Dental Crowns – all you ever wanted to know

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London: Crowns are an excellent way to get beautiful teeth. The animations right and below graphically illustrate the procedure of placing dental crowns:

CROWNS

Q What is a crown?

A Crowns are an ideal way to rebuild teeth which have been broken, or have been weakened by decay or a very large filling. The crown fits right over the remaining part of the tooth, making it strong and giving it the shape and contour of a natural tooth. Crowns are sometimes also known as ‘caps’. An ‘Anterior Crown’ is a crown fitted to the front eight teeth.

Q Why would I need a crown?

A There are a number of reasons. For instance:
 the tooth may have been weakened by having a very large filling
 you may have discoloured fillings and would like to improve the appearance of the tooth
 you may have had a root filling which will need a crown to protect it
 you may have had an accident and damaged the tooth
 it may help hold a bridge or denture firmly in place.

Q What are crowns made of?

A Crowns are made of a variety of materials and new materials are being introduced all the time. Here are some of the options available at present:

 Porcelain bonded to precious metal: this is what most crowns are made from. A precious metal base is made and layers of porcelain are then applied over it.
 Porcelain: these crowns are not as strong as bonded crowns but they can look very natural and are most often used for front teeth.
 Porcelain and composite: porcelain and composite resin materials can sometimes look the most natural. However, these crowns are not as strong as bonded metal crowns.
 Glass: these crowns look very natural and are used on both front and back teeth.
 Precious metal (gold and palladium): these crowns are very strong and hard-wearing, but are not usually used at the front of the mouth, where they are highly visible.

Q How is a tooth prepared for a crown?

A The dentist will prepare the tooth to the ideal shape for the crown. This will mean removing most of the outer surface, and leaving a strong inner ‘core’. The amount of the tooth removed will be the same as the thickness of the crown to be fitted. Once the tooth is shaped, the dentist will take an impression of the prepared tooth, one of the opposite jaw and possibly another to mark the way you bite together. The impressions will be given to the technician, along with any other information they need to make the crown.

Q Who makes the crown?

A The impressions and information about the shade of your teeth will be given to a dental technician who will be skilled in making crowns. They will make models of your mouth and make the crown on these to be sure that the crown fits perfectly.

Q Will the crown be noticeable?

A No. The crown will be made to match your other teeth exactly. The shade of the neighbouring teeth will be recorded, to make sure that the colour looks

natural and matches the surrounding teeth. A temporary crown, usually made in plastic, will be fitted at the end of the
first appointment to last until the permanent one is ready. These temporary crowns may be more noticeable, but they are only in place for about two weeks.

Q How long does the treatment take?

A You will need to have at least two visits: the first for the preparation, impression, shade taking and fitting the temporary crown, and the second to fit the permanent crown.

Q Does it hurt to have a tooth prepared for a crown?

A No. A local anaesthetic is used and the preparation should feel no different from a filling. If the tooth does not have a nerve, and a post crown is being prepared, then local anaesthetic may not be needed.

Q Are post crowns different?

A Post crowns may be used when the tooth has been root filled. The weakened crown of the tooth is drilled off at the level of the gum. The dentist makes a double-ended ‘post’ to fit into the root canal. This can be either prefabricated stainless steel or custom made of gold. One end of the post is cemented into the root canal, and the other end holds the crown firmly in place.

Q Are there any alternatives to post crowns for root-filled teeth?

A If a root-filled tooth is not completely broken down, it may be possible to build it up again using filling material. This

‘core’ is then prepared in the same way as a natural tooth and the impressions are taken.

Q How long will a crown last?

A The life of a crown will depend on how well it is looked after. The crown itself cannot decay, but decay can start where the edge of the crown joins the tooth. It is very important to keep this area as clean as your other teeth, or decay could endanger the crown. Properly cared for crowns will last for many years – your dentist will be able to tell you how long.

Q How are crowns fixed to teeth?

A Once the fit and appearance of the crown has been checked – and approved by you – it will be cemented in place with special dental cement. The cement also forms a seal to help hold it firmly in place.

Q Will the crown feel different?

A Because the shape of the crown will be slightly different from the shape of your tooth before it was crowned, you may be aware of it to begin with. Within a few days it should feel fine, and you will not notice it. The crown may need some adjustment if it feels higher than the surrounding teeth. If it is at all uncomfortable ask your dentist to check and adjust it.

Q Is there an alternative to a crown?

A A veneer may be an alternative to having an anterior crown. Your dentist will advise you of any suitable alternatives.

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Crowns – animation and Qs and As

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CROWNS

Q What is a crown?

