Aftercare of crown and bridge restorations
Teeth that have received large restorations like crowns are never as strong as totally intact teeth and proper care should be taken to ensure that these teeth give you long trouble-free service.
The key things to remember with crowns and bridges are:
Bite Force
It is important to remember that while crowns and bridges are strong restorations they are not indestructible. In general you should never try using your teeth in place of gadgets such as nutcrackers or bottle openers and this applies even more to your crowns and bridges. Very hard foods (like crabshells, ice and the like) should be avoided.
There is also a correlation between the degree and frequency of hard biting or clenching and the speed at which crown and bridge restorations are damaged and require replacement.
Factors that increase the biting force and stresses on crowns and bridges (as well as all the other structures of the mouth) include:
Any patient who exhibits any of these factors should have a mouthguard made to protect, not only the crowns and bridges but also the rest of the intact teeth
Oral Hygiene
The surface of a crown/ bridge is highly polished ceramic (or more rarely metal). These surfaces do not attract plaque or stain easily.
However every crown/bridge has a margin where it meets the tooth structure. When the bridge/crown is fitted we try to make this margin as smooth as we possibly can, it is still not perfectly smooth as constitutes the Achilles heel of the entire restoration. This margin must be kept meticulously clean to avoid development of dental caries or gum disease.
Can dental crowns/bridges be repaired?
There are many scenarios that can arise in terms of dental crowns/bridges being damaged but they can be broadly classified into 2 categories:
(1) Failure of the underlying tooth structure/core material
This usually leads to the crown/bridge loosening or falling out, usually completely intact. In these scenarios the crown/bridge is not damaged and is not in need of repair. Treatment is directed toward the underlying structure. The most common causes of such failure are dental caries (tooth decay), gum disease causing loosing of the teeth from the jaw and fracture of the tooth structure.
(2) Cracking of the structure of the crown/bridge
All metal crowns/bridges are practically immune from this sort of failure though in some extreme cases they can be worn through (perforated) by excessive wear from the opposing tooth. This sort of damage is almost always associated with ceramic structure.
Normally a cracked/chipped crown/bridge will need to be replaced. Temporary repair is often possible using a special chemical to surface treat the ceramic and then bonding composite resin to the crown/bridge. However such repairs are regarded as temporary as the strength of the bond and the repair material itself is much less than the ceramic of the crown/bridge.
The key things to remember with crowns and bridges are:
Bite Force
It is important to remember that while crowns and bridges are strong restorations they are not indestructible. In general you should never try using your teeth in place of gadgets such as nutcrackers or bottle openers and this applies even more to your crowns and bridges. Very hard foods (like crabshells, ice and the like) should be avoided.
There is also a correlation between the degree and frequency of hard biting or clenching and the speed at which crown and bridge restorations are damaged and require replacement.
Factors that increase the biting force and stresses on crowns and bridges (as well as all the other structures of the mouth) include:
- Night grinding or clenching
- Sports and other activities that cause heavy clenching - weight lifting
- High stress occupations which may predispose to a high degree of clenching and grinding during work.
Any patient who exhibits any of these factors should have a mouthguard made to protect, not only the crowns and bridges but also the rest of the intact teeth
Oral Hygiene
The surface of a crown/ bridge is highly polished ceramic (or more rarely metal). These surfaces do not attract plaque or stain easily.
However every crown/bridge has a margin where it meets the tooth structure. When the bridge/crown is fitted we try to make this margin as smooth as we possibly can, it is still not perfectly smooth as constitutes the Achilles heel of the entire restoration. This margin must be kept meticulously clean to avoid development of dental caries or gum disease.
Can dental crowns/bridges be repaired?
There are many scenarios that can arise in terms of dental crowns/bridges being damaged but they can be broadly classified into 2 categories:
(1) Failure of the underlying tooth structure/core material
This usually leads to the crown/bridge loosening or falling out, usually completely intact. In these scenarios the crown/bridge is not damaged and is not in need of repair. Treatment is directed toward the underlying structure. The most common causes of such failure are dental caries (tooth decay), gum disease causing loosing of the teeth from the jaw and fracture of the tooth structure.
(2) Cracking of the structure of the crown/bridge
All metal crowns/bridges are practically immune from this sort of failure though in some extreme cases they can be worn through (perforated) by excessive wear from the opposing tooth. This sort of damage is almost always associated with ceramic structure.
Normally a cracked/chipped crown/bridge will need to be replaced. Temporary repair is often possible using a special chemical to surface treat the ceramic and then bonding composite resin to the crown/bridge. However such repairs are regarded as temporary as the strength of the bond and the repair material itself is much less than the ceramic of the crown/bridge.