Dentistry is the application of the science of placement, arrangement and function of teeth, as well as their supporting bones and soft tissues. Unlike other human tissue, the dental structures cannot repair themselves hence requiring regular care to maintain their health and vitality.

Tooth decay is one of the most common diseases and accounts for almost half of all tooth extractions. Almost 80% of the population in developed countries have experienced the problem. However, dental restoration (fillings) do not last forever, hence 60% of restorative dentistry is done for replacement of restorations. Restorative dentistry refers to the restoration of natural teeth that have been damaged, decayed or lost. Crowns and bridges are the major part of restorative dentistry, along with the permanent implants. Inlays, onlays, and veneers are also part of restorative dentistry to some point. Patients are keeping their teeth later in life so practitioners are looking for new restorative solution that can increase the teeth’s life. Teeth that might have been extracted in the past are now restored with the use of crowns and bridges.

A crown is constructed to restore a damaged tooth back to its original form and function and a bridge is used to replace one or more teeth.

Crowns

The crowns are dental restorations known as “caps” and are coverings that fit over teeth. They are necessary because of broken old fillings, fractured and chipped teeth and also in the case of sensitive teeth. The crowns are also used to improve the appearance of natural teeth that are discoloured, malpositioned or malformed. They also strengthen and protect the remaining tooth structure, improving the appearance of the teeth.

They are made of natural looking porcelain and are designed to improve the overall smile and to blend in with the rest of the teeth.

A patient should need a crown if they are experiencing the following problems:

• A previously filled tooth has now more filling than tooth so the structure weakens and cannot support the filling anymore
• Damage by decay
• Compromised esthetics and loss of colour
• Fractures
• Root canal
• Bridges

The crowns can be made from different materials, such as: porcelain crown, porcelain fused-to-metal crown and the all-metal crown.

Fitting the crown requires, generally, at least two appointments. During the first appointment, the tooth is prepared, a mold of the tooth is made and a temporary crown is placed on the tooth. During the second appointment, the temporary crown is removed and the final crown is fitted, adjusted and cemented into place.

Bridges

If teeth are missing and there are teeth on every side of the gap, a bridge is the ideal solution to replace the missing teeth. The replacement teeth can be attached to two crowns constructed for the two teeth on the sides of the gap. The space left from the missing tooth may cause some other problems like teeth drifting and changing the bite, which can lead to sore jaws, gum disease or decay.

As the crowns, the bridges can be made of porcelain, metal or a combination of those two. After you are examined by the doctor, the teeth used to attach the bridge are reshaped. During the time it takes to make the bridge, a temporary acrylic bridge is cemented into place.

Veneers

They are used to fix the front teeth. Veneers are used to whiten teeth, close spaces between teeth and create a great smile.

The veneers are great for:

• Diastemas
• Chipped and broken teeth
• Stained and wash out fillings
• Stained and discolored teeth
• Crooked teeth

The porcelain veneers are the answer for instant orthodontics like straightening the smile, closing the spaces and reshaping the teeth. The veneers are always thin and are bonded in front of the teeth. They are about 0.3 mm to 0.5 mm thickness but are very strong once bonded to the teeth.

Also the veneers have several advantages over the crowns: the absence of the “black line” sometimes seen with older crowns, they have more natural look then crowns and don’t require that much grinding as the crowns do.

Combined with other cosmetic dentistry, the veneers really give the patient the perfect smile. However, the veneers are not considered a reversible form of treatment.

Other Techniques

The partial denture refers to a removable dental appliance that is used to replace multiple missing teeth. The removable partial denture fills the space created by missing teeth and usually consists of replacement teeth attached to a gum-coloured plastic base that is connected by metal framework. They attach to the natural teeth with metal clasps or precision attachments.

Small Glossary of Terms

Acrylic – A plastic used in dentistry for various purposes.

Bridge – A dental restoration which fills an area that has no teeth, being connected to natural teeth at each end.

Crown – Reproduces the aspects of the natural tooth.

Diastemas – Spaces between the teeth.

Inlay/Onlay – it is recommended as an alternative to a full crown.

Porcelain – A tooth-coloured material, consisting of kaolin, feldspar and flux.

Preparation – Grinding down a tooth to allow a crown to be placed on it.

Restoration – Replacing a tooth using metal and/or tooth-coloured materials.