Do you have a broken or worn down tooth that needs to be fixed? Is a missing tooth keeping you from chewing comfortably? We can help! Crowns and bridges are very popular, long term treatment options to these issues. Since they are bonded onto your teeth, they are very secure, helping you feel like "you" again!
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Who exactly needs a crown? Am I a candidate for a bridge?
Dental crowns, also known as "caps," allow dentists to protect and restore damaged teeth. Typically, when tooth decay is severe enough that it can no longer be treated with "just" a filling, a dental crown may be necessary cover and protect the tooth, thereby restoring it back to its original size, shape, and chewing strength. Dental crowns are also used in the case of teeth that are heavily worn down, have fractured or cracked, or that have other developmental issues that require additional protection. Crowns are also commonly used to seal teeth that have been treated with root canal therapy, when appropriate. Occasionally, dental crowns are also used for cosmetic purposes or in smile makeovers.
It is important to note that not all crowns are created equal. In the old days of dentistry, crowns were the only go-to treatment option in such cases listed above. Today, with modern advances, there are often other options that may be available to you, that allow us to preserve more of your natural tooth structure and remain as conservative as possible. These restorations are made possible by the advances in modern adhesive dentistry, and allow us to replace only the missing or unsupported areas of the tooth, rather than fitting over the entire tooth, the way a crown does. These restorations are called inlays, onlays, or partial coverage crowns. Rest assured that Dr. Ahmed and Dr. Barra are very committed to conservative dentistry, and will always select the least invasive option for you. In some cases, crowns are still the most appropriate choice, and if so, careful selection regarding the most suitable material for your particular needs will be made.
A dental bridge, on the other hand, is a type of dental restoration that replaces one or two missing teeth. Dental bridges can also be made in longer spans when necessary, for multiple scattered missing teeth. A typical dental bridge is made when a single tooth is missing in between two healthy, intact teeth. Those two adjacent teeth then serve as the "anchors" for the false tooth to attach to, to close the gap. It is helpful to think of this as three connected crowns, with the two on the ends serving as the supports, and the center crown "floating" over the gap. This bridge is cemented in place just as a single crown would be, and closes your gap in a comfortable way, helping you chew better and feel confident without the missing space.
Did you know…
Dental crowns are also referred to as “caps” because they cap the existing tooth structure in order to restore it.
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Caring Team
Our caring team is dedicated to making you feel right at home, ensuring a comfortable and welcoming experience every step of the way.
NO NEED FOR MESSY IMPRESSIONS!
You know the feeling: you need a dental impression, and the material and tray makes you gag! For years, this was the only option in dentistry. Not anymore! Say goodbye to those goopy impressions! Our high-tech, 3D intraoral scanner allows us to capture very high resolution images and create digital models of your teeth for a completely mess-free experience.
Expect Expert Care
Dr. Ahmed, consistently voted as a "Top Dentist" by peers in Washingtonian Magazine, brings expertise and compassion to every treatment and ensures the highest standard of care for our patients.
Types of dental crowns and bridges
Custom - Made Laboratory Crowns
Lab-made crowns are custom designed and fabricated by highly experienced ceramic technicians at labs across the country. Dr. Ahmed and Dr. Barra have hand selected several labs with tried and true results, to ensure the highest quality outcomes. Once your scan or impression is taken, along with any photos or other necessary information, it is all sent to the lab for the technician to begin fabrication of your own custom tooth or teeth.
Using an advanced manufacturing process, your crowns will be built out of durable and lifelike ceramic materials, and sent back to us for the final fitting and placement. Lab-made crowns look and feel very natural, and are usually the most long-lasting and durable type of crown.
Traditional Bridges
Traditional dental bridges are made out of two traditional crowns, which are attached permanently to “abutment" teeth, and serve as the anchors for the suspended tooth in between. These abutment (anchor) teeth, are the healthy teeth located next to one or more missing teeth within your mouth. The suspended tooth, also called a "pontic," along with the two connected side crowns, literally “bridge” the gap between your missing teeth, restoring your smile.
Cantilever Bridges
Unlike a traditional fixed bridge, which supports your bridge using two abutment teeth, a cantilever bridge uses only a single tooth to support your bridge. In this type of bridge, a single tooth is shaped and adjusted next to your missing tooth. Then, a bridge is made that consists of a single crown and a single artificial tooth. The crown is attached to your abutment tooth, and then the artificial tooth is suspended in the gap where your missing tooth used to be, restoring your smile.
