Crowns and Bridges in Redmond

Crowns and bridges are custom-made restorations that are cemented or bonded onto your teeth or onto dental implants. Unlike dentures, they stay in place and aren’t removed for cleaning. A crown covers and protects a single damaged tooth, while a bridge fills the gap left by one or more missing teeth.

What Is a Dental Crown?

A crown, sometimes called a cap, covers the entire visible part of a tooth above the gumline. It restores the tooth’s shape, size and strength, and improves how it looks.

When a Crown May Be Recommended

• A large filling. When a filling would make up most of the tooth, the tooth that remains can be weak and likely to crack.
• A cracked or broken tooth. A crown holds the tooth together and protects it from further damage.
• After a root canal. Back teeth that have had root canal treatment are usually covered with a crown to help keep them from breaking.
• A dental implant. The visible tooth on top of an implant is a crown.
• Severe wear. Teeth worn down by grinding or acid erosion can be rebuilt.
• Appearance. A crown can improve a tooth that is badly discolored or misshapen when other options aren’t suitable.

Crown Materials

Crowns can be made from several materials. Your dentist will recommend one based on where the tooth is, how much chewing force it takes, and how it needs to look:

• Porcelain and other ceramics are tooth-colored and can closely match your natural teeth, which makes them a popular choice for front teeth.
• Zirconia is a very strong, tooth-colored ceramic that is often used for back teeth, which do the heaviest chewing.
• Porcelain fused to metal crowns have a metal base covered with porcelain, combining strength with a tooth-colored surface.
• Metal crowns, such as gold alloy, are very durable and need less of the tooth to be reshaped, but they aren’t tooth-colored, so they’re mostly used on back teeth.

How a Crown Is Done

A crown is usually completed in two visits: one to prepare the tooth and one to place the finished crown.

1. Exam and planning. Your dentist examines the tooth and takes X-rays to check the root and the bone around it. If the nerve inside the tooth is badly damaged or infected, a root canal may be needed first; if so, we’ll refer you to a specialist (an endodontist).
2. Preparing the tooth. After numbing the area, your dentist removes any decay and old filling material and shapes the tooth so the crown can fit over it. If much of the tooth is missing, it may first be rebuilt with filling material, called a core buildup.
3. Digital scan. Instead of a putty impression, we take a digital scan of the prepared tooth and the teeth around it. The shade of your neighboring teeth is recorded so the crown can be color-matched.
4. Temporary crown. A temporary crown is placed to protect the tooth while your permanent crown is made by a dental laboratory.
5. Fitting and cementing. At the second visit, the temporary is removed and the permanent crown is checked for fit, bite and color. Once you and your dentist are happy with it, it is cemented or bonded in place.

What Is a Dental Bridge?

A bridge replaces one or more missing teeth by spanning, or “bridging,” the gap. A traditional bridge is made as one connected piece: crowns on the teeth on each side of the gap, called abutment teeth, hold the replacement tooth or teeth between them, called pontics. The bridge is then cemented onto the abutment teeth.

Filling the space does more than complete your smile. When a tooth is missing, the neighboring teeth can drift or tip into the gap, and the opposing tooth can shift up or down, which can change your bite.

Types of Bridges

• Traditional bridge: crowns on the teeth on both sides of the gap support the pontic. This is the most common type.
• Cantilever bridge: the pontic is supported by an abutment tooth on one side only. It is used in specific situations.
• Resin-bonded (Maryland) bridge: the pontic is held by small metal or ceramic wings bonded to the back of the neighboring teeth, so those teeth need little or no reshaping. It is most often used for front teeth.
• Implant-supported bridge: dental implants, rather than natural teeth, support the bridge. It is often used when several teeth in a row are missing.

How a Bridge Is Done

A traditional bridge follows steps similar to a crown:

1. Exam and planning. Your dentist checks the health of the abutment teeth, gums and bone, and talks with you about whether a bridge, an implant or another option fits your situation.
2. Preparing the abutment teeth. With the area numbed, the teeth on each side of the gap are shaped so crowns can fit over them.
3. Scan and shade. The prepared teeth and the gap are scanned the same way, so the laboratory can make the bridge, and the shade is matched to your teeth.
4. Temporary bridge. A temporary bridge protects the prepared teeth and fills the space while the final bridge is made.
5. Fitting and cementing. Your dentist checks the fit, bite and appearance of the final bridge, then cements it in place.

Caring for Crowns and Bridges

Crowns and bridges can’t decay, but the natural tooth underneath can, especially where the crown meets the gum. Brush twice a day and clean between your teeth daily. To clean under a bridge, use a floss threader, special floss or a small interdental brush beneath the pontic. Avoid chewing ice and other very hard objects, and ask about a night guard if you grind your teeth. At regular checkups, your dentist will check the edges of your crowns and bridges and the health of the gums around them.