All crowns are designed to restore functionality to a damaged tooth. But crowns can differ from one another in their appearance, in the material they’re made from, and how they blend with other teeth.
A crown is a metal or porcelain artifice that’s bonded permanently over a decayed or damaged tooth. Every crown process begins with preparation of the tooth so the crown will fit over it. Afterward, we make an impression of the prepared tooth digitally or with an elastic material that most often is sent to a dental laboratory to create the new crown.
It’s at this point where crown composition and design can diverge. Most of the first known crowns were made of metal (usually gold or silver), which is still a component in some crowns today. A few decades ago dental porcelain, a form of ceramic that could provide a tooth-like appearance, began to emerge as a crown material. The first types of porcelain could match a real tooth’s color or texture, but were brittle and didn’t hold up well to biting forces. Dentists developed a crown with a metal interior for strength and a fused outside layer of porcelain for appearance.
This hybrid became the crown design of choice up until the last decade. It is being overtaken, though, by all-ceramic crowns made with new forms of more durable porcelain, some strengthened with a material known as Lucite. Today, only about 40% of crowns installed annually are the metal-porcelain hybrid, while all-porcelain crowns are growing in popularity.
Of course, these newer porcelain crowns and the attention to the artistic detail they require are often more expensive than more traditional crowns. If you depend on dental insurance to help with your dental care costs, you may find your policy maximum benefit for these newer type crowns won’t cover the costs.
If you want the most affordable price and are satisfied primarily with restored function, a basic crown is still a viable choice. If, however, you would like a crown that does the most for your smile, you may want to consider one with newer, stronger porcelain and made with greater artistic detail by the dental technician. In either case, the crown you receive will restore lost function and provide some degree of improvement to the appearance of a damaged tooth.
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
There is much to contend with as we grow older, including a higher risk for dental disease. One possible contributing factor: dry mouth from a lack of saliva.
Also known as xerostomia, dry mouth occurs when the salivary glands secrete less than the normal two to four pints a day. Saliva performs a number of functions, but perhaps the most important for dental health is as an acid neutralizer. Within a half hour to hour after eating, saliva can restore the mouth's normal pH level to prevent acid from softening tooth enamel. When there isn't enough saliva, acid levels stay high leading to erosion of the enamel. This vastly increases the chances for tooth decay.
Although there are several causes for dry mouth, one of the more common is as a side effect from certain medications. It's estimated over 500 drugs — many taken by seniors — can cause dry mouth, including diuretics for high blood pressure and heart failure, antidepressants, and antihistamines. Some diseases like diabetes or Parkinson's may also reduce saliva flow, as well as radiation and chemotherapy.
If you've developed chronic dry mouth, there are some things that may help restore adequate saliva flow. If medication is the cause you can talk to your doctor about an alternative medication or add a few sips of water before swallowing the pills and a full glass afterwards. You should also drink plenty of non-caffeinated beverages (water is the best) during the day and cut back on sugary or acidic foods. And a cool-air humidifier running while you sleep may also help keep your mouth moist.
We may further recommend an over-the-counter or prescription stimulant for saliva. For example, xylitol, a natural alcohol sugar that's found in many gums and mints, has been found to stimulate saliva and reduce the risk of tooth decay as an added benefit.
Last but not least, be sure to brush and floss daily to remove disease-causing plaque and see us at least twice a year for cleanings and checkups (if your mouth is very dry, three to four times a year is a better prevention program). Managing chronic dry mouth along with proper oral hygiene will help ensure your mouth continues to stay healthy as you grow older.
If you would like more information on the causes and treatment for dry mouth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Dry Mouth.”
Athletes in contact sports are at significant risk for traumatic injury to their teeth and mouth. It’s estimated 600,000 emergency room visits each year involve a sports-related dental injury.
Athletic mouthguards have become the premier safeguard against sports-related oral injuries. First worn by professional boxers in the 1920s, mouthguards are now required for use by various sports associations and leagues — from amateur youth to professional — for a number of sports. The National Collegiate Athletic Association (NCAA), for example, requires their use during play for hockey, lacrosse, field hockey and football. The American Dental Association recommends mouthguards for 29 sports or exercise activities.
But do mouthguards actually prevent injury? To answer that question in a scientific manner, the Journal of Sports Medicine published an evidence-based report in 2007 on mouthguard effectiveness for preventing or reducing the severity of oral-facial injuries and concussions. While the report objectively analyzed many of the problems and issues associated with mouthguards (like materials, design and durability), it concluded the risk of an oral-facial injury was nearly two times greater without the wearing of a mouthguard.
That being said, most dentists and other professionals in sports safety would advise not all mouthguards are alike. The stock, “off the shelf” mouthguard found in many retail stores with limited size offerings is the least expensive, but also least protective, of mouthguard types. Mouth-formed or “boil-and-bite” protectors, which are softened in boiling water and then bit down on by the player to form the fit, are better than the stock version — however, they often don’t cover all of the player’s back teeth.
The best option is a custom-designed guard made by a dentist for the individual patient. Although relatively expensive (costs range in the hundreds, compared with $25 or less for a stock guard), they provide the highest recognized level of mouth protection.
The bottom line: a mouthguard is a must-wear part of any uniform for any sport that involves contact or high velocity objects of play. If you or a family member is a contact sport athlete, it’s essential you protect your teeth and mouth with a custom-fit, high quality mouthguard.
If you would like more information on mouthguards, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Athletic Mouthguards.”
Although oral cancer isn't the most prevalent among metabolic diseases, it is one of the most deadly with only a 50% survival rate after five years. That's because it can be difficult to detect in its early stages when treatment is most effective.
That's why prevention to reduce your chances of oral cancer is so important. Many people know quitting tobacco products, including smokeless varieties, and moderating alcohol consumption are key to any prevention strategy. But there's one other factor you should also consider: your diet.
We've learned quite a bit in the last few decades about how certain foods we eat contribute to the cancer disease process. Cancer seems to originate when elements in the body or environment (known as carcinogens) damage DNA, our unique genetic code, on the cellular level. For example, a class of chemicals called nitrosamines is a known carcinogen: we often encounter it in the form of nitrites used to preserve meat (like bacon or ham) or as byproducts in beer, seafood or cheese.
Another form of carcinogen is the unstable molecules produced during normal cellular function called free radicals. But our bodies have a natural neutralizer for free radicals called antioxidants. We obtain these substances in our food in the form of vitamins and minerals. While you can also ingest these in the form of supplements, the best way to obtain them is through a diet rich in plant-based food, particularly fruits and vegetables.
So in addition to lifestyle changes like quitting tobacco or moderating alcohol consumption, make sure your diet is a healthy and nutritious one. Limit your intake of processed foods (especially meats) and increase your portions of fresh fruits, vegetables and dairy products.
And don't neglect practicing effective brushing and flossing each day, along with regular dental cleanings and checkups. All of these healthy practices will greatly decrease your chances for life-threatening oral cancer.
If you would like more information on preventing oral cancer, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Diet and Prevention of Oral Cancer.”
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