DxD Session held on August 31, 2018.
Dr. Steven Soo is a Specialist in Prosthodontics (Teeth Replacement & Cosmetic Dentistry) at Specialist Dental Group®. He was a Specialty Dentist in Implant Prosthodontics at King’s College Dental Hospital and an Overseas Registration Examiner while maintaining a successful private practice in Fitzroy Square, Central London.
He has also given numerous academic presentations on complex implant prosthodontics cases and authored various scientific publications. He has a special interest in prosthetic and implant restorative dentistry. He is currently teaching at National University of Singapore and was formerly a Clinical Lecturer at the Eastman Dental Institute and Clinical Teacher at the GKT Dental Institute.
If you have damaged or decayed teeth, you can consider getting dental prosthetics like crowns, bridges, or veneers to fix them.
Dr Steven answered readers questions on:
- Cost of crowns, bridges and veneers
- Difference between crowns, bridges, & veneers
- How to choose the best solution
- How to best maintain them
Crowns, bridges, and veneers are different types of prosthetic solutions.
Crowns cover the whole tooth to strengthen and improve the appearance (colour and shape), bridges replace missing teeth and often consist of several crowns linked together attached to the teeth either side of the gap.
Veneers cover only the front of the tooth to improve the appearance and occasionally strength. All of them are made of porcelain and are provided for different reasons.
Hi Gui Fang,
The treatment options available depends on the size of your gap. A small gap can be closed using braces or white (composite) fillings. A medium gap can be closed with braces, white fillings or crowns. A large gap (the size of a tooth) can be closed with braces and perhaps an additional tooth in the form of a bridge or an implant.
Providing a crown is generally a two visit procedure.
The first visit will take approximately one hour to prepare the tooth and make an impression.
- During preparation of the tooth, you will be given some local anaesthesia to numb your tooth and gum tissue around it. The natural tooth is then trimmed away to allow sufficient space for the dental crown.
- Next, a dental impression is taken either with a hand-held scanner or with an impression tray. The dental impression is then sent to the dental laboratory to fabricate the definitive (final) crown.
- A temporary crown is provided on the same visit to protect the tooth and to allow patients to leave the clinic with a complete smile.
- Lastly, your Prosthodontist/dentist will go through the shade guide with you to select an appropriate colour shade for your new dental crown.
Crowns should last approximately 10 years if maintained well and not abused (i.e. biting very hard things). Therefore, it is important to take good care of them so that they can last as long as possible. Refer to this question for tips on how to care for your dental crowns and bridges.
Hi Qing Ying,
There are two basic types – gold or porcelain (ceramic). Gold is very hard wearing and good for patients who have a partially heavy bite or habit to grind their teeth. Unfortunately, the colour is not to everyone’s liking.
Providing a crown necessitates some tooth preparation by drilling. As the tooth has a nerve, this can cause transient pain/sensitivity. However, if the discomfort is more severe and longer lasting, you are recommended to call your prosthodontist/dentist for an evaluation.
One of the possible cause of pain from a new dental crown is nerve inflammation
In Singapore, the cost of dental crowns generally ranges from $700 to $3,000.
The cost varies widely depending on material, laboratory costs, clinician chosen and clinical time spent. The fees from a Prosthodontist (crown specialist) will be naturally higher to reflect the expertise and experience of a specialist.
Medisave can be used for certain surgical procedures only. As crowns, veneers and dental bridges do not require involve surgery, patients are unable to use Medisave to cover part of their treatment fee.
The various types depend on many factors such as:
- number of teeth to be replaced
- condition of adjacent teeth
- age of patient
- position of missing tooth
Firstly, a clinical examination of your dental condition will be carried out. This is when we check on the condition of the teeth and gums.
Secondly, a radiographic examination is done to check on the condition of the underlying bone and any other condition that may not be seen during the clinical examination.
Thirdly, a consultation is done to explain any dental issues that need to be fixed, along with each treatment option’s pros and cons for patient’s consideration.
Here are two simple tips I give to all my patients with regards to caring for their dental bridge/crown:
1. Treat it as if it were your own natural tooth. Brush two times a day for at least two minutes each, floss at least once a day and visit a dentist two times a year.
It is essential to continue with these oral care routine as a dental bridge/crown is equally susceptible to decay along the gum line. If you are unsure of how to floss effectively, ask your dentist so that he/she can guide you.
A Prosthodontist specialises in the replacement of teeth using crowns/bridges, dentures and dental implants. Several general dentists can also provide this treatment but a prosthodontist’s training is specifically for this type of treatment.
A recognised Prosthodontist in Singapore needs to receive additional three to four years of training, build up clinical cases (and experience) and sit for the Prosthodontic Specialist Exit Exam.
It is often said that veneers are minimally invasive and do not involve much preparation of the teeth. Whilst this is true, veneers are not totally reversible.
In fact, it is considered permanent because the outer layer of your enamel needs to be removed to give way to the veneers, changing the original structure of your teeth.
Porcelain veneers by the nature of the material can chip and break when encountering hard foods. Treat them gently and they can last a long time.
Gum disease is a separate issue from veneers but with all dental restorations, it is advisable to make sure the foundations are healthy before improving the appearance.
A crown is like a house, and our gums are like the foundation. If the gums are not healthy, the foundation is not stable and it will not be ideal to build the “house” (crown) on it.
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