crowns, bridges, dentures & veneers
What is a crown?
A crown is a cap that is placed over a tooth and held in place by dental adhesive or cement.
Crowns are used for several reasons:
as a protective cover for badly decayed teeth or fractured teeth
as a permanent restoration for teeth with large fillings
to correct minor problems in natural teeth like spacing and irregular shape or severe discolouration.
What are crowns made from?
Crowns can be made from a variety of materials. They can be made from plastic, ceramic or metal alloys. A combination of metal and ceramic is also possible to maximise strength and simulate the appearance of natural teeth.
How are crowns made?
Firstly, a thorough clinical examination is conducted with radiographs, by the dentist. The suitability for crowns is assessed and any preparatory work is carried out. Your dentist will also be able to advise on material choices, treatment sequence and any other concerns you may have.
At the second appointment, the teeth to be crowned are prepared. This involves reduction of the tooth size (usually under local anaesthesia) followed by an impression or mould of the prepared tooth. This trimming of the tooth is required to create space for the crown to be fitted. The mould taken is then sent to a laboratory where skilled technicians will fabricate the crown. In the meantime, a temporary crown is made and fitted onto the trimmed tooth.
At the third appointment, the temporary crown is removed and the tooth surfaces cleaned. The completed crown is tried on the tooth for fit, harmony with the bite, and appearance. Finally, the crown is cemented onto the prepared tooth with dental cement.
How long do crowns last and how do I care for them?
Crowns are made of inert materials that do not deteriorate over time. However, the underlying tooth is still prone to decay and gum disease.
Ceramic on the surface may chip or fracture. Avoid chewing excessively-hard substances like ice or bones. Daily brushing and flossing are essential for maintaining good oral health as well as keeping the crown trouble-free. The most vulnerable portion of the crown is the margin or the junction between tooth and crown.
Regular check-ups will enable your dentist to detect any problems with your crown and recommend necessary treatment.
What are bridges made of?
Bridges are usually made of a precious metal. If the bridge will show, porcelain is then bonded to the base. Sometimes, there are other non-precious metals used in the base for strength.
Are bridges expensive?
Although a bridge may seem costly they can be a wise investment that will give many years of good service. It will also improve your appearance and bite. A bridge uses the considerable skill of the dentist and technician, and in this way, it’s similar to ordering a piece of hand-made jewellery.
How do I look after my bridge?
You need to clean your bridge every day, to prevent problems such as bad breath and gum disease. You also have to clean under the false tooth every day. Your dentist or hygienist will show you how to use a bridge needle or special floss, as a normal toothbrush cannot reach.
Dentures are removable false teeth made of acrylic (plastic), nylon or metal. They fit snugly over the gums to replace missing teeth and eliminate potential problems caused by gaps.
Gaps left by missing teeth can cause problems with eating and speech, and teeth either side of the gap may grow into the space at an angle. Sometimes all the teeth need to be removed and replaced.
You may therefore need either:
complete dentures (a full set) – which replace all your upper or lower teeth, or
partial dentures – which replace just 1 tooth or a few missing teeth
Dentures may help prevent problems with eating and speech and, if you need complete dentures, they may also improve the appearance of your smile and give you confidence.
This page provides information for anyone who's considering dentures and advice for those who already wear them.
How dentures are fitted
A full denture will be fitted if all your upper or lower teeth need to be removed or you're having an old complete denture replaced. The denture will usually be fitted as soon as your teeth are removed, which means you won't be without teeth. The denture will fit snugly over your gums and jawbone. But if you have dentures fitted immediately after the removal of several teeth, the gums and bone will alter in shape fairly quickly and the dentures will probably need relining or remaking after a few months. Occasionally, your gums may need to be left to heal and alter in shape for several months before dentures can be fitted. You can either see a dentist or a qualified clinical dental technician to have your dentures made and fitted.
The difference between a dentist and a clinical dental technician (in terms of producing dentures) is outlined below.
a dentist – will take measurements and impressions (moulds) of your mouth, and then order your full or partial dentures from a dental technician
a clinical dental technician – will provide a full set of dentures directly without you having to see your dentist (although you should still have regular dental check-ups with your dentist)
A trial denture will be created from the impressions taken of your mouth.
