Fixed and Removable Prosthodontics

What are Dental Crowns and Tooth Bridges?

Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily, crowns and bridges are cemented onto existing teeth or implants and can only be removed by a dentist.

How do Crowns Work?

A crown is used to entirely cover or "cap" a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function. Porcelain or ceramic crowns can be matched to the color of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive.

Your dentist may recommend a crown to:

• Replace a large filling when there isn't enough tooth remaining
•  Protect a weak tooth from fracturing
•  Restore a fractured tooth
•  Attach a bridge
•  Cover a dental implant
• Cover a discolored or poorly shaped tooth
•  Cover a tooth that has had root canal treatment

How do Bridges Work?

A bridge may be recommended if you're missing one or more teeth. Gaps left by missing teeth eventually cause the remaining teeth to rotate or shift into the empty spaces, resulting in a bad bite. The imbalance caused by missing teeth can also lead to gum disease and temporomandibular joint (TMJ) disorders.

Bridges are commonly used to replace one or more missing teeth. They span the space where the teeth are missing. Bridges are cemented to the natural teeth or implants surrounding the empty space. These teeth, called abutments, serve as anchors for the bridge. A replacement tooth, called a pontic, is attached to the crowns that cover the abutments. As with crowns, you have a choice of materials for bridges. Your dentist can help you decide which to use, based on the location of the missing tooth (or teeth), its function, aesthetic considerations and cost. Porcelain or ceramic bridges can be matched to the color of your natural teeth.

How are Crowns and Bridges Made?

Before either a crown or a bridge can be made, the tooth (or teeth) must be reduced in size so that the crown or bridge will fit over it properly. After reducing the tooth/teeth, your dentist will take an impression to provide an exact mold for the crown or bridge. If porcelain is to be used, your dentist will determine the correct shade for the crown or bridge to match the color of your existing teeth.
Using this impression, a dental lab then makes your crown or bridge, in the material your dentist specifies. A temporary crown or bridge will be put in place to cover the prepared tooth while the permanent crown or bridge is being made. When the permanent crown or bridge is ready, the temporary crown or bridge is removed, and the new crown or bridge is cemented over your prepared tooth or teeth.

How Long do Crowns and Bridges Last?

While crowns and bridges can last a lifetime, they do sometimes come loose or fall out. The most important step you can take to ensure the longevity of your crown or bridge is to practice good oral hygiene. A bridge can lose its support if the teeth or bone holding it in place are damaged by dental disease. Keep your gums and teeth healthy by Brushing with fluoride toothpaste twice a day and flossing daily. Also see your dentist and hygienist regularly for checkups and professional cleanings.

Removable Prosthodontics

What are Dentures?

Dentures are replacements for missing teeth that can be taken out and put back into your mouth. While dentures take some getting used to and will never feel exactly the same as one's natural teeth, today's dentures are natural looking and more comfortable than ever.
There are two main types of dentures: full and partial. Your dentist will help you choose the type of denture that's best for you based on whether some or all of your teeth are going to be replaced and the cost involved.

Partial Denture Basics

Benefits of Dentures

Replacing missing teeth will help to improve your appearance and smile. Without support from the denture, facial muscles sag, making a person look older. Dentures can help you eat and speak more comfortably.

A partial denture is one type of appliance your dentist may recommend. With this type of dental appliance, the false teeth are supported by a metal framework. The metal framework attaches to the natural teeth on either side of the false teeth, somewhat like a retainer. You can easily remove the appliance at home, which will allow you to take it out at night and clean it thoroughly, explains the Canadian Dental Association (CDA).

How do Dentures Work?

With full dentures, a flesh-colored acrylic base fits over your gums. The base of the upper denture covers the palate (the roof of your mouth), while that of the lower denture is shaped like a horseshoe to accommodate your tongue.

Dentures are custom-made in a dental laboratory from impressions taken of your mouth. Your dentist will determine which of the three types of dentures described below is best for you.

• Conventional Full Denture

A conventional full denture is placed in your mouth after any remaining teeth are removed and tissues have healed. Healing may take several months, during which time you are without teeth.

• Immediate Full Denture

An immediate full denture is inserted immediately after the remaining teeth are removed. (Your dentist takes measurements and makes models of your jaw during a prior visit.) While immediate dentures offer the benefit of never having to be without your teeth, they must be relined several
months after being inserted. The reason is that the bone supporting the teeth reshapes as it heals, causing the denture to become loose.

• Partial Denture

A partial denture rests on a metal framework that attaches to your natural teeth. Sometimes crowns are placed on some of your natural teeth and serve as anchors for the denture. Partial dentures offer a removable alternative to bridges.

How Long Before I Get Used to My Dentures?

New dentures may feel awkward or uncomfortable for the first few weeks or even months. Eating and speaking with dentures might take a little practice. A bulky or loose feeling is not uncommon, while the muscles of your cheeks and tongue learn to hold your dentures in place. Excessive saliva flow, a feeling that the tongue does not have adequate room, and minor irritation or soreness are also not unusual. If you experience irritation, see your dentist.

How Long do Dentures Last?

Over a period of time, your denture will need to be relined, remade, or rebased due to normal wear. Rebasing means making a new base while keeping the existing denture teeth. Also, as you age, your mouth naturally changes. These changes cause your dentures to loosen, making chewing difficult and irritating your gums. At a minimum, you should see your dentist annually for a checkup.

Here are tips for caring for your dentures:

• When handling your dentures, stand over a folded towel or basin of water. Dentures are delicate and may break if dropped.
• Don't let your dentures dry out. Place them in a denture cleanser soaking solution or in plain water when you're not wearing them. Never use hot water, which can cause them to warp.
•  Brushing your dentures daily will remove food deposits and plaque and help prevent them from becoming stained. An ultrasonic cleaner may be used to care for your dentures, but it does not replace a thorough daily brushing.
• Brush your gums, tongue and palate every morning with a soft-bristled brush before you insert your dentures. This stimulates circulation in your tissues and helps remove plaque.
• See your dentist if your dentures break, chip, crack or become loose. Don't be tempted to adjust them yourself — this can damage them beyond repair.

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