Crowns, bridges and implants: choosing how to rebuild or replace a tooth

A broken tooth or a missing one raises a practical question: what now? The answer depends on how much of the tooth is left, the health of your gums and the teeth around it, and what you want from the result. The main options are crowns, bridges, implants and removable dentures, and they solve different problems.

Crowns: covering a tooth that is still there

A crown is a cap that fits over a tooth and restores its shape, strength and appearance. Dentists recommend crowns for teeth that are cracked or badly worn, teeth with a large filling that no longer has enough tooth around it, and teeth that have had a root canal. A crown can also hold together a weak tooth, or cover one that is misshapen or discolored.

To place one, the dentist reshapes the tooth, makes an impression or digital scan, and has a crown made to fit. A temporary crown usually protects the tooth in the meantime. Crowns can be made from porcelain or other materials, and porcelain can be matched to the shade of your natural teeth, which is why crowns show up in both general and cosmetic dentistry.

Bridges: filling a gap with help from the neighbors

A bridge replaces one or more missing teeth by anchoring a false tooth to the teeth on either side of the gap. Those neighboring teeth are reshaped and capped with crowns, and the replacement tooth is joined between them like a span between two supports.

A bridge can be a good fit when the teeth on either side of the gap are already heavily filled or crowned, or when they are strong enough to take on the extra load. The tradeoff is that healthy neighbors may need to be reshaped to support it. A bridge also depends on those anchor teeth staying healthy, so careful cleaning underneath it matters. Your dentist or hygienist can show you how to floss under one.

Implants and removable dentures

A dental implant is a different approach. Instead of leaning on neighboring teeth, an implant replaces the root. A small post, usually titanium, is placed in the jawbone, and over several months the bone grows around it and holds it firmly. A crown is then attached on top. Because the post sits in the bone, it helps preserve the jaw where the tooth used to be, and the neighboring teeth are left alone.

Implants are not right for everyone. They need enough healthy bone and healthy gums. People who smoke or who have uncontrolled health conditions may face more risk, and treatment takes longer than a bridge, since the healing between steps cannot be rushed. Your dentist will go over your health history and examine your mouth before telling you whether an implant makes sense.

When many teeth are missing, or when someone cannot or does not want to have implants or bridges, removable dentures are still a good option for many people. They come out for cleaning, they can replace several teeth or a full arch, and they do not require surgery. Dentures need to be kept clean, and they may need adjustments over time as your mouth changes. Implants can also be used to help secure some dentures, which many people find more stable. Ask whether that is an option for you.

How the options compare, and what to ask

• Crown: for a tooth that is still there but damaged. It keeps your natural tooth and root.
• Bridge: for a gap, using the neighboring teeth as anchors. Treatment is generally quicker than an implant, and the neighbors have to be prepared to hold it.
• Implant: for a gap, replacing the root itself. It takes longer and needs enough bone, and it leaves the neighboring teeth untouched.
• Removable denture: for several missing teeth, or a full set. It can be taken out and cleaned, and it may need adjusting as your mouth changes.

Every mouth is different, so the best way to decide is to ask. These questions can get a useful conversation going:

• What is wrong with this tooth, and what happens if I wait?
• Which options are realistic for my situation, and why?
• How long does each option take from start to finish, and how many visits?
• What will care and cleaning look like afterward?
• What happens if this option does not last, and what are my fallback choices?
• What will my insurance estimate say, and what is my own share before we begin?

A good dentist will answer each of those directly and will not rush you into a decision. It is also reasonable to take a day or two to think it over.

Talk it through at Mill Creek

Mill Creek Family Dental in Lafayette lists crowns and bridgework, dental implants, extractions and removable dentures among its general dentistry services, with crowns and implants also available as cosmetic work. The practice reviews treatment and cost and goes over insurance estimates before work begins, and it works with CareCredit financing. Dr. Cronkhite is happy to explain what he sees and what each option would mean for you. Call 765-471-6025 to schedule a visit.