Cantilever bridges are less invasive than traditional bridges, since only one tooth is involved. However, the indications for this type of prosthesis are very limited, and they typically can only be used in a few areas of the mouth, based on your bite and the health of your teeth.
BONDED Maryland Bridges
A Maryland bridge does not typically require removal of enamel or preparation of the adjacent teeth. In this treatment, a false tooth is built using a durable ceramic framework with either a single or double “wings” that attach to the adjacent tooth or teeth. These “wings” are attached to the backs of your teeth using dental cement, holding the false tooth in place and restoring your smile.
Maryland bridges are commonly used in the case of a missing front tooth, and are ideal if you would like to restore your smile without any invasive dental treatment. They are also very common on adolescent patients with missing teeth who are not yet ready for more permanent dental implants. On adult patients, there are various indications for this type of prosthesis as well; Dr. Ahmed and Dr. Barra can help you determine if this procedure is right for you.
Implant Bridges
Unlike traditional bridges which are affixed over your natural teeth, an implant bridge is fabricated to fit over dental implants, effectively replacing multiple missing teeth at once. There are a variety of implant bridge options, that each have different indications, based on the number of missing teeth and their location within your mouth. We can help you determine if you are a candidate for this procedure, depending on your bone, your bite, and your goals. Implant bridges look, feel, and function just like healthy natural teeth, and are extremely secure. They can also help save some expense, rather than replacing each missing tooth with its own implant and corresponding crown.
How dental crowns and bridges work together
Preparation of Abutment Teeth
Your dentist will gently numb your mouth, and then begin to prepare your tooth or teeth for your crown or bridge. This process involves trimming a very thin layer of enamel from the involved tooth/teeth in order to make room for the porcelain. These are known as “abutment teeth” and they will hold your crowns or bridge in place.
DIGital scans or traditional impressions
Once your abutment teeth have been prepared, your dentist will take digital scans (or a traditional impression if indicated) of your upper and lower teeth. These scans are critical to transfer accurate information to the dental lab, in order to get you the best possible results, with the most precise fit. We exercise extreme precision in this process, as it directly determines longevity of your restoration. This process cannot be rushed.
Custom-made Temporary crown or Bridge
Depending on your needs, your dentist will custom make and place a temporary resin crown or bridge to protect your prepared abutment tooth/teeth. These temporary teeth, or provisional teeth, serve as a both a cosmetic and functional placeholder until your lab-made dental work is ready for delivery, ensuring that your prepared teeth are covered and protected during the lab processing time.
Permanent Placement
Once your permanent crown or bridge is ready, your dentist and their highly trained assistant will carefully remove your temporary crown or bridge, clean your abutment teeth, and try on your prosthesis. Several rounds of adjustments are done to ensure a perfect fit. An X-ray will be taken to ensure the most ideal outcome. Once both you and your dentist have determined that the fit of your crown or bridge feels exactly right, and that the look is correct as well, they will use powerful dental bonding materials to adhere it permanently to your abutment tooth/teeth, restoring your smile and your bite. Your dentist will discuss with you how best to maintain your new crown or bridge, to ensure longevity.
Before & Afters
A smile is worth 1,000 words.
Frequently Asked Questions
How do crowns and bridges work?
While each type of crown or bridge is slightly different, crowns and bridges share similar characteristics and work in similar ways. When a crown is not necessary, an inlay or an onlay is made by removing and reshaping the diseased, broken down, or fractured areas of the tooth, leaving the rest of the tooth untouched, and a lab-made porcelain filling is used to seal those areas. A crown is made by gently trimming a thin layer of the entire outer portion of enamel around the tooth, along with building up the foundation of the tooth, called a "core buildup." The tooth is prepared with clear borders, or "margins," that ensure a precise fit for the crown to be placed on top of the tooth. A traditional bridge uses these same principles, but does so on (at least) the two teeth adjacent to the missing space. A false tooth, or "pontic," is fixated to the two outer crowned teeth to cover the missing space. On the other hand, cantilever bridges use this process on only one adjacent tooth, and Maryland bridges do not use full coverage crowns, but rather, "wings" to adhere to the adjacent tooth. Lastly, implant bridges function in a similar way to traditional bridges, but instead of being adhered to a prepared abutment tooth, they are adhered to "implant abutments," which securely hold the bridge in place with special screws or special implant cement, depending on various factors.
