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18/Jun/2019

Dental Crowns

What is a dental crown?

 

Your dentist may recommend placing a dental crown to cover your tooth to protect and strengthen it, restore the tooth’s shape, size, and/or improve its appearance. Dental crowns are used for various purposes, including:

  • Protecting and restoring a broken or decayed tooth with a large filling
  • Restoring a tooth after a root canal
  • Covering misshapen or severely discolored teeth for cosmetic purposes

What types of crowns are there?

Temporary crowns are made in your dentist’s office, and are used as a temporary restoration while your permanent crown is constructed by a lab.

 

Stainless steel crowns are often used as a temporary measure. Prefabricated stainless steel dental crowns are sometimes used to cover baby teeth that are badly decayed, and can also be used preventatively to protect the teeth of a child at high risk for tooth decay.

 

Metal crowns tolerate chewing forces well and rarely chip or break. Metal crowns may be fabricated with gold alloy, other alloys or a base ­metal alloy such as chromium or nickel. Compared with other types of dental crowns, when preparing the tooth, less tooth structure is removed, and wear to the crown and opposing teeth is minimal. Metal dental crowns are a good choice for rear molars, as they are a noticeable metallic gold or silver in color.

 

Porcelain ­fused ­to ­metal crowns are made of metal alloys and coated with porcelain. They are color-matched to your existing teeth but may show a dark sliver of color at the gumline. This type of dental crown can be used for either front or back teeth.

All­-ceramic dental crowns provide a better natural color match than any other crown type and are more suitable for people with metal allergies. Although they are not as strong as porcelain-­fused ­to ­metal crowns and can wear down opposing teeth a little more than other types of crowns, they are often used for cosmetic purposes, and are an aesthetically pleasing choice for front teeth.

 

All-­resin crowns are less expensive, but wear down over time and are more prone to breakage and fractures than other types of dental crowns.

 

Milled crowns require no impression and are digitally constructed in dental offices that have the software and hardware to produce them. They are commonly fabricated and inserted in one visit.


18/Jun/2019

 

Pulp capping prevents damage to the tooth pulp and the eventual need for a root canal.

What is Pulp Capping?

Pulp capping is an alternative to root canal treatment. Endodontists use this technique to keep dental pulp, and subsequently your actual tooth, from dying. You may be surprised to know that a toothache is often a signal that a cavity has reach your tooth’s pulp and the throbbing is alerting you to the fact that your tooth is dying. Pulp capping saves your tooth by isolating cavities from your tooth’s pulp.

Why Pulp Capping is So Essential

Most people associate endodontics with the area of dentistry responsible for doing the root canal. But endodontic treatment is actually about treating diseases that affect the pulp of your tooth. In essence, endodontists are charged with the responsibility of saving dying teeth.

Endodontists use several techniques to save teeth. One technique is pulp capping, which they use to keep tooth decay from attacking the tooth’s pulp chamber. If the pulp becomes infected and the tooth dies, a root canal will be needed to save the tooth from tooth extraction.

If the tooth’s nerve is still alive, you endodontist can use pulp capping to keep the tooth decay (or tooth disease is probably more accurate way to think of this) from infiltrating the pulp chamber. Pulp capping is also used as a preventive measure to keep a large tooth filling from getting too close to the nerve.

There are several reasons why you and your dentist might choose pulp capping over a root canal. Pulp capping:

  • Saves the nerve and preserves the tooth
  • Is less invasive than a root canal or extraction
  • Requires a shorter recovery time
  • Brings about less sensitivity following the procedure
  • Costs less than a root canal
  • Can use a dental filling instead of a dental crown to restore the tooth 

How the Pulp Capping Works

The procedure for pulp capping is done in several steps. First, your endodontist drills the dental cavity to reach the pulp. Then, your dentist will clean the area and cover the pulp with medicine to protect it from becoming infected and stimulate the pulp to create reparative dentin, a hard material that protects the pulp.

Once the pulp is capped, the dentist will place a temporary or permanent dental filling in the tooth. If it works, dentin should regenerate over the pulp cap in 1 to 3 months. The procedure usually requires a follow-up visit after several weeks to see if the dentin is developing as expected.

There are two types of pulp capping: direct and indirect. Direct pulp capping is used when the pulp is exposed after drilling. In some cases, the dentist may not need to expose the pulp, and will cap the soft layer of dentin that covers the pulp chamber. This is known as indirect pulp capping.

When to Perform Pulp Capping

There is a very small window in which pulp capping can be performed. For pulp capping to be successful, your dental situation must meet these four criteria:

  1. The nerve has to have been exposed recently
  2. There should be minimal, if any, exposure of the pulp
  3. The nerve needs to be alive — pulp capping will not work on a dead tooth
  4. There cannot be any signs of infection or dental abscess

Whether or not a dentist can perform a pulp cap as a dental treatment depends on our situation meeting the four criteria above. Your dentist may need to administer some tests to determine if the tooth is healthy enough to withstand pulp capping. As you can guess, pulp capping is much less common than root canals, given all the restrictions surrounding this procedure.

Why Choose Pulp Capping

Some may choose pulp capping because they fear the idea of a root canal. But modern root canals are not painful like they were a few decades ago. Although the success rate of pulp capping varies from case to case, the success rate is much lower than the success rate of root canals.

If a pulp cap fails, as approximately 40 percent of them do, the tooth will require a root canal or extraction. That means more money spent and more time in the dental chair. This won’t just end up costing you more financially, but it will lead to even more time in the dental chair.

In addition to the four criteria listed above, pulp capping treatment also depends on the patient’s age and health status, the amount of damage to the tooth, and what type of pulp cap is needed. For example, direct pulp capping isn’t usually recommended for young children due to a low success rate in baby teeth.

Pulp capping is used to save a diseased tooth from extraction. But the longer you wait to have the treatment done, the more likely you are to end up having a root canal instead.


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