Diagnosing A failing Filling
Restoring a Failed Filling
When we need to replace a filling, the best option is frequently to protect your tooth with a crown instead of placing a filling. Placing a crown when a filling has broken or worn out, helps to protect and strengthen your tooth.
Can you replace a filling with something else?
Sometimes, we can replace your filling with another filling, but this can weaken the tooth because more tooth structure must be removed to hold the new filling. This means that a larger filling must be used to replace the old one. A large filling weakens your tooth and leaves it more vulnerable to damage.
Replacing a filling with another filling can remove so much supporting tooth structure that the tooth can break. This is especially true if decay has formed underneaththe old filling, requiring us to remove the decayed areas also.
Benefits of a crown
Placing a crown can prevent these problems. A crown covers and protects the tooth. It seals out plaque and bacteria and restores the strength and shape of the tooth.\
Determining the need for a crown
When we evaluate a filling that needs replacement, we consider both the size of the filling and the amount of healthy tooth structure that remains. To determine if a crown is right for you, we perform a thorough examination. If we find that a crown is the most appropriate treatment for your situation, we talk with you about the best kind of crown to use.
Crowns after Root Canal Therapy
Crowns and Root Canals
After a tooth has had root canal therapy, we recommend placing a crown on the tooth. Root canal therapy reduces the strength of the tooth, and a crown can cover and protect it.
How does root canal therapy affect a tooth?
Root canal therapy leaves a tooth brittle and weak. The inner pulp layer of a tooth contains its nerves and blood vessels, so the tooth loses much of its blood supply when the infected pulp is removed and the tooth’s root canals are cleaned out. The tooth is weaker also because only the sides of the tooth are left for support when the center of the tooth is gone.
These factors make it much easier for a tooth to break when you bite down on food. Biting and chewing place a tremendous amount of force on teeth, and weak, brittle teeth are especially vulnerable.
A crown protects the tooth
A crown can prevent these problems by covering and protecting the tooth and restoring its strength and shape.
There are many kinds of crowns, including crowns made of gold, porcelainfusedtometal,
and porcelain. We’ll talk with you about the best one for your situation to help you keep your healthy and beautiful smile.
Diagnosing margin Decay
While it is true that a crown protects and strengthens a tooth, sometimes decay can start at the margin of a crown, where the tooth meets the crown. Early detection and treatment will protect the tooth and help prevent future problems.
Why decay can form next to a crown
Decay can form in the area where the crown meets the tooth structure. This happens because it is one of the toughest spots to keep free of plaque and the bacteria that cause tooth decay.
It is important to treat tooth decay as soon as possible. Once decay has become
established, it can grow quickly. If the cavity penetrates the outer enamel layer of the tooth and reaches the softer dentin layer, bacteria can cause an infection in the pulp layer, which contains your tooth’s nerves and blood vessels. The only way to treat the infection is by performing root canal therapy to remove the infected tissue.
Diagnosis and treatment
We begin by performing a thorough examination, and then we determine the best treatment for you.
If the decay has just started in an area that we can reach, we may be able to remove the decay and restore your tooth with a filling. If the decay has advanced, it is likely that we will need to replace the crown with a new one. There are several kinds of fillings and crowns, so we talk with you about the best one for your situation.
Treatment will reseal and protect your tooth. By treating the decay as soon as possible, we can often prevent it from spreading and causing unnecessary damage to your tooth, and more
complicated, extensive treatment.
Diagnosing a Large Cavity
Restoring a Large Cavity
When a tooth has a large cavity, the best treatment is often to protect the tooth with
a crown instead of placing a filling. A filling may weaken the tooth, while a crown covers and protects it.
Why not place a filling?
Placing a filling can weaken the tooth because first the decay must be removed,
and then the remaining tooth structure must be shaped to hold the filling.
With small fillings, this process may leave enough structure to support the tooth. However, when a large portion of your tooth has been damaged by decay, we need to remove a significant amount of the tooth in order to remove all of the decay.
Placing a large filling can leave your tooth without much of its natural structure; so it also loses much of its support and strength. As a result, the tooth can easily fracture, or a portion of it can break away entirely.
Benefits of a crown
Placing a crown can prevent these problems. A crown covers and protects the tooth. It seals out plaque and bacteria and restores the strength and shape of the tooth.
Determining the need for a crown
When we evaluate the cavity in your tooth, we consider both the size of the cavity and the amount of healthy tooth structure that remains. To determine if a crown is right for you, we perform a thorough examination.
There are several kinds of crowns, including those made from gold, porcelain fused to a metal
base, and porcelain. Together, we will decide which kind of crown is best for your situation.