Are dental crowns and bridges covered by insurance?
Dental crowns and bridges that are required for restorative purposes, such as restoring teeth with severe decay (cavities) or a broken tooth, are typically covered by insurance. The exact amount of coverage you receive will depend on the deductible and yearly limits of your policy. As always, we will file a courtesy claim on your behalf to help maximize the reimbursement you will receive.
If you require a crown or bridge for cosmetic purposes, such as covering up a discolored tooth, the procedure may or may not be covered by insurance. To get more information about whether your procedure will be covered or to what extent, we recommend consulting with your insurer.
As always, we will file a courtesy claim on your behalf to help maximize the reimbursement you will receive.
How do I know if I need a dental crown or bridge?
If you have one or more damaged or severely decayed or broken down teeth, you may need a dental crown or similar restoration. If you have one more missing teeth and you aren't sure if you want to proceed with an dental implant, you may benefit from a bridge. If your teeth are visibly damaged or discolored or if you are not sure, the best thing to do would be to set up a consultation with your dentist for evaluation and discussion of your options. Depending on the cause of your dental issues, they may recommend a dental crown, dental bridge, or another restorative treatment to best serve you.
How long do dental crowns and bridges last?
You may hear the term "permanent" when discussing a crown or bridge. These are considered "permanent" in the sense that only a dentist can remove them; however, nothing in dentistry, or in life, is truly permanent. A well-made and properly placed dental crown or bridge will typically last anywhere from 5-15 years, on average. However, when very well-cared for, crowns and bridges can last significantly longer than this. It is critical to maintain good oral health habits to enhance your crown or bridge’s longevity. These practices include brushing twice per day, string flossing and water flossing at least once per day, and seeing your dentist every 6 months for a professional cleaning and exam. This also takes into consideration managing other dietary concerns that can reduce this lifespan, addressing relevant medical conditions, wearing a night guard when necessary, among other factors.
How do I care for my dental crown and bridge?
You can treat your dental crown or bridge just like you would a natural tooth. Make sure you brush twice a day for at least two minutes, ensuring you gently brush the full surface of every tooth, including at the gumline, which is where most issues occur with crowns and bridges. You should floss at least once per day, preferably at night. If you have a bridge, or large spaces between your teeth or crowns, you should also use a Waterpik or another type of water flosser for best results. This should only take a few minutes of your day, but the payoff for long term success is directly dependent on it. You should also see your dentist every six months for a check-up to make sure that your dental work and teeth are healthy and in good condition.
DO dental crowns and bridges EVER NEED TO be repaired or replaced?
Just like anything else in life, there is a lifespan to dental work, including crowns and bridges. The need for repair or replacement is often largely dependent on your daily home care. This can include your dietary and daily oral hygiene habits, your use of a night guard when necessary, certain medical conditions and medications, and a variety of other factors. It is also dependent on how frequently you are seen for your regular check ups to catch any potential issues as early as possible. Crowns and bridges are susceptible to decay or to heavy grinding wear, similar to the way your teeth would be, and require the same level of care you would use on your natural teeth. If your crown or bridge needs to be replaced, it is always best to do so as soon as there is a problem detected, to ensure you have the most healthy tooth structure to work with for a long term replacement.
How much do dental crowns and bridges cost?
The cost of dental crowns or bridges can vary among patients, depending on various factors. Some of these factors include the type of material used, the location in the mouth, the span of the prosthesis (number of teeth involved), complexity, any pre-treatment surgeries (like tooth extraction), and more. The best way to find out what your particular needs are, is to schedule a consultation with your dentist.
Dental crowns and bridges are usually covered, at least in part, by dental insurance when they’re used to restore missing teeth. Contact your insurance provider to learn more about your coverage.
What are dental crowns and bridges made of?
Modern dentistry has several materials available for crowns and bridges, each with very specific properties and uses. These various materials are available for dentists to be able to determine what will work best for each patient, in each particular scenario. In some cases, even within the same mouth, different materials may be chosen based on the structural, functional, and cosmetic needs of the particular tooth or area of the mouth. There are various dental ceramics/porcelain, resins, ceramic-resin hybrid materials, gold and other metals, acrylics, and more.
What Are Inlays And Onlays, And How Do They Differ From Traditional Fillings And Crowns?
