than a partial denture and less discomfort or difficulty with eating.
ROOT CANAL TREATMENT
Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed to reach all the way to the pulp. Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged and require root canal therapy. When the pulp becomes traumatized, an infection could develop and extend through the root tip(s) and form an abscess. Once the pulp is infected it must be treated as it cannot heal on its own. It can even weaken the entire immune system. This can be dangerous and very painful. Symptoms that the pulp has become infected may include sensitivity to hot/ cold or sweets, pain to biting or pressure, and a bad taste in the mouth. Sometimes a patient may experience no symptoms and is unaware of any problem until their checkup.
A root canal procedure is performed to clean out the infected tooth pulp and disinfect the canal(s) of the tooth. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. Usually a core build-up and crown is recommended to restore a root canal treated tooth to proper function. If a patient chooses not to have a root canal procedure completed, the tooth may need to be extracted.
This is an option for filling the space created by the loss of one or more teeth. It is designed to look like the missing teeth and is supported by the adjacent teeth. A bridge replaces the missing teeth to restore both function and cosmetics. The materials used may be gold alloy, porcelain bonded to metal alloy, or all ceramic material. The choice of material depends on the requirements for strength, wear, and/or esthetic. Bridge work is as much an art as it is an exact science.
It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated, the teeth surrounding the gap can begin to shift. Teeth use their neighbors for support and to maintain alignment. As the teeth shift into the space, the bite can change in response to the pressure. This can result in problems with the entire jaw including TMJ discomfort, misaligned teeth and localized periodontal pocketing. The difficulty to restore the area increases with each compounding problem.
TMJ stands for temporal-mandibular joint. Temporal, as in temple area of skull; mandibular as in mandible, or lower jaw; joint as in where the head and jaw meet. Problems in this joint may be caused by a misalignment of the teeth, trauma, or excess muscle tension. Aside from the two bones that meet there, cartilage buffers them and five muscles are involved in the area.
Problems in this area can cause many uncomfortable conditions for the patient. Some of which include headaches, earaches, trouble/soreness in opening and closing the mouth, clicking or popping of the jaw, pain in the jaw muscles and soreness in the area, sometimes extending to the face.
Dental treatments for the condition can include replacing missing teeth, moving teeth, adjusting the bite, and filling spaces between teeth. There is no one solution that is right for all cases. Sometimes a plastic mouthpiece is fabricated to prevent clenching or grinding that may be contributing to the problem. If untreated and taken to extremes, surgery may be required to repair a badly damaged joint.
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