Crowning achievements in dentistry include the modern restoration: fillings, crowns and bridges that chew like teeth and look natural. They are strong enough to chew with and natural enough to pass for real teeth, yet we often take them for granted. In this article, Southern York Smile Care in Shrewsbury, PA looks at what these materials have to survive, and how today's options compare.
A crown, a filling or a bridge does a remarkable job in a very hostile place. Understanding that job can help you make better choices about your own dental work and how to care for it.
Imagine designing the perfect tooth material
Pretend you are an engineer working before modern dental restorations existed. People with damaged or missing teeth want a man-made substitute, and you have been hired to invent the material for fillings, crowns and bridges. Here is your list of requirements.
It must be tough
- It must withstand strong biting forces hundreds of times a day, day after day, for years.
- It must resist cracking and chipping, even when someone bites down on an olive pit.
- Yet it cannot be so hard or rough that it wears down the enamel of the teeth it bites against.
It must be stable
- It must keep its size and shape and not shrink or swell over time.
- It must bond securely to living tooth structure, and to any other materials it is used with.
- It must handle hot coffee followed by ice water without cracking or leaking.
It must be safe
- It must be gentle on the gums, cheeks and tongue, as well as on enamel, dentin and bone.
- It should not cause allergic reactions.
- It must resist corrosion from saliva, food and drink, and hold up in a mouth full of bacteria.
- It should not release substances you would rather not absorb.
It must be beautiful
And we have not even touched on looks. Ideally, your material would match real teeth in color, in the way light passes partly through enamel, and in the slight glow at the edges. It should be easy to shade so it blends in beside natural teeth of any color.
That is a tall order. Remarkably, materials that meet most of it already exist.
The materials used today
Dental restorations have a long history, and several materials are in use, alone or in combination.
Porcelain and ceramics
Porcelain, one of the best materials in modern restorative dentistry, was first developed in China nearly 2,000 years ago. The craftspeople who perfected molding, firing and painting fine tableware and vases could hardly have imagined their invention living in the mouths of millions of people twenty centuries later. Modern dental ceramics, including zirconia and other high-strength porcelains, are far tougher than early versions. They are tooth-colored, stain-resistant and gentle on the gums. Learn more on our all-porcelain crowns page.
Composite resin
Composite is a tooth-colored blend of resin and fine glass-like particles. It bonds directly to the tooth, so fillings can be smaller and save more healthy structure. Southern York Smile Care uses tooth-colored, BPA-free white fillings.
Metals
Gold and other metals are very strong and work well in the back of the mouth, but many patients do not like how they look. Silver amalgam fillings, which contain mercury, were common for generations. Southern York Smile Care is a mercury-free office and does not place silver fillings.
Crowns, fillings and bridges: what each one does
- Fillings repair small to moderate areas of decay or damage. A white filling is usually done in one visit.
- Crowns cover the whole visible part of a tooth. They protect teeth that are cracked, heavily filled, badly worn or treated with a root canal. Read Coronation: dental crowns in Shrewsbury, PA for more.
- Bridges replace one or more missing teeth by joining a false tooth to crowns on the teeth beside the gap. See dental bridges.
- Implant crowns and bridges sit on dental implants instead of natural teeth, so neighboring teeth do not need to be reshaped.
Not sure whether you need a crown or a veneer? Our article Crown or Veneer? explains the difference.
How modern technology helps
The best material still needs a precise fit. Southern York Smile Care uses technology that makes restorations more accurate and visits more comfortable:
- iTero Element 3D scanner for digital impressions, so many patients avoid trays of impression putty
- Intraoral camera so you can see the cracked filling or worn tooth on screen
- Digital X-rays with up to 90% less radiation than film
- DIAGNOdent laser cavity detection to find decay early, when a small filling may be enough
See our dental technology page for the full list. Dr. Steven Haywood, who trained in cosmetic dentistry through the NYU Aesthetic Continuum, pays close attention to shade, shape and bite so that new work blends in and feels right.
Making your restorations last
Even the best crown depends on the tooth and gums underneath it. A few habits help your dental work last:
- Brush twice a day and clean between your teeth daily, paying close attention to the edges where crowns and fillings meet the tooth.
- Keep up with regular cleanings and exams. At our office, each cleaning is a full 60 minutes.
- Wear a night guard if you clench or grind.
- Don't chew ice, hard candy or pens, and don't use your teeth as tools.
- Call promptly if a crown feels loose, a filling feels rough, or a tooth becomes sensitive.
How long do restorations last?
There is no single answer. How long a filling, crown or bridge lasts depends on its size, the material, where it sits in your mouth, how hard you bite, and how well the tooth and gums around it are cared for. Large fillings in back teeth take more stress than small ones in front. A crown on a tooth that is kept clean, checked regularly and protected from grinding has the best chance of a long life. At each checkup, Dr. Haywood looks closely at the edges of your existing dental work, so wear or small leaks can be fixed early, often with a simpler repair than waiting would require.
Restore your smile in Shrewsbury
Southern York Smile Care offers restorative dentistry, exams and cleanings, cosmetic dentistry, porcelain veneers, dental implants and sedation dentistry with oral sedation. The office is out of network with every insurer: you pay at your visit and the team files your claim for reimbursement, and CareCredit and Cherry payment plans are available.
To talk about a worn filling, a cracked tooth or a missing tooth, call (717) 235-3871 or request an appointment at 4 S. Main St in Shrewsbury.
DDS cum laude 1987, US Air Force residency, NYU cosmetic training and Fellow of the International Congress of Oral Implantologists, with 35+ years in practice.
Meet Dr. Haywood →
Crown or Veneer?
Coronation: Dental Crowns in Shrewsbury PA
Creating Lifelong Partnerships