As a result of tooth decay, portions of the healthy tooth dissolve away leaving structural defects in the tooth. Once the bacteria are removed, the missing portion of the tooth needs to be reconstructed with some type of a filling material.
The most common material of choice today is a tooth colored composite or structurally reinforced plastic. Gold or porcelain is another option which has its specific indications as well. Dental amalgam also referred to as a silver filling while used extensively in the past continues to have indications for use, although limited in today’s aesthetically conscious culture. Finally, I have used a material called glass ionomer which is a cement that releases fluoride over time extensively in those patients who get cavities on their roots as a result of dry mouth.
Tooth decay left unattended to can cause pain, infection and lost time from school and work.
When extensive tooth destruction takes place as a result of decay or trauma, a simple filling is not strong enough to restore a tooth to its original form and function. Most teeth that receive root canal therapy become sufficiently weakened to warrant reinforcement with a crown as well. Fractured, broken and unsightly stained teeth sometime require crowns. There are times when due to excessive wear and lost tooth structure all the teeth have to be crowned in order to reestablish a normal and functional bite. Smile makeovers, although elective require that crowns be placed on those teeth that are involved when a patient smiles.
There are a variety of materials used to crown teeth, In the past porcelain fused to metal or gold crowns were used extensively. Today my practice has incorporated all ceramic crowns. They are durable as well as beautiful and typically require less tooth preparation. Since I no longer take impressions and have incorporated 3 Shape Digital Impressions into my practice, many of my crowns are fabricated using CAD/CAM technology increasing the accuracy and longevity of our crowns.
When a missing tooth needs to be replaced, a fixed bridge is an alternative for treatment to be considered. In essence, the teeth on either side of the missing tooth or teeth need to be crowned. To those crowns a replacement tooth or teeth is attached. The entire prosthesis, crowns and replacement teeth are then cemented in place. Fixed bridges are not removable and proved an esthetic durable alternative to replace missing teeth.