Crowns
Crowns, also known as caps, are used in cases where other procedures will not be effective. Crowns have the longest life expectancy of all cosmetic restorations, but are the most time consuming.

Crowns range from full coverage conventional crowns, to conservative onlays or partial crowns. A crown is recommended when there is not enough tooth structure to predictably hold a filling. Crowns are imperative after root canal therapy. Often, crowns are recommended as a better alternative to fillings, or as a preventive measure when there is already a filling in place.

Alternative Treatments:
A filling may be an alternative; often a crown is the only choice to save the tooth. If decay is present, and you choose to do nothing, decay will grow, eventually causing pain, more expensive treatment and or tooth loss. If a preventive crown has been recommended, that tooth is at risk to fracture until treatment is provided.

**Crowns Can Now be Placed in a Single Visit with CEREC2
· The dentist performs the restoration in a single session, usually less than 1 hour.
· No need for a temporary crown that can come off or break requiring additional visits.
· No need for a second visit to deliver the crown.
· The restoration is natural looking, as it is made out of tooth-colored ceramic.

Our office is equipped with an instrument called CEREC 2, allowing us to make and install crowns in one visit. A conventional crown can take 2-10 visits. Here’s how it works. First, Dr. Belote prepares the damaged tooth by painting a thin layer of reflective powder on the tooth surface. Using a special camera, she then takes a picture of the tooth. This eliminates the need to make a messy impression. Dr. Belote works from this photo, which is actually a pin sharp optical impression of the tooth. Using computer technology, she is able to design the crown from the optical impression. Because the design is done chair-side on a color monitor, the patient can watch the design take place. They can also watch as the crown is made. The crown is made out of a block of ceramic material that matches the patients tooth color. It takes about eight minutes. After that, Dr. Belote bonds the newly milled crown to the tooth using an adhesive. In addition to partial and full crowns, veneers and all other single tooth restorations can be made. It’s a win-win situation for the patient and the dentist. Despite the $75,000 price tag, Dr. Belote says her patients won’t see any increase in her fees. The CEREC system was developed in Europe and introduced to the US in the late 1980’s. An updated version is now in place. Over 2 million restorations have been placed worldwide.

How is a crown placed?
A crown is a simple procedure. The decay or existing restoration is removed, and a porcelain or gold crown is made to very accurately fit your tooth. You should be comfortable during the procedure. An impression of teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.

Will it look natural?
Yes. The dentist's main goal is to create crowns that look like natural teeth. That is why dentists take an impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape, and length of your natural teeth. Any one of these factors alone can affect your appearance. If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.

Why crowns and not veneers?
Crowns require more tooth structure removal, hence, they cover more of the tooth than veneers. Crowns are stationary and are customarily indicated for teeth that have sustained significant loss of structure, or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.

How long do crowns last?
Crowns should last approximately 5-8 years. However, with good oral hygiene and supervision most crowns will last for a much longer period of time. Some damaging habits like grinding your teeth, chewing ice, or fingernail biting may cause this period of time to decrease significantly. Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth.

Post-op instructions:

1. You may experience some discomfort and temperature sensitivity. Deep decay will cause stronger symptoms, possibly even the need for root canal therapy.

2. Your gums may be tender, use topical numbing agents.

3. If your bite feels high, you may need a bite adjustment.

4. Be careful not to chew your cheek or tongue while you’re numb.

5. If you have any questions or concerns, contact our office 24 /7.

Additional Fees and Procedures:

1. About 5% of the time, a tooth that needs a crown will need root canal therapy during or after crown treatment. In other words, any tooth that needs a crown is a candidate to need root canal therapy. We try to avoid root canal therapy whenever possible.

2. In some cases we have to perform a surgical procedure on your gums using an electrosurgery unit. The gums will require healing time if this procedure is performed. 

3. Small changes in your bite can trigger pre-existing problems in your joint to lead to joint dysfunction.

4. No medical or dental treatment has a 100% success rate. Treatment can fail, requiring additional procedures to be performed. The tooth can decay around a crown, porcelain can fracture, abrasion can wear a hole in a crown… Most people can expect to replace crowns in their lifetime.

5. Diagnostic techniques are limited and a tooth may require additional, unanticipated treatment.

Bridges--Back to Top
A bridge is a restoration which replaces or spans the space where one or more teeth have been lost. There are two types of bridges - fixed and removable. Fixed bridges are bonded into place and can only be removed by a dentist. On the other hand, you can take out a removable bridge for cleaning. Removable bridges, while less expensive, may not be as desirable as fixed bridges and are not generally as stable.

Why do I need a bridge?
Your appearance, dental health and the proper functioning of your mouth are all important reasons for wearing a bridge. A bridge helps maintain the natural shape of your face and may help support your lips and cheeks. The loss of a back tooth may cause your mouth to sink and your face to look older. More importantly though, your dental health may suffer when teeth are not replaced. Teeth were designed to complement each other. When a tooth is lost, the nearby teeth may tilt toward the empty space, or teeth in the opposite jaw may move up or down toward the space. this places unusual stress on both the teeth and tissues in your mouth. In addition, the gum tissues and the bone that hold teeth in place can break down, increasing the risk of gum disease. Teeth that have tipped are difficult to clean, making them more likely to decay. Missing teeth can also affect the way you chew and speak. Chewing on only one side may cause stress to your mouth. You also need your teeth to speak properly, since they help make the many sounds needed in speech.

How is a bridge attached?
A fixed bridge is commonly cemented to the natural teeth next to the space left by the missing tooth. A false tooth replaces the lost tooth. Crowns which are cemented to the natural teeth, provide support for the bridge.

Some of this information was compiled for you by the Academy of General Dentistry. Your dentist cares about long-term dental health for you and your family and demonstrates that concern by belonging to the Academy of General Dentistry. As one of the 37,000 general dentists in the United States and Canada who are members of the Academy, your dentist participates in an ongoing program of professional development and continuing education to remain current with advances in the profession and to provide quality patient treatment. Visit the AGD's website below.