Crowns
The top visible portion of the tooth is called the crown. When the majority of the crown is filling material or important parts of the tooth that provide structural integrity have been destroyed, a prosthetic crown will be recommended. For this procedure the enamel layer or what would have been enamel layer is removed and a prosthetic or fake enamel layer is placed. These prosthetic crowns are fabricated as one unit to give strength back to the visible portion of the tooth. All gold crowns provide the best functioning restorations in that they act the most like natural enamel and have the best seal but look like metal. All ceramic crowns look the best but anything with ceramic can break if overloaded with force. Porcelain fused to metal crowns are crowns that are hybrids of the other two attempting to get the best of both. They can have excellent metal seals and some porcelain coverage in the visible areas but are not always recommended and, as they contain porcelain, they can break. Onlays and inlays are basically partial coverage restorations similar to crowns and try to provide more structural stability in the tooth in situations where a crown is not quite needed but a filling is not strong enough. They can be made of metal or ceramic. Within these basic categories of metal, ceramic and porcelain fused to metal there are also differing compositions and materials and you will need to talk with your dentist on the options available to you at their office. Crowns take a lot of time to make as the removal of the enamel layer must be done. Then an impression is taken with a digital system or hardening pvs gel. This must then be sent to a lab to be fabricated. In the meantime a temporary crown is made and cemented. When the crown is finished you will return to your dentist to have it permanently cemented. The length of time between these appointments can vary drastically. Rural dentists who have to work with far away labs can take weeks and weeks to deliver the crown. In instances where there is a lab next door to the dentist it could be days. There are also machines some dentists have that make the crown in the office and the wait could be mere hours.
Bridges
There are many options for a missing tooth space. We will talk in this section about the option of a bridge. A bridge is also known as a fixed partial denture. Crown like preparations are done on the teeth next to the space. These are called retainers instead of crown in this case but are very similar. A false tooth also known as a pontic is connected to these retainers and the teeth next to the space support the false tooth. The retainers are cemented to the prepared tooth just as a crown would be and the space is filled. Bridges can only be done If the space is not too big. A bridge is fixed and not removable. One must keep the area under the fake tooth clean with floss. Stiff ended floss is a great way to do this. A down side to this option is that when a crown is not needed on the teeth next to the space for other reasons, you will actually increase the long term risk for the teeth holding the pontic. Another is the fact that if one of the teeth get a cavity or part of the retainers breaks on one tooth you could end up having to do a completely new one. In other words since they are now connected, what happens to one tooth could have consequences to the other. Please see the crown article for the process of fabrication.
Veneers
Veneers have been a popular treatment for some time. A veneer is a ceramic tooth restoration that covers or replaces visible enamel on teeth to make them appear straighter or more uniform. This many times requires removal of enamel on the front surfaces of teeth to allow for adequate thickness and strength of the veneer. There are situations in which this removal of natural enamel may not be necessary. This will be determined by the examination of the dentist. The benefit of these restorations include that they typically have beautiful outcomes and can help improve looks substantially at times without the need for braces and other treatment. The down side to them includes the fact that most need removal of otherwise healthy enamel. The restorative material is good but not as good as healthy natural enamel and if possible the usual recommended option is to receive orthodontic treatment and align the teeth in this way. In situations where there are many fillings that are visible and color changes are readily evident, veneers may be the optimal choice.
Veneers can take several appointments to make as the removal of the enamel layer must be done. Then an impression is taken with a digital system or hardening pvs gel. This must then be sent to a lab to be fabricated. In the meantime a temporary veneer is made and cemented. When the veneer is finished you will return to your dentist to have it permanently cemented. The length of time between these appointments can vary drastically. Rural dentists who have to work with far away labs can take weeks and weeks to deliver the crown. In instances where there is a lab next door to the dentist it could be days. There are also machines some dentists have that make the veneer in the office and the wait could be mere hours.