882C Emerson Street
Palo Alto, CA 94301
Mack, Thomas P D.D.S.
703 Welch Rd # A3
Palo Alto, CA, 94304-1707
Bahl, Shachi D.D.S.
511 Byron St
Palo Alto, CA, 94301-2098
Fotovtjah, Mehran D.D.S.
1805 El Camino Real
Palo Alto, CA, 94306-1162
Dr. Harvey P Boyarsky D.D.S.
888 Middlefield Rd
Palo Alto, CA, 94301-2915
(650) 327-3172
The crown serves two important functions. First, it restores the appearance of your teeth and your face. If your tooth is severely decayed or cracked, the dentist will need to restore it prior to preparing a cap. Teeth also support the muscles in our faces, so anything less than a full tooth may affect the way you look.
Second, a crown will be the same size and shape as the natural tooth. As a result, it will keep your jaw and bite aligned; it will also make sure that other teeth don't shift locations or take on a greater share of the work of biting and chewing.
Crowns are most often made of gold or porcelain. Crowns also can be made of stainless steel, but those crowns are often temporary and not designed for long-term wear.
Porcelain crowns usually are built on a metal base, which fits snugly over the natural tooth. Your dentist will choose a porcelain that matches the color of your natural teeth. Porcelain crowns usually are so carefully matched in color, they cannot be distinguished from your natural teeth. Many people choose porcelain crowns for the cosmetic appearance and the confidence it gives them.
New materials are now available that allow the use of "all-ceramic" crowns in some cases. They have a beautiful life-like appearance and short-term studies support their success, with long-term trials ongoing.
Crowns also can be made of all gold. Some people prefer not to use gold because it stands out from the other teeth in appearance. At the same time, if the crown is on a back molar, some people feel the cosmetic issue is not a big one. Your dentist will discuss the types of materials available if a crown is recommended.
Once your crown is in place, make sure the area is brushed well and that you floss below the gum line. While the crown protects your remaining tooth from further decay, you must protect the base of the crown from bacterial growth and gum disease. Regular brushing and flossing as you would your natural teeth will ensure that your crown will be in place for years to come!
By Danine M. Fresch, DDS
The term malocclusion literally means "bad bite." It is a generalized dental care term that refers to many different types of mal-relationships of the lower teeth to the upper teeth. In popular usage, any arrangement of the teeth that is at variance with a prescribed ideal is considered to be a malocclusion in dentistry. But that is an oversimplification because some occlusions that appear to be ideal may be in disharmony with the jaw joints (the TMJs). Such disharmony can be a source of many different problems with the teeth, the TMJs, or the jaw muscles. Even minute disharmonies of the bite can be a major factor in loosening the teeth, wearing away of the enamel, or fracturing off cusps. Other malocclusions can cause headaches or cause the teeth to be sore or sensitive to cold. Some malocclusions may be most noticeable because they result in an unattractive smile. Some severe malocclusions cause no discomfort whatsoever, while some minor bite problems can be a major source of pain.
Perhaps the best way to understand malocclusion is to understand what an ideal occlusion is. This understanding starts with a basic appreciation for how the jaw joints (the TMJs) function. The TMJs are important because they form the hinge for opening or closing the jaw. During closure in an ideal occlusion, the teeth should all contact simultaneously and with equal pressure when the jaw joints are fully seated up in their sockets. This harmony between the TMJs and the teeth is the most important requirement for a comfortable, stable bite. Any disharmony between the TMJs and the teeth requires the jaw muscles to hold the jaw joint out of its socket in order to completely close the teeth together. This type of malocclusion can cause many different problems but unfortunately the disharmony is easily missed unless the dentist is very careful in examining for it. It is commonly missed because the occlusion is examined visually without first verifying that the jaw joints are completely seated when the bite relationship is examined.
Depending on the type of malocclusion, correction of a bite disharmony requires careful selection from a variety of different treatment procedures. Even though principles of bite correction have been established with enough clarity to permit highly predictable results of comfort and stability, some dental educators claim that occlusal harmony is unimportant because the body can adapt. This viewpoint has resulted from a profuse amount of misinformation that has found its way into the literature. Patients with bite problems should feel free to ask the dentist to show them the problems that are resulting from the bad bite such as loose teeth, excessive tooth wear, or other visible signs, in addition to an understandable explanation of why the recommended treatment was selected.
The most common, and also the most practical methods for correcting most minor occlusal disharmonies is called occlusal equilibration. It involves direct reshaping of the biting surfaces by grinding and polishing selected tooth surfaces that interfere with comfortable jaw movements. When correctly done on properly selected patients, it is a conservative and effective treatment.
Some malocclusions may require more extensive treatment such as orthodontics. Teeth that are badly worn or that need the biting surfaces re-shaped may need dental crowns or other types of restorations. Surgical correction may be needed in some severe jaw misalignments to achieve the best result and appearance.
Most malocclusions can be corrected in a reversible trial approach by making a plastic appliance that fits over the teeth to change the biting surfaces so the jaw can close with even tooth contacts. These appliances are referred to as occlusal splints. A fancier name for them is "orthosis" but it means the same thing.
The important thing to understand about your bite is that you should be able to close your teeth together and squeeze very hard without causing any sign of tenderness or pain in any tooth or in the jaw joint. If you can't do this you probably have a malocclusion. You should know that the discomfort is almost always correctable with the right selection of treatment. Your dentist must also examine for other possible causes of pain that may exist in combination with your bite disorder. Nothing takes the place of a carefully made examination to determine the specific cause (or causes) for your discomfort.
By Peter E. Dawson, DDS