The dentist or clinical dental technician will try this in your mouth to assess the fit and for you to assess the appearance.
The shape and colour may be adjusted before the final denture is produced.
A partial denture is designed to fill in the gaps left by one or more missing teeth. It's a plastic, nylon or metal plate with a number of false teeth attached to it.
It usually clips onto some of your natural teeth via metal clasps, which hold it securely in place in your mouth. It can easily be unclipped and removed.
Occasionally, the clips can be made of a tooth- or gum-coloured material, although this type of clip isn't always suitable because it tends to be more brittle than metal.
Your dentist can measure your mouth and order a partial denture for you, or you can see a qualified clinical dental technician, who can provide a partial denture for you directly after you have first seen your dentist for a treatment plan and certificate of oral health.
A fixed bridge is an alternative to a partial denture and may be suitable for some people.
Crowns are put on the teeth either side of the gap and joined together by a false tooth that's put in the gap.
Looking after your dentures
Dentures may feel a bit strange to begin with, but you'll soon get used to wearing them. At first, you may need to wear your dentures all the time, including while sleeping. Your dentist or clinical dental technician will advise you on whether you should remove your dentures before you go to sleep. It isn't always necessary to remove your dentures at night, but doing so can allow your gums to rest as you sleep. If you remove your dentures, they should be kept moist – for example, in water or a polythene bag with some dampened cotton wool in it, or in a suitable overnight denture-cleaning solution. This will stop the denture material drying out and changing shape.
Keeping your mouth clean is just as important when you wear dentures.
It's important to regularly remove plaque and food deposits from your dentures.
Clean your dentures as often as you would normal teeth (at least twice a day: every morning and night).
brush your dentures with toothpaste or soap and water before soaking them to remove food particles
soak them in a fizzy solution of denture-cleaning tablets to remove stains and bacteria (follow the manufacturer's instructions)
brush them again as you would your normal teeth (but don't scrub them too hard)
Dentures may break if you drop them, so you should clean them over a bowl or sink filled with water, or something soft like a folded towel.
Eating with dentures
When you first start wearing dentures, you should eat soft foods cut into small pieces and chew slowly, using both sides of your mouth. Avoid chewing gum and any food that's sticky, hard or has sharp edges. You can gradually start to eat other types of food until you're back to your old diet. Never use toothpicks.
If your dentures fit properly, you shouldn't necessarily need to use denture fixative (adhesive). But if your jawbone has shrunk significantly, adhesive may be the only way to help retain your dentures. Your dentist or clinical dental technician will advise you if this is the case. At first, some people feel more confident with their dentures if they use adhesive. Follow the manufacturer's instructions and avoid using excessive amounts. Adhesive can be removed from the denture by brushing with soap and water. Remnants of adhesive left in the mouth may need to be removed with some damp kitchen roll or a clean damp flannel.
When to see your dentist
You should continue to see your dentist regularly if you have dentures (even if you have complete dentures) so they can check for any problems. Your dentures should last several years if you take good care of them. But your gums and jawbone will eventually shrink, which means the dentures may not fit as well as they used to and can become loose, or they may become worn.
See your dentist as soon as possible if:
your dentures click when you're talking
your dentures tend to slip, or you feel they no longer fit properly
your dentures feel uncomfortable
your dentures are visibly worn
If poorly fitting or worn dentures aren't replaced, they can cause great discomfort and lead to mouth sores, infections or problems eating and speaking.
Veneers are thin, custom-made shells crafted of tooth-coloured materials designed to cover the front side of teeth to improve the overall appearance of teeth. They are made of either thin plastic resin or porcelain and can be placed to:
Correct poorly formed or mildly mal-positioned teeth
Close gaps between teeth
Mask internal stains
Restore partially broken-down teeth
Tooth preparation is minimal and confined to the enamel structure. The veneer is bonded to the tooth structure with tooth-coloured resin cement. Several visits are necessary to complete treatment.
Patients should be aware that this is usually an irreversible process because it’s necessary to remove a small amount of enamel from your teeth to accommodate the shell.
To enable the smooth running of the practice we would request that all patients give us at least 24 hours’ notice in order to change or cancel their appointment. We also politely ask that patients inform us when they have a cold-sore to allow us to re-arrange your appointment to prevent any wasted journeys or time.