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HEALTH: Crown and Bridges

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By Dr. Matthew Weekes
July 3rd, 2013 Edition

A crown commonly called a cap is a dental restoration that is placed over a tooth that is lacking in natural tooth structure. This may be the result of cavities, fractured off segments, or severe wear and tear. Some teeth erupt into the mouth underdeveloped as is often seen with peg shaped upper lateral incisors. A crown is often used to transform these teeth to a natural form and size.

To restore small defects tooth matching bonding resins are used, but they are not suitable to restore the form and function of extensively compromised teeth. A crown is an excellent restoration in this case. It is fabricated to look and function like a natural tooth with ideal anatomy. It is made either of very hard durable porcelain as is often the case for restoring the four front teeth in either arch, or porcelain fused to metal. The posterior teeth which require more resistance to wear are usually made with porcelain fused on the top of a semi-precious metal.

All teeth that have had root canal treatment should be crowned. As these teeth have no vital tissue, they become more brittle as time goes by and hence are more susceptible to fracture. By placing a crown on the tooth soon after the root canal therapy is performed, the strength of the tooth is greatly increased and the chances of fracture is very unlikely.

A bridge is a fixed prosthesis shaped like a single tooth or several natural teeth and used to replace a single missing tooth or multiple missing teeth. It is attached and supported by crowns that are placed on the prepared teeth at both ends of the vacant space. Bridges like crowns are aesthetically pleasing and restore the ability to chew your food efficiently. Bridges can either be supported by natural healthy teeth or by implants. The advantage of a bridge over a denture is that you do not have to take it out at night and it preserves the soft tissue and bone around the teeth much better than a denture. However very often there are several teeth missing and the treatment of choice could be a combination of bridges and partial dentures, a partial denture alone, or a complete full denture if no natural teeth are present.
A discussion with your dentist will determine the best treatment plan for you and the various alternatives to treatment.

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Dental

The Effects of Stress on Oral Health

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BY DR MATTHEW WEEKES

Stress is detrimental to the entire body. It results in physical and mental dysfunction. The ripple effect is felt throughout societies globally. Stress is like the wind. We don’t see it and sometimes we are not aware it is there.

The level of stress in today’s modern world appears to be increasing at an alarming rate with no end in sight. From the time you get up in the morning there is stress. It could be rushing to get the kids ready for school, trying to get to work on time for a special appointment or arriving on time for a school exam and getting stuck in traffic, just to name a few of the many common experiences.

There is a significant relationship between stress and oral health. In addition to the harmful effects of intense, uncontrolled stress, such as a high level of anxiety, emotional problems, high blood pressure and a large variety of other ailments that results in the intervention of a physician, your dentist is often the healthcare practitioner that becomes aware of the warning signs. He or she may see the “smoke before the fire”.

Overstressed individuals may grind their teeth while they sleep and not be aware of it. This is called bruxism. The uncontrolled movement of the jaws during sleep can severely damage teeth. It can cause headaches, earaches, spasms of the facial muscles, toothaches.

Many patients are stressed due to a lack of sleep. Adequate sleep is very important for maintaining excellent health. This cannot be overemphasised. Longevity depends on it. The repair and growth of cells are most active during sleep. If there is lack of sleep due to frequent arousals, find out why?  The most likely cause is snoring and obstructive sleep apnea.

During times of stress people tend to smoke, drink heavily, neglect their oral hygiene, eat foods high in sugar, drink a lot of unaltered coffee. These compound the problem.

These are some of the reasons to find out if your oral problems are affecting your general health. We will be happy to address your concerns.

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Dental

Dental Pain – A Vacation Spoiler

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BY DR. MATTHEW WEEKES

A vacation is a highly anticipated event especially if it is one of the popular cruises. A lot of planning and time management is usually involved. At this time of year most of us wish to get away from the bitter cold and enjoy the tropical scenery of the Caribbean with its invigorating breeze, lovely beaches, fruit punch and so many niceties.

For some their expectation of a blissful time is spoiled by a sudden toothache or pain in the gums or cheeks. When a toothache occurs while on vacation in the air, sea or land the conditions for this sudden flare up exist. The tooth is like a simmering volcano that may erupt at any time if there is a pre-existing condition of disease.

To prevent distressing dental events, before you leave, I recommend that you have a dental checkup preferably at least two weeks before you leave or any time before you leave. If you know that there are problems based on your own visual examination, if the bite does not feel right or there is pain when you bite down or clench the teeth and occasional symptoms, seek dental advice. Very often a simple dental treatment, which does not involve extraction, may be all that is needed to prevent a painful experience.

Sometimes painful dental episodes may not be from the teeth but from infection of the gum. If you have not had your teeth cleaned for at least a year and your flossing is non-existent or irregular and if you notice your gums bleed and there are deposits adhering to the teeth, the chances are that you are a candidate for a painful episode. A thorough cleaning would significantly lessen the chance of pain if no other conditions exist.

There are some people that have reoccurring small red lesions on the gums and cheeks. They are usually very painful and of viral origin. Like canker sores they should go away within two weeks. Your dentist can prescribe medication to take care of the symptoms and restore comfort. It is a good idea to take a tube along with you. Some can also be used on denture sores.

Check out the condition of your dentures before you leave. Examine for cracks or severely worn down areas. Minor repairs can be done the same day.

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Dental

Root Canal Therapy

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BY DR. MATTHEW WEEKES

The prevalence of multiple missing teeth is low compared to a few generations ago. The common toothache was the result of a cavity that progressed into the hollow chamber of the tooth allowing bacteria to infect the enclosed pulp resulting in moderate to severe pain. Filling the tooth at that stage would not solve the problem, and the only option was extraction.

Today the availability of RCT and improved economic conditions has resulted in saving teeth and preventing the worry and embarrassment that so many of our predecessors experienced. This dental procedure is performed either by your general dentist or a specialist called an endodontist, referred to by your dentist.

RCT is usually as a result of a painful emergency. Usually it is done in one or two visits depending on the severity of the infection and the circumstances. Once anesthetised the procedure is mostly pain free. The first stage of treatment is to eliminate the pain and remove the infected pulpal tissue and drain the abscess if it exists. The patient may be placed on antibiotics and pain medication. An appointment is then made to complete the treatment at a subsequent visit.

After the tooth has settled down, and evaluated to be healthy and symptom free it should be protected by a crown to prevent breakage and maintain the best esthetics. Teeth that have RCT may become brittle and more susceptible to fracture and also may get darker in colour.

RCT should always be the treatment of choice where esthetics and chewing your food is a major consideration and there is no barrier to treatment.

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