Crowns and bridges are considered top-of-the-line dentistry, and despite their relatively high cost, should be expected to last many years. A dental crown is a porcelain and gold tooth replica that is designed to fit over a trimmed down tooth or dental implant protecting and rebuilding it. A dental bridge is two or more joined crowns that may also serve to permanently replace missing teeth. Crowns and bridges can also be used for cosmetic improvement when other options are not sufficient. Despite their importance, poorly made or designed crowns and bridges can have a number of problems, including a loose fit, porcelain fracture, an opening near the gum-line, improper shape or color, and difficulties with the teeth that are supporting them.
The properly done crown or bridge can easily last 10 to 20 years if the patient sees his or her dentist twice a year and has good oral hygiene. The poorly made crown or bridge may be uncomfortable from the start and could become a chronic problem. The most common problem occurs when a crown or bridge is loose and comes out frequently. This can happen if there is not enough tooth to support the crown or not sufficient teeth to support the bridge. A loose-fitting crown or bridge can also occur if the mechanical preparation of the tooth is inadequate, tooth decay forms under it, or if the dental laboratory does not properly construct it. Another potential problem is porcelain fracture. Porcelain fracture can occur if the dentist misjudges the mechanics of a person's bite, if the laboratory has a processing error, or a combination of both. A different problem can happen if the edge of the crown or bridge does not cover the tooth completely. An open space between the crown or bridge and the tooth is a prime target for cavities. If the crown or bridge is too bulky or slim, the patient can irritate their cheek or trap food between the teeth. In some instances, the problem can be cosmetic in nature. The crown or bridge can be too light, dark, or too opaque.
Although many problems can occur from the crown or bridge itself, in some cases, it is the tooth that is causing trouble. A percentage of teeth that are prepared for a crown or bridge may at some point begin to feel sensitive. Careful evaluation is needed, but a root canal may be required to remove the infected nerve after a tooth has been prepared for a crown or bridge. Problems can arise with a bridge if too few teeth are used to replace multiple missing ones. The dentist must consider the strength of the existing teeth to see if they can support a large bridge.
A poorly made crown or bridge can sometimes be adjusted, but in most cases, serious problems can only be corrected by having it remade. If a tooth under the crown or bridge becomes infected, a root canal will generally solve the problem. Most crowns and bridges remain comfortable and intact for many years, but your dentist should address all problems.
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