Dental crowns are an essential means for restoring damaged or unattractive teeth. A well-crafted crown not only functions well, it looks and blends seamlessly with the rest of the natural teeth.
Crowns are artificial caps that cover an entire visible tooth, often used for heavily decayed or damaged teeth or as added protection after a root canal treatment. Most crowns are produced by a dental lab, but some dentists are now creating them in-office with computer-based milling equipment. On the whole, the various crowns now available function adequately as teeth—but they can vary in their appearance quality.
In the early to mid 20th Century the all-metal crown was the standard; but while durable, it could be less than eye-pleasing. Although more life-like dental porcelain existed at the time, it tended to be brittle and could easily shatter under chewing stress.
Dentists then developed a crown that combined the strength of metal with the attractiveness of porcelain: the porcelain fused to metal or PFM crown. The PFM crown had a hollow, metal substructure that was cemented over the tooth. To this metal base was fused an outer shell of porcelain that gave the crown an attractive finish.
The PFM reigned as the most widely used crown until the mid 2000s. By then improved forms of porcelain reinforced with stronger materials like Lucite had made possible an all-ceramic crown. They’re now the most common crown used today, beautifully life-like yet durable without the need for a metal base.
All-ceramics may be the most common type of crown installed today, but past favorites’ metal and PFM are still available and sometimes used. So depending on the type and location of the tooth and your own expectations, there’s a right crown for you.
However, not all crowns even among all-ceramic have the same level of aesthetic quality or cost—the more life-like, the more expensive. If you have dental insurance, your plan’s benefits might be based on a utilitarian but less attractive crown. You may have to pay more out of pocket for the crown you and your dentist believe is best for you.
Whatever you choose, though, your modern dental crown will do an admirable, functional job. And it can certainly improve your natural tooth’s appearance.
When things get unpleasant in your mouth, it’s most often related to some underlying cause. In fact, the discomfort you’re feeling is often a call to action to have it checked and treated.
The American Dental Association recently surveyed approximately 15,000 U.S. adults about their oral problems. If you have any of the top 3 problems found in this survey, it could be a “warning bell” sounding in your mouth right now.
Here, then, are the top 3 dental problems in America, what they mean and what you should do about them.
#3: Tooth Pain. About a third of respondents (more among those younger or from lower-income households) indicated pain as a problem. As a warning sign of something wrong, tooth pain could be telling you that you have a decayed tooth, a gum abscess or something similar. The best thing to do is get a checkup as soon as possible. It’s unlikely that whatever is causing the pain will go away on its own and procrastination could make ultimate treatment more complex and difficult.
#2: Difficulty Biting. A slightly higher number of people named difficulty chewing and biting as their main oral problem. As with tooth pain, chewing difficulty causes could be many: cracked, loose or decayed teeth, ill-fitted dentures, or a jaw joint disorder (TMD). Again, if it hurts to chew or bite, see a dentist. Besides the underlying problem, chewing difficulties could also affect the quality of your nutrition.
#1: Dry Mouth. Chronic dry mouth garnered the highest response in the survey, especially among older adults. This is more serious than the occasional “cotton mouth” feeling we all experience—with chronic dry mouth the salivary glands aren’t producing enough saliva to neutralize mouth acid or fight disease, thus increasing your risk for tooth decay or periodontal (gum) disease. It’s most likely caused by medications or systemic conditions, so talk with your dentist or physician about boosting saliva flow.
Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.
Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!
Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…
While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!
When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.
If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”
On your way to a more attractive smile, you’ll have to deal with some inconveniences while wearing braces like avoiding certain foods or habits or dealing with possible embarrassment about your new “metal smile.” But there’s one consequence of wearing braces that could dramatically affect your dental health: the difficulty they pose for keeping your teeth clean of dental plaque.
Dental plaque is a thin film of bacteria and food particles that if allowed to build up on tooth surfaces could trigger tooth decay or periodontal (gum) disease. Brushing and flossing thoroughly every day helps prevent this buildup.
Unfortunately, metal brackets and wires can get in the way and cause you to miss areas while performing these hygiene tasks. This could cause plaque buildup in those isolated areas that could trigger an infection. And if you (or someone you love) are also a teenager, the natural adolescent surge in hormones can increase your infection risk.
If while wearing braces you notice your gums are reddened, swollen or bleeding when you brush, these are all signs of infection and the body’s inflammatory response to it. The longer the infection continues, the weaker the tissues become, causing them to gradually detach from the teeth. Along with bone deterioration (another effect of the disease), this can ultimately lead to tooth loss.
To prevent this from happening, you’ll need to be as thorough as possible with daily brushing and flossing. To help make it easier, you can use special tools like an interproximal brush that can maneuver around the braces better than a regular brush. For flossing you can use a floss threader to more readily guide floss between teeth or a water flosser that uses a pressurized stream of water rather than floss thread to remove plaque.
This extra cleaning effort while wearing braces can greatly reduce your disease risk. But you’ll still need to keep an eye out for any symptoms like swollen or bleeding gums, and see your dentist as soon as possible. If the symptoms become severe you may need your braces removed until the disease can be brought under control. The health and future vitality of your teeth and gums is what’s of primary importance.
If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”
Undergoing regular dental cleanings is an essential part of periodontal (gum) disease prevention. While a daily habit of brushing and flossing cleans bacterial plaque from most tooth surfaces, it’s difficult to remove from places your brush or floss can’t access well. That, as well as hardened plaque deposits known as calculus, must be removed by a hygienist or dentist with a technique known as scaling.
Scaling is traditionally performed manually using specialized hand instruments known as scalers. Although hand scalers are quite effective, they must be used carefully to avoid damage to gum tissue or, during deeper cleaning known as root planing, the tooth roots. A different method for plaque removal known as ultrasonic scaling has grown in popularity as an alternative to manual scaling.
Ultrasonic scaling uses equipment emitting vibrational energy that crushes and loosens plaque and calculus, and disrupts growing bacterial colonies in biofilm. Plaque particles are then washed away using water irrigation. The most recent models of ultrasonic scalers have matched the effectiveness of hand scaling in removing plaque and calculus in shallow gum pockets, and surpassed the manual technique in cleaning out pockets greater than 4 mm. In experienced hands, they’re kinder to tooth structure and other tissues. Water irrigation also improves healing by removing bacteria and scaling by-products, which also makes the area easier to view by the hygienist.
On the other hand, any type of power scaler must be used with caution with patients who have pacemakers, and are not recommended for those with hypersensitive teeth or teeth that are in the early stages of de-mineralization. The technique may also produce an aerosol of finely misted particles (with possible contamination) that requires added measures to contain them.
For most patients, though, ultrasonic scalers are an effective tool for plaque and calculus removal. As ultrasonic devices continue to evolve, patients will ultimately benefit from greater comfort and reduced treatment times.
If you would like more information on plaque removal with ultrasonic scalers, 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 “Dental Cleanings Using Ultrasonic Scalers.”
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