Modern Crowns

What’s new with crowns?

In terms of crowns or ‘caps’ for single teeth and ‘bridges’ for one or more missing teeth - new materials are being used. Traditionally metal was used for crowns and bridges due to its strength. Then the use of porcelain fused to metal crowns became the material of choice because of their esthetics and strength. The inner layer is metal with a tooth-coloured porcelain outer covering to match the other teeth in the mouth. However, porcelain fused to metal crowns can sometimes have a small gray rim of metal at their base.

The newest crowns can now be made with a ceramic base which is white in colour. Introduced in the last decade, Zirconia has mechanical properties which are the highest reported for any dental ceramic. Zirconia bases can be used with a porcelain outer layer to deliver great esthetic outcomes. Ceramic crowns can either have two layers or just one layer. In our office we have Cerec crowns. These ceramic crowns can be finished in one appointment! Usually a crown requires 1 week fabrication at a dental laboratory. With Cerec the crown is milled in the office at the same appointment! Ask us today if you are a candidate!

Since they are relatively new, only short term follow-up studies have been conducted but they show promising results. Long-term studies are needed to further assess clinical outcomes.

 

Impacted Wisdom Teeth

 Sometimes there isn't enough room for the wisdom teeth to erupt into the dental arch which leaves them either completely or partially submerged in your jaw bone. The partial submersion can cause a food trap which leads to constant irritation, pain and infection at the back of your mouth. This condition itself can be treated by diligently cleaning the area.

However, it is often very difficult for patients to keep this area clean on their own, as it is hard to reach. If care is not given, the irritation over time can cause bone loss at the back of your second molar (the one right before the wisdom tooth). This can lead to constant infection of the partially erupted tooth, called ‘pericoronitis’. This is what is happening when someone tells you his or her wisdom teeth hurt.

Braces and Wisdom Teeth?

Q: I already had braces but now I need to get my wisdom teeth out – Will my teeth shift?

A: No!

There is no evidence in studies that says wisdom tooth removal affects the alignment of straightened teeth in front of them! Also, if there is crowding in the front of your mouth, removal of the wisdom teeth will NOT fix it. Sometimes orthodontic treatment can ‘relapse’ or go back to the position of the teeth before treatment but this is usually due to not wearing a retainer!

Q: Can my dental implant get a cavity?

A: No! 

Implants are made of a different material than natural teeth, which makes them resistant to tooth decay. This doesn’t mean that you don’t have to brush and floss! Dental implants can still experience inflammation of the tissues surrounding them and even bone loss! This is called peri-implantitis. Your implants can be best maintained with diligent home care (brushing and flossing) and hygiene visits to have them professionally cleaned along with the rest of your teeth.

So many people get their wisdom teeth removed... Is it really necessary?

The quick answer is: sometimes! 

Your wisdom teeth, also known as third molars, are the most posterior teeth in the mouth and they erupt last. Some people have lots of room in their jaws and the third molars are able to grow into the arch and function well – in this case there is no need for removal. 

Unfortunately, a lot of the time this isn't the case. Usually there is not enough room in the jaws for these teeth to come in. When there is not enough room, sometimes the wisdom teeth only partially erupt. Sometimes they don’t erupt at all and remain ‘impacted’ or stuck in your jaw bones. Sometimes,  they can even grow in the wrong direction – sideways, downwards, horizontal etc.  These improper eruption patterns can cause problems. 

Math and Beauty

The golden proportion [1.618:1] can be found in plants, butterflies and elsewhere in nature. It has also been proposed that we perceive teeth to be more esthetically pleasing when the width of a central incisor related to the lateral is found at a ratio of 1.618:1.This ratio is also found in nature in butterfly’s wings, plant’s leaves and more. When things are arranged in this ratio, we perceive them to be more esthetically pleasing.

So you have a dental emergency...

My tooth just came out? What do I do?!

If it is a permanent (adult) tooth, your dentist may be able to put it back if you see them within about 1 hr of the incident!. Here’s what to do to improve your outcome:

• Handle the tooth by the crown only (the whiter part  -avoid touching the root)
• If dirty, rinse in salt water
• The tooth can be transported in milk,  saline, or if there’s nothing around just keep it in your own mouth! Don’t put it in plain water!
• Go to your nearest dentist or emergency center

More information for parents from Sick Kids Hospital: http://www.sickkids.ca/pdfs/dentistry/12902-dentalinjuries.pdf




I broke a piece of my tooth! What do I do?!

If you can find the piece, bring it to the dentist. Depending on how large the fracture is you may need either a filling or a crown (cap). If the nerve was injured or exposed, you may need a root canal as well.