All crowns are designed to restore functionality to a damaged tooth. But crowns can differ from one another in their appearance, in the material they’re made from, and how they blend with other teeth.
A crown is a metal or porcelain artifice that’s bonded permanently over a decayed or damaged tooth. Every crown process begins with preparation of the tooth so the crown will fit over it. Afterward, we make an impression of the prepared tooth digitally or with an elastic material that most often is sent to a dental laboratory to create the new crown.
It’s at this point where crown composition and design can diverge. Most of the first known crowns were made of metal (usually gold or silver), which is still a component in some crowns today. A few decades ago dental porcelain, a form of ceramic that could provide a tooth-like appearance, began to emerge as a crown material. The first types of porcelain could match a real tooth’s color or texture, but were brittle and didn’t hold up well to biting forces. Dentists developed a crown with a metal interior for strength and a fused outside layer of porcelain for appearance.
This hybrid became the crown design of choice up until the last decade. It is being overtaken, though, by all-ceramic crowns made with new forms of more durable porcelain, some strengthened with a material known as Lucite. Today, only about 40% of crowns installed annually are the metal-porcelain hybrid, while all-porcelain crowns are growing in popularity.
Of course, these newer porcelain crowns and the attention to the artistic detail they require are often more expensive than more traditional crowns. If you depend on dental insurance to help with your dental care costs, you may find your policy maximum benefit for these newer type crowns won’t cover the costs.
If you want the most affordable price and are satisfied primarily with restored function, a basic crown is still a viable choice. If, however, you would like a crown that does the most for your smile, you may want to consider one with newer, stronger porcelain and made with greater artistic detail by the dental technician. In either case, the crown you receive will restore lost function and provide some degree of improvement to the appearance of a damaged tooth.
Roughly 75% of American adults are missing at least one tooth, mostly from disease, trauma or extraction for other dental reasons. A few missing teeth, though, never erupted in the first place.
It’s a rare occurrence, but sometimes people are born without certain teeth, usually back molars or premolars that may not be as visible. Occasionally, though, it’s the more visible upper lateral incisors positioned on either side of the central incisors (the two front teeth on either side of the midline of the face).
Missing incisors can lead to poor bites and create difficulties for speech development and nutrition. But these highly visible (or in this case, “invisible”) teeth can also detract from an otherwise attractive smile.
There are ways, however to correct a smile with missing lateral incisors. Here are 3 of those ways.
Canine substitution. We can fill the vacancy created by the missing incisors by orthodontically moving the canines (the “eyeteeth,” normally next to them) into the space. Braces can close the gap in a conservative way, while possibly correcting any existing bite problems. Because canines are larger than incisors, its often necessary to re-contour them and restore them with a crown, veneer or bonding material to look more natural.
Fixed bridge. A second way to fill the space is with a dental bridge. A bridge consists of a series of crowns fused together in a row. The middle crowns replace the missing teeth; the end crowns cap the natural teeth on either end of the gap, which establishes support for the bridge. Another variation is a cantilever bridge in which only one natural tooth is capped for support. With either type, though, the capped teeth will be permanently reduced in size to accommodate the crowns.
Dental implants. This popular restoration is also a favorite for correcting missing incisors. Implants provide a life-like and durable replacement for missing teeth, while not requiring any alterations to existing teeth as with a bridge. But they are more expensive than the other options, and they require adequate space between the adjacent teeth for insertion, as well as healthy bone for proper placement and anchorage. This is also an option that must wait until the jaw has fully matured in early adulthood.
If you would like more information on treating congenitally missing teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “When Permanent Teeth Don't Grow: Treatment Options for Congenitally Missing Lateral Incisors.”
Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"
"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.
The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.
Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.
Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).
The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.
Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.
So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”
For years people tuned in to enjoy one of David Letterman's "Top 10 lists," a frequent gag performed on his show Late Night. Each countdown list poked fun at off-the-wall topics like "Top 10 New York City Science Projects" or "Top 10 Questions People Ask when Shopping for an Umbrella."