A Crowns are an ideal way to rebuild teeth which have been broken, or have been weakened by decay or a very large filling. The crown fits right over the remaining part of the tooth, making it strong and giving it the shape and contour of a natural tooth. Crowns are sometimes also known as ‘caps’. An ‘Anterior Crown’ is a crown fitted to the front eight teeth.

Q Why would I need a crown?

A There are a number of reasons. For instance:
 the tooth may have been weakened by having a very large filling
 you may have discoloured fillings and would like to improve the appearance of the tooth
 you may have had a root filling which will need a crown to protect it
 you may have had an accident and damaged the tooth
 it may help hold a bridge or denture firmly in place.

Q What are crowns made of?

A Crowns are made of a variety of materials and new materials are being introduced all the time. Here are some of the options available at present:

 Porcelain bonded to precious metal: this is what most crowns are made from. A precious metal base is made and layers of porcelain are then applied over it.
 Porcelain: these crowns are not as strong as bonded crowns but they can look very natural and are most often used for front teeth.
 Porcelain and composite: porcelain and composite resin materials can sometimes look the most natural. However, these crowns are not as strong as bonded metal crowns.
 Glass: these crowns look very natural and are used on both front and back teeth.
 Precious metal (gold and palladium): these crowns are very strong and hard-wearing, but are not usually used at the front of the mouth, where they are highly visible.

Q How is a tooth prepared for a crown?

A The dentist will prepare the tooth to the ideal shape for the crown. This will mean removing most of the outer surface, and leaving a strong inner ‘core’. The amount of the tooth removed will be the same as the thickness of the crown to be fitted. Once the tooth is shaped, the dentist will take an impression of the prepared tooth, one of the opposite jaw and possibly another to mark the way you bite together. The impressions will be given to the technician, along with any other information they need to make the crown.

Q Who makes the crown?

A The impressions and information about the shade of your teeth will be given to a dental technician who will be skilled in making crowns. They will make models of your mouth and make the crown on these to be sure that the crown fits perfectly.

Q Will the crown be noticeable?

A No. The crown will be made to match your other teeth exactly. The shade of the neighbouring teeth will be recorded, to make sure that the colour looks natural and matches the surrounding teeth. A temporary crown, usually made in plastic, will be fitted at the end of the first appointment to last until the permanent one is ready. These temporary crowns may be more noticeable, but they are only in place for about two weeks.

Q How long does the treatment take?

A You will need to have at least two visits: the first for the preparation, impression, shade taking and fitting the temporary crown, and the second to fit the permanent crown.

Q Does it hurt to have a tooth prepared for a crown?

A No. A local anaesthetic is used and the preparation should feel no different from a filling. If the tooth does not have a nerve, and a post crown is being prepared, then local anaesthetic may not be needed.

Q Are post crowns different?

A Post crowns may be used when the tooth has been root filled. The weakened crown of the tooth is drilled off at the level of the gum. The dentist makes a double-ended ‘post’ to fit into the root canal. This can be either prefabricated stainless steel or custom made of gold. One end of the post is cemented into the root canal, and the other end holds the crown firmly in place.

Q Are there any alternatives to post crowns for root-filled teeth?

A If a root-filled tooth is not completely broken down, it may be possible to build it up again using filling material. This

‘core’ is then prepared in the same way as a natural tooth and the impressions are taken.

Q How long will a crown last?

A The life of a crown will depend on how well it is looked after. The crown itself cannot decay, but decay can start where the edge of the crown joins the tooth. It is very important to keep this area as clean as your other teeth, or decay could endanger the crown. Properly cared for crowns will last for many years – your dentist will be able to tell you how long.

Q How are crowns fixed to teeth?

A Once the fit and appearance of the crown has been checked – and approved by you – it will be cemented in place with special dental cement. The cement also forms a seal to help hold it firmly in place.

Q Will the crown feel different?

A Because the shape of the crown will be slightly different from the shape of your tooth before it was crowned, you may be aware of it to begin with. Within a few days it should feel fine, and you will not notice it. The crown may need some adjustment if it feels higher than the surrounding teeth. If it is at all uncomfortable ask your dentist to check and adjust it.

Q Is there an alternative to a crown?

A A veneer may be an alternative to having an anterior crown. Your dentist will advise you of any suitable alternatives.

Dentists & Cosmetic Dentists

Harley Street Dental Studio, London, W1

Renowned cosmetic dental surgeon, Dr Mark Hughes has recently launched the new Harley Street Dental Studio in London.

The studio has state of the art equipment and the latest techniques are performed in a stylish and fashionably holistic spa environment.