Inlays and onlays are conservative dental restorations that offer a middle ground between fillings and crowns. At Old Town Smiles in Alexandria, Dr. Seema Ahmed and Dr. Mohammad Barra often recommend these options for patients with moderate tooth decay or damage.
Inlays are custom-made restorations that fit within the cusps (raised points) of a tooth's chewing surface. They're typically used when the damage is too extensive for a simple filling but not severe enough to require a full crown. Onlays, sometimes called partial crowns, are similar but extend over one or more cusps of the tooth.
Unlike traditional fillings, which are molded directly in the mouth, inlays and onlays are fabricated in a dental laboratory based on precise impressions of your tooth. This allows for a more accurate fit and better durability. They're usually made from materials like porcelain, composite resin, or gold.
Compared to crowns, inlays and onlays preserve more of your natural tooth structure. A crown requires significant removal of tooth material to fit over the entire visible portion of the tooth, while inlays and onlays only replace the damaged area. This conservation of tooth structure is a key principle at Old Town Smiles, where Dr. Ahmed and Dr. Barra prioritize minimally invasive treatments whenever possible.
What Are The Benefits Of Choosing Inlays Or Onlays Over Traditional Crowns?
At Old Town Smiles, Dr. Seema Ahmed and Dr. Mohammad Barra often recommend inlays and onlays due to their numerous benefits:
- Conservation of tooth structure: Inlays and onlays require less removal of healthy tooth material compared to crowns. This preservation of natural tooth structure is crucial for long-term oral health.
- Improved fit and seal: Being custom-made in a lab, inlays and onlays often provide a more precise fit than traditional fillings. This can result in a better seal against bacteria, potentially reducing the risk of further decay.
- Durability: Inlays and onlays are typically more durable than large fillings. They can last 10-30 years with proper care, which is comparable to or even longer than many crowns.
- Aesthetics: Especially when made from tooth-colored materials like porcelain, inlays and onlays can be virtually indistinguishable from natural tooth structure.
- Easier cleaning: Unlike crowns, which cover the entire visible portion of the tooth, inlays and onlays allow for easier cleaning around the margins of the restoration.
- Less temperature sensitivity: The materials used for inlays and onlays often provide better insulation against temperature changes compared to metal fillings.
- Strengthening of the tooth: In cases where a large portion of the tooth needs restoration, an onlay can actually increase the strength of the tooth, similar to a crown but with less tooth reduction.
Dr. Ahmed and Dr. Barra at Old Town Smiles carefully evaluate each patient's unique situation to determine if an inlay or onlay would be the most beneficial option for restoring their tooth while maintaining as much natural structure as possible.
How Do Dr. Seema Ahmed And Dr. Mohammad Barra Determine Whether An Inlay, Onlay, Or Crown Is The Best Option For A Patient?
At Old Town Smiles, Dr. Ahmed and Dr. Barra take a comprehensive approach to determining the most appropriate restoration for each patient. Their decision-making process typically involves:
- Thorough examination: They start with a detailed visual inspection of the tooth, often aided by intraoral cameras and magnification to assess the extent of decay or damage.
- X-rays: Digital X-rays provide crucial information about the internal structure of the tooth and the extent of decay beneath the surface.
- Assessment of remaining tooth structure: The amount of healthy tooth structure is a key factor. If there's sufficient healthy tooth material, an inlay or onlay may be preferable to preserve it.
- Location of the damage: The position of the decay or damage on the tooth influences the choice. Inlays are suitable for damage within the cusps, while onlays are used when the damage extends to one or more cusps.
- Bite forces: They consider the amount of force the tooth endures during biting and chewing. Molars, which bear more force, might sometimes require the full coverage of a crown.
- Patient's oral hygiene and risk factors: The patient's history of decay, oral hygiene habits, and risk factors for future dental problems are taken into account.
- Aesthetic considerations: For visible teeth, the doctors consider which option will provide the most natural-looking result.
- Patient preferences: Dr. Ahmed and Dr. Barra discuss the options with the patient, explaining the pros and cons of each approach and considering the patient's preferences and concerns.
- Long-term prognosis: They evaluate which option is likely to provide the best long-term outcome for the tooth.
By carefully weighing all these factors, Dr. Ahmed and Dr. Barra at Old Town Smiles ensure that each patient receives the most appropriate and conservative treatment for their specific situation, whether that's an inlay, onlay, or crown.
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