Recently, the American Dental Association presented their own kind of list—"America's Top 3 Oral Health Problems"—based on surveys of around 15,000 people across the U.S. But unlike the popular Late Night lists, this one is no laughing matter.
Coming in at #3, 29% of the respondents indicated they had experienced tooth pain at some time in their life. Tooth pain is the body's way of alerting to trouble in the mouth, anything from a decayed tooth to a gum abscess. The best thing to do if you have any persistent oral pain is to see your dentist as soon as possible for a thorough examination. And you should do this even if the pain goes away.
The second most prominent oral problem among people is difficulty biting or chewing, about 31% of those in the surveys. As with tooth pain, the reasons can vary greatly, including cracked, loose or deeply decayed teeth, dentures or jaw joint disorders (TMD). Because dental disease is usually the ultimate culprit, the best way to avoid this is to practice daily brushing and flossing and regular dental visits. And, as with tooth pain, you should see your dentist if you're having symptoms.
At 33% of respondents, the number one oral problem in America is chronic dry mouth. It's a constant inadequate flow of saliva often caused by medications or certain systemic conditions. Because saliva helps protect the mouth against infection, a restricted flow increases your risk of disease. If you notice your mouth is dry all the time, you should talk to your dentist about ways to boost your saliva. If you're taking medications, ask your doctor if they could be causing your symptoms and if you could change to something else.
While any of these Top 3 oral problems can be a stepping stone to more serious dental problems, it doesn't necessarily have to lead to that. You can improve your dental health through daily oral hygiene and regular dental treatment. And it might help you stay off this unpleasant list.
If you would like more information on treating dental disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Top 3 Oral Health Problems.”
Be sure to mark August 6 on your calendars—and not just because it's the day in 1661 when the Dutch sold Brazil to Portugal, or when President Johnson signed the Voting Rights Act in 1965, or when the Ramones performed for the last time in 1996. August 6 also happens to be National Fresh Breath Day! But since fresh breath is important to us every day, we like to celebrate all month long.
Celebrating fresh breath might not seem as noteworthy as these other historical moments, but if you're a frequent halitosis (bad breath) sufferer, you know it can be downright embarrassing. More importantly, it could be a sign of a deeper health problem. It turns out there are a number of reasons why you might have bad breath. Here are the most common.
You're not adequately cleaning your mouth. Certain strains of bacteria are known for emitting volatile sulfur compounds, which give rise to that "rotten egg" smell and are a major component of bad breath. Because they feed on leftover sugars and proteins from food, you can keep them and their noxious odors at bay by brushing and flossing your teeth and brushing the broad surface of the tongue, a prime breeding ground for these bacteria.
You're not producing enough saliva. This unsung bodily fluid is a key part of good oral health. Besides helping to rinse the mouth of food particles after eating, saliva also fights odor-causing bacteria. If your mouth is dry because you're not producing enough saliva, bacteria can grow and create a number of oral health problems, including bad breath. You may be able to relieve chronic dry mouth and accompanying bad breath by using saliva-boosting agents or drinking more water. You should also talk to your doctor about any medications you're taking that might interfere with saliva production.
It could be caused by disease. Tooth decay or periodontal (gum) disease naturally give rise to bad breath—but so can other diseases like diabetes, cancer or respiratory infections. As you're dealing with these other conditions, you may also need to contend with bad breath as a side effect. You can help reduce any disease-based odors by keeping up your daily oral hygiene, especially if you're undergoing treatment for a systemic condition. Obtaining treatment, particularly if you have tooth decay or gum disease, will help reduce these embarrassing foul odors.
National Fresh Breath Day may not share the same pedestal with other momentous August dates, but if it reminds you to keep your mouth clean and see your dentist regularly, fresh breath certainly deserves its own day.
If you would like more information about the causes and remedies for bad breath, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Bad Breath: More Than Just Embarrassing” and “Dry Mouth.”
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