Fillings & Crowns

Dental cavities are small cracks or holes in your tooth that happen when the surface of a tooth breaks down (tooth decay). These openings can allow tiny food particles and germs to enter inside the tooth. Without treatment, cavities can lead to infection, pain, difficulty eating and drinking, and even loss of the tooth. To prevent these problems, it is important to have the openings covered as soon as possible. This is usually done with a filling or a crown.

What is a filling?

When a you have a small cavity that does not weaken the tooth too much, a filling can be used. A filling is a small amount of material that is inserted into the cavity. The filling completely seals the opening and restores full biting and chewing function of the tooth. In addition to treating current tooth disease, fillings also prevent further tooth decay.

Fillings can be made of mixtures of metal that appear gold or silver. These are also called amalgam fillings. If you would prefer a filling that matches the color of your natural tooth, porcelain (ceramic) or composite (resin) fillings can be used. Along with appearance, you might choose filling materials based on strength of the material. Gold and silver fillings are sturdier and will last longer than porcelain and composite fillings.

What can I expect when having a filling done?

Your dentist will start by numbing the tooth with a special gel and small injection of numbing medicine. This ensures you do not have any discomfort during the following procedure:

Before placing the filling, the decayed portion of the tooth is cleaned out using a tiny drill and other instruments. You may hear a buzzing sound and feel some vibration, depending on the instruments used. However, you should not experience any pain. During this procedure, your dentist will take special care to protect to nerve of your tooth.

Once the affected portion of the tooth is cleaned out, your dentist fills and reshapes your tooth to its original form, using the filling material you have chosen. For resin material, the filling will be applied in thin layers, hardening each layer with a special light.

What can I expect after having a filling done?

The numbing medicine used during your procedure may last for several hours. Once it wears off, it is normal to have a mild amount of discomfort. This can usually be managed with over-the-counter pain medicine. Placing ice packs over the area can also help ease discomfort.

How do I know if there is a problem with my filling?

Most people have no problems after having a cavity filled. Rarely, problems do occur. Contact your dentist if you have:

• Discomfort or pain that lasts more than 48 hours after your filling repair is completed
• Continued numbness after 8 hours
• A fever
• Redness, swelling or puss near the tooth that was repaired

When is a different choice needed to treat tooth decay?

While fillings are a simple and less expensive way to treat small cavities, larger amounts of decay can weaken a tooth and require a sturdier repair. When this is the case, a crown is needed to cover the whole tooth, replacing the entire biting or chewing surface.

What is a crown?

There are several types of crowns including:
• Metal
• Porcelain (ceramic)
• A combination called porcelain fused to metal (PFM)

Metal crowns may appear silver or gold, but they are actually made of a combination of metals (alloys) to make them as strong as possible. In fact, some people choose metal crowns because they are the strongest of all three types. When cared for properly, metal crowns can last for decades.

Porcelain crowns can be designed to look almost identical to the tooth it will cover, when the tooth was in a healthier state. Techniques are used to color the crown so that it blends in with the surrounding teeth. While not as strong as metal crowns, porcelain crowns are also a great option and can last for many years when well cared for.

PFM crowns combine the strength of metal with the appearance of porcelain. Special care is taken when attaching the porcelain top of the crown to the metal base—all of which will slide over the top of the unhealthy tooth. Like the other two types, PFM crowns can last for many years with proper care.

What can I expect when having a crown installed?

Creating and placing a dental crown takes time—most crowns require two separate appointments to complete. During the first appointment, the tooth is prepared to have the crown placed and then a mold of the tooth is taken. The mold is then used to make the crown at a dental lab.

A variety of techniques can be used to prepare (shape) the existent tooth, but most start with numbing up the area to keep the procedure as painless as possible. Once the numbing medicine has taken effect, special tools are used to isolate the tooth being worked on, making sure the surrounding teeth and gums are protected. Several layers are then removed from the top and sides of the damaged tooth, preparing it to receive the new crown. After the tooth is re-shaped and small enough to slide the permanent crown on during the next appointment, a temporary crown is inserted to prevent problems with tooth sensitivity.

At your next appointment, the permanent crown will be secured to your tooth with a special adhesive. If needed, small adjustments to the crown shape or size can be done at the time of fitting. Although rare, another appointment may be needed if the crown needs to be sent back to the lab for further shaping to achieve a perfect fit.

What can I expect after my crown is completed?

It is normal to have a mild amount of discomfort after your first appointment when your tooth is prepared to receive the crown. This can usually be managed with over-the-counter pain medicine and should not last more than a few days. Ice packs placed over the area can help ease discomfort. Most people will have minimal to no pain after having the permanent crown fitted.

How do I know if there is a problem with my crown?

After the first few days of getting used to the feeling of the new crown in your mouth, you should not be able to tell it is even there. Although rare, problems with crowns can happen. Contact your dentist right away if you experience:
• A crown that causes pain in the nearby gums or teeth
• A crown that changes how your teeth come together (bite) or alters your chewing. Jaw pain or headaches may be a sign of this.
• A porcelain or PFM crown that appears very different from your other teeth
• A crown that appears cracked, loose, or falls out

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