Resin Crown Procedure
A resin crown restoration
When a tooth needs a restoration or you want to improve your smile, sometimes the best
choice is a resin crown. A resin crown is made of a mixture of microscopic glasslike particles
and plastic resin that is cured for strength.
A resin crown is precisioncrafted in a dental laboratory, so it may take two or more appointments to restore your tooth with a resin crown.
Placing a resin crown
On your first visit, we numb the area to make you comfortable. We may also use a rubber
dam to protect your mouth and the back of your throat while we work.
Using the handpiece, we remove any decay and shape the tooth, so it will securely hold the crown. Next we take an impression of your teeth. The dental lab uses this impression to make an accurate model of your mouth; then they use the model to create a crown that precisely fits your tooth and bite. In the meantime, we often place a temporary crown to protect your tooth.
On your next visit, we remove the temporary crown and try in your new resin crown. We check the fit, and when everything looks good, we bond the crown in place.
The benefits of a resin crown
A resin crown has several benefits. Like all crowns, it covers and protects your tooth. But in addition, a resin crown is
- made of a material that expands and contracts like natural tooth structure.
- gentle on the opposing teeth when you chew.
- natural looking because it can be made to closely match or improve your own tooth color.
Why a Root Canal After a Crown?
Why Crowns Need RCT
Why we place a crown If you have a crown, it was placed because the outside of the tooth was
damaged and needed more than just a filling. But the crown doesn’t protect the inside of the tooth, called the pulp.
The pulp contains the nerves, blood and veins that keep the tooth alive. If this pulp becomes infected it will need root canal therapy.
Infected pulp will not heal on its own. If we don’t perform root canal therapy, the infection can spread and cause a painful abscess.
When do we place a crown?
There is no way to predict when the need for root canal therapy might occur. But, because the tooth was damaged enough to need a crown, it is likely the pulp is in a compromised state.
In some cases, we may be able to enter through the crown. Once we clean and repair the root
canals, we can simply restore the crown much like we’d restore a natural tooth.
Otherwise, we may have to remove the crown in order to remove the infected pulp and treat the roots. We’ll then need to create and place a new crown.
Root canal therapy, even on a crowned tooth, is done to help save the tooth. It’s our goal to give you a healthy, beautiful smile.
Alternatives to a Crown
After a lot of tooth structure has been lost, your choices are limited. You could choose to -
- try a filling.
- have the tooth extracted.
- delay treatment.
- restore the tooth with a crown.
Trying a filling
A filling may be an alternative, but only when enough tooth structure is available to hold the filling in place. If not, biting forces can cause the tooth to break when you chew. After a
tooth breaks, it often requires much more extensive treatment, sometimes even extraction.
Having the tooth extracted
Extracting a tooth instead of restoring it is only a shortterm solution. Teeth need each
other for support. A missing tooth sets off a chain reaction of shifting teeth and receding
jawbone. Changes in your bite can also increase your risk for tooth decay, gingivitis,
periodontal disease, and maybe even more tooth loss.
If you choose to delay treatment, the situation is just going to get worse. A tooth that has
lost a lot of structure may break below the gumline and require extraction. Tooth decay or
fracture can allow bacteria to get into the pulp of the tooth, causing pain and requiring root
canal therapy to save the tooth.
Restoring your tooth with a crown
A crown is an excellent way to restore a damaged tooth. It seals out plaque and bacteria,
covers and protects the tooth, and restores its strength and shape. That’s why we recommend a crown to help keep your tooth and smile healthy.
Homecare Temporary Crowns
Chesing and eating
Now that we have placed a temporary crown, it is important to follow these recommendations to
ensure the success of your final restoration.
If we used an anesthetic during the procedure, avoid chewing until the numbness has completely worn off.
Avoid chewing for at least one halfhour to allow the temporary cement to set.
To keep your temporary crown in place, avoid eating hard or sticky foods, especially chewing
gum. If possible, chew only on the opposite side of your mouth.
Brushing and flossing
Brush normally, but floss very carefully. Remove floss from the side to prevent removal of the
temporary crown. In some cases, we may advise you to avoid flossing around the temporary crown.
If your teeth are sensitive to hot, cold, or pressure, use desensitizing toothpaste. If sensitivity increases or persists beyond a few days, call us.
Medication and discomfort
Take antibiotics or other medications only as directed.
To reduce any discomfort or swelling, rinse your mouth three times a day with warm salt water. Use about one teaspoon of salt per glass of warm water. It is normal for your gums to be sore for several days.
When to call us
Call us if your temporary crown comes off. Save the temporary, so it can be recemented.
It is very important for the proper fit of your final crown that your temporary crown stay in place.
Call our office if your bite feels uneven, you have sensitivity or discomfort that increases or continues beyond three or four days, or if you have any questions or concerns.