The range of treatments available at the Harley Street Dental Studio is vast and covers all aspects of reconstructive and cosmetic dental work. Mark and his team use the latest practices to give you the smile you want.

As one of the only dental surgeons in the UK using Di Vinci Veneers, Mark and his experienced team can ensure teeth are corrected and aligned to give the most beautiful smile. These ultra-thin shells of ceramic material are bonded to the front of teeth with little or no anaesthetic to mask discolorations, brighten teeth, and to improve your smile.

When fitting veneers, the Studio offers a bespoke service; patients can choose the shade and size of teeth that suits them and their face the best.
Mark personally works with a patient to ensure that they get the most attractive and natural smile.

Facial rejuvenation is also offered at the Studio and is the dental equivalent of a facelift. The procedure replaces worn or missing teeth, improving bone structure and having a dramatic anti-ageing effect on facial appearance.

In addition to using the latest dental techniques, the Studio also offers the ultimate lifestyle experience: a plasma screen showing a DVD of your choice, complete with Bang and Olufsen surround sound, ensures your time in the Studio is as comfortable and soothing as possible. For those who areshort of time, or simply want the ultimate pampering experience, a manicure or pedicure can be carried out whilst you have your teeth whitened – all within your lunch hour. The Harley Street Dental Studio uses Zoom 2 whitening products from California, which achieve results in just 40 minutes.

Dr Hughes is dedicated to clinical excellence and has built a reputation as one of the finest aesthetic dentists in London. He is well known in the industry for his impeccable standards and for working closely with patients to provide outstanding quality in dental and aesthetic treatments to create the most natural looking teeth and the best results.

Escaping the busy street and stepping into a Zen-like zone with crisp, sleek interiors and exotic flowers gracing every table, the Harley Street Dental Studio removes any fears you may have about visiting a dentist. All of the finer details have been carefully thought out – from the carefully positioned Buddha’s that provide serenity, to the many bowls of crisp green apples that remind you of where you are.

About Harley Street Dental Studio:
www.harleystreetdentalstudio.com

London Centre For Cosmetic Dentistry T: +44(0)20 7722 1235.
Consultations for cosmetic surgery are free of charge.

The London Breath Centre
93 Haverstock Hill, London, NW3 4RL
T: +44(0)20 7722 1235 or +44(0)20 7586 7237
Email:mervken@aol.com

Other useful commercial websites:

www.whiterteeth.co.uk
www.teethwhitening.co.uk
www.fresherbreath.com
www.smilelift.co.uk

These are professional bodies who can give you unbiased advice about practitioners:

UK

British Academy of Aesthetic Dentistry
Suite 152
84 Marylebone High Street
London W1M 3DE

British Dental Association
64 Wimpole Street
London W1M 8AL UK
T: 44 (0)20 7935 396

US
www.aacd.com
American Academy of Cosmetic Dentistry

www.ada.org
American Dental Association

Europe

European Academy of Esthetic Dentistry

A-Z of treatments

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Amalgam fillings

Once a standard treatment, amalgam silver coloured fillings have now been replaced by composites to white ones.

Bleaching

Can improve colour of teeth by up to 70% but not stains caused by the antibiotic tetracycline or the white patches caused by demineralisation – need to use micro-abrasion. The latest treatment is laser whitening, in which a hydrogen peroxide solutions is painted onto the patients teeth and subjected to a laser that speeds up the procedure.

Bonding

Tooth coloured material is stuck. Tooth is etched using a week acid to create grooves to enable the material, such as veneers (see below) to bond.

Crowns

These are coverings that replace the top part of the tooth. This treatment is used when the teeth are severely decayed, factured or for cosmetic reasons. They are usually made of porcelain, with metal or glass bases.

Endodontics (root canal therapy)

This is the removal of dying or dead nerves which are replaced with a filling material, which can give a tooth an extra ten years of life.

Implants

Used to replaced lost teeth but could only be used if there was enough bone to screw in the implant made of titanium. Now however surgeons are able to graft the patients own bone into the mouth to create a base.

Light curing

This is used to harden fillings, to whiten or bleach teeth.

Orthodontics

The process of aligning the teeth using fixed braces and in difficult cases may also involve surgery. The latest braces are ceramic.

Scaling and polishing

3-6 monthly appointments with hygenist to get rid of plaque and stains. Now use ultrasonic descalers and the air-abrader
that uses an abrasive powder to clean the teeth.

Veneers

A thin layer of porcelain is bonded to the tooth. Disadvantages is that they can easily chip or even fall off and may cause damage to teeth.