Crowns, Bridges & Dentures

Rebuilding a damaged tooth, and replacing missing teeth without surgery.

Written by the Shield Dental Care team, Burke VA

Restorative dentistry is best understood as a ladder. Each rung does more than the one below it, and which rung you are on is decided by a single question: how much sound tooth is left? A filling rebuilds part of a tooth. A crown covers what remains of one. A bridge or a denture replaces teeth that have gone entirely.

Fillings

A filling restores a tooth damaged by decay, fracture or wear — the decayed structure is removed, the cavity cleaned and prepared, and the material placed, often in layers. Local anaesthetic means most patients feel little during it, and mild sensitivity to hot, cold or pressure for a few days afterwards is normal.

Several materials are used here: tooth-coloured composite resin, glass ionomer, ceramic, and in some cases amalgam or gold. They differ in appearance, strength and how long they last. As a rough guide, tooth-coloured fillings last five to ten years or more, with the size and position of the filling and your hygiene making a large difference.

One thing worth knowing afterwards: sensitivity that persists, worsens, or produces a sharp pain when you bite is not the normal settling-in period. That is worth a call rather than a wait.

Crowns

When too little sound tooth remains to hold a filling — after a large cavity, a fracture, or root canal treatment — a crown covers the whole visible tooth and takes the biting load off the weakened structure underneath. The judgement is about how much healthy tooth is left to build on, not about the size of the hole.

Porcelain crowns and porcelain veneers are made from the same material and look identical once fitted. The difference is coverage: a veneer is a facing bonded to the front of a tooth for appearance, a crown encases the tooth to restore its structure. That is why one is cosmetic and the other is restorative, even where the finished result looks similar.

Bridges

A conventional bridge replaces a missing tooth by anchoring a false one to the teeth on either side. It is faster and cheaper than an implant, needs no surgery, and comes with one significant cost: the anchor teeth have to be prepared, which means removing healthy enamel from teeth that did not have anything wrong with them.

That trade-off is the whole comparison with an implant, which replaces the root instead and leaves the neighbours alone. Where the adjacent teeth already need crowns, a bridge makes more sense than it otherwise would — the preparation is happening anyway.

Dentures

Dentures replace several teeth or a full arch and rest on the gums rather than in the jaw. They are the least expensive option and need no surgery. They are also removable, which is the source of most of what patients find difficult about them: movement while eating or speaking, and the fact that chewing efficiency is noticeably lower than with fixed teeth.

Partial dentures fill in around teeth you still have. Where stability is the main complaint, implants can be used to retain a denture rather than replace it — a middle option that keeps much of the cost advantage.

Choosing between them

Three questions usually settle it. How much healthy tooth is left? That decides filling versus crown. What are the neighbouring teeth like? Healthy neighbours are an argument against a conventional bridge. How long do you want this to last? The cheapest option per visit is often not the cheapest per year, because replacement cycles add up.

Looking after restored teeth

A filling or crown does not decay, but the tooth around and beneath it does — and the join between restoration and tooth is exactly where decay starts. That makes flossing around restored teeth more important than around intact ones, not less. Grinding shortens the life of everything on this page, so if you clench at night, a night guard protects the work as well as the teeth.

Treatments at Shield Dental Care

What we do for this, and what each appointment involves.

Articles

5 articles from the Shield Dental Care team, all reviewed by Dr. Pejman Ghorbani, DDS.

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