Crowns and bridges

Crowns and bridges. Durable replacements for teeth

Crowns and bridges are intended as durable replacements for teeth. They approximate the original shape and function as much as possible. Treatment for a crown or bridge is more complicated than for a regular filling. You will therefore need to return to your dentist several times. 

What is a crown?

Crown, a cap over a tooth

A crown is a cap made of metal and/or porcelain that fits precisely over a chipped tooth. The cap is glued to the tooth. A crown restores the tooth to its original shape and function.

When might a crown be needed?

A crown over a front tooth

1. There is insufficient retention for a filling. Due to tooth decay, a large part of the tooth may have been lost.

2. Improving appearance. This usually involves discoloured and/or badly shaped teeth or molars at the front of the mouth.

What is a bridge?

Bridge, two crowns fitting the piers and a bridge intermediate section

A bridge is made to replace one or more missing teeth and/or molars. A bridge is attached to two or more pillars. These are ground-down teeth or molars on either side of the open space of the missing tooth. A bridge consists of two or more crowns that fit onto pillars and a bridge abutment, also called a ‘dummy’. This consists of one or more artificial teeth and/or molars that come in place of the open space.

When might a bridge be needed?

Lateral view of a jaw: outgrowth and misalignment of molars

1. To chew better.
2. Improving appearance.
3. To prevent teeth misalignment and/or outgrowth.

If teeth are missing, the teeth of the other jaw may grow towards the open space. Also, the teeth on either side of the open space may grow towards each other, causing them to become crooked.

What types of bridges are there?

Ordinary bridgeFree-ending bridgeEtching Bridge

Ordinary bridge
In an ordinary bridge, the piers are on either side of the open space.







Free-ending bridge
In a free-ending bridge, the pillars are on one side of the missing tooth.






Etching Bridge
An etch bridge is usually possible when the teeth on either side of the open space are almost flawless. This construction hardly requires any grinding off of the intact teeth. The etch bridge is mainly used to replace one or two teeth. The bridge is glued invisibly to the inside of the teeth by means of metal attachment plates with a special glue. An etch bridge, if necessary, can usually be removed quite easily.

What material are crowns and bridges made of?

Crown of metalCrown of porcelainMetal-porcelain crown

Porcelain
Crowns made of porcelain can be used in many situations. New techniques eliminate the risk of fracture. The material is tooth-coloured and looks very natural.











Metal-porcelain
In this process, metal is used as the base. For appearance, a layer of tooth-coloured porcelain is applied over the visible metal.


















Metal
Sometimes crowns and bridges are made of metal only. This material is very strong and hard-wearing. They are then given a gold or silver-coloured gold alloy. Because of the colour, the dentist only places them in the back of the mouth.

What is the procedure for a crown or bridge?

Grinding off the toothImpression tray with impression materialWax plate for bite registrationDefine colourFixing with quick-setting cementConstructionCrown over construction

De behandeling van een kroon of brug verloopt in stappen. Hiervoor twee of drie bezoeken aan uw tandarts nodig. Een kroon of brug wordt niet direct in uw mond gemaakt, maar in een tandtechnisch laboratorium. Hiervoor is ongeveer één tot twee weken tijd nodig.

The treatment in steps

Grinding off the tooth
First, part of the tooth is ground off until there is enough space to make a crown or bridge. If necessary, you will be given a local anaesthetic.


Print
Next, the dentist takes an impression of your entire jaw or the area where the abraded molar is located. To do this, the dentist inserts an impression tray containing a rubbery mass into your mouth. This creates an impression into which plaster is later cast in a dental laboratory. The crown or bridge is made on this plaster model. 


Bite registration
With bite registration, the dentist determines how the teeth of your lower and upper jaw fit together. This requires an impression of the opposite jaw. For this, the dentist uses a wax plate.


Define colour
If the crown or bridge is at the front of the mouth, it usually has a tooth-coloured outer layer. Together with your dentist, you will choose a suitable colour.

Emergency facility
For your comfort and to protect the chipped tooth , the dentist will make an emergency device (temporary crown). Do not eat any hard or sticky products with it. The temporary crown is not designed for that. If the temporary crown breaks or becomes loose, contact your dentist.


Fix
At the last appointment, your dentist fits and secures the crown or bridge in your mouth. On the inside of the crown or bridge, he applies a quick-curing cement. He then slides the crown or bridge into place and presses it down firmly.



Construction

If your tooth does not have enough hold for a crown or bridge, your dentist may first make a buildup. He glues the superstructure into the root canal with a pin. Then he places the crown or bridge over the superstructure.

Maintenance of crowns and bridges

Brush with a soft toothbrush

De dagelijkse mondhygiëne is bij kronen en bruggen extra belangrijk. Vooral het tandvlees rondom de kroon of brug moet u goed reinigen. Een kwetsbare plek is de rand van de kroon of brug. Daarop kan gemakkelijk tandplak achterblijven. Plak veroorzaakt gaatjes langs de rand van uw kroon of brug en ontsteking van het tandvlees. Poets dit gebied zorgvuldig met een zachte tandenborstel en gebruik tandenstokers, ragers en/of flossdraad. Uw tandarts of mondhygiënist kan u hierbij adviseren.

How long does a crown or bridge last?

De materialen zijn zo duurzaam dat een kroon of brug minstens tien jaar meegaat. Een goede mondhygiëne heeft veel invloed op de duurzaamheid. Door een ongelukje kan het natuurlijk voorkomen dat een kroon of een brug al voortijdig wordt beschadigd.

Will I suffer from post-operative pain during treatment for a crown or bridge?

After placement, a tooth fitted with a crown or bridge can sometimes be sensitive. This is usually temporary. Consult your dentist if the sensitivity persists or becomes more severe.

What does a crown cost?

De kosten voor een kroon hangen af van de soort kroon, het materiaal dat wordt gebruikt en de kosten voor het tandtechnisch laboratorium. Bovendien is het van belang of een opbouw nodig is. Vraag uw tandarts vooraf om een begroting.

What does a bridge cost?

De kosten voor een brug hangen af van de soort brug en het aantal tanden en kiezen dat moet worden vervangen. Een etsbrug is vaak goedkoper dan een gewone brug. Ook hiervoor geldt: vraag uw tandarts vooraf om een begroting.

Are crowns and bridges covered by insurance?

Reimbursements vary according to your insurance policy. Your health insurance policy will tell you which reimbursements you are entitled to.

Want to know more?

Then download the free app GezondeMond. The app is available for Android and tablets, available via Google Play. The app for iPhone and iPad can be found in the iTunes App Store.

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