Dental Crown / Bridge

A dental crown is a cap placed over a damaged or weakened tooth to restore its shape, strength, and appearance, while a dental bridge uses two or more crowns on neighbouring teeth to fill the gap left by a missing tooth.

When a tooth is badly decayed, cracked, or missing, it can no longer do its job properly. A crown works by completely covering the visible part of the tooth, protecting what remains underneath. A bridge works in a similar way, but it also spans an empty space: the crowns on either side act as anchors, and an artificial tooth — called a pontic — hangs between them, restoring your ability to bite and chew and preventing neighbouring teeth from shifting out of place.

Crowns and bridges are recommended when a tooth is too damaged to be repaired with a simple filling, or when one or more teeth are missing and an implant or denture is not the right option. Your dentist will assess the health of the remaining teeth and gum before deciding which solution fits best.

• A tooth that has lost a large portion to decay and cannot hold a filling alone.
• A tooth that is cracked or fractured and at risk of splitting further.
• A tooth that has been weakened by a root canal treatment (removal of the nerve and inner tissue).
• A severely worn-down tooth caused by grinding or acid erosion.
• One or more missing teeth where the neighbouring teeth are healthy enough to serve as bridge anchors.
• A discoloured or misshapen tooth that affects both appearance and function.
• Protection of a baby tooth that is at high risk of decay in a young child, until the adult tooth grows in.

There are situations where a crown or bridge may not be the most suitable choice.

• The anchor teeth (abutment teeth) for a bridge are too weak, heavily decayed, or have insufficient bone support.
• Severe gum disease (periodontitis — infection and inflammation of the gums and bone around the teeth) has not been treated first.
• The gap to be filled is too wide, putting too much stress on the bridge.
• The patient has a strong teeth-grinding habit that has not been addressed, which could crack or dislodge the crown.
• Active infections or abscesses in the area that need to be resolved before any crown work begins.

Dental crowns and bridges are among the most routine procedures in dentistry and are generally well tolerated, but like any dental work they carry some recognised risks.

• Tooth sensitivity — the treated tooth or neighbouring teeth may feel sensitive to hot, cold, or sweet foods for a period after the crown is placed.
• Discomfort or soreness around the gums where the crown meets the gum line, especially in the first days after fitting.
• Poor fit or bite misalignment, which may need an adjustment appointment.
• Chipping or fracturing of the crown material, particularly with all-ceramic (porcelain) crowns if exposed to very hard foods.
• The crown or bridge coming loose or falling off, usually due to cement washing out over time.
• Decay developing underneath the crown if oral hygiene is not maintained, affecting the remaining natural tooth structure.
• Nerve damage in rare cases during tooth preparation, which might eventually require root canal treatment.
• Allergic reaction to the metal alloy used in some crown types — uncommon, but possible in people with known metal sensitivities.
• For bridges specifically: gradual bone loss (resorption) in the jaw beneath the artificial tooth, as there is no tooth root to stimulate the bone.

Crown and bridge procedures are usually done in the dental chair under local anaesthesia (numbing injection into the gum), so they do not require the same level of preparation as a procedure done under general anaesthesia. However, there are still some steps patients are asked to follow before and during the appointment.

Before the procedure, your dentist may ask you to:

• Inform the dental team of all medications you currently take, including blood thinners, diabetes medications, and any supplements, as some may affect bleeding or healing.
• Tell the dentist about any metal allergies, as this will influence the choice of crown material.
• Attend any pre-treatment appointments needed to address active gum disease, decay, or infection before the crown work starts.
• Avoid eating or drinking for a short time before the appointment if sedation (a relaxing medication) has been planned — your dentist will advise you specifically.
• Arrange transport home if sedation is used.

The dentist will usually take X-rays (dental radiographs) to assess the roots of the teeth and the surrounding bone before starting. Moulds or digital scans of your teeth are taken so the crown or bridge can be made to the exact shape needed.

The procedure itself typically unfolds in the following steps, though the exact number of appointments and steps may vary between clinics and individual cases:

• 1. The area is numbed with a local anaesthetic injection so you do not feel pain during the procedure.
• 2. The dentist reshapes (prepares) the tooth by filing it down to create a firm base for the crown to sit on. For a bridge, two or more neighbouring teeth are prepared as anchors.
• 3. An impression (mould) or digital scan of the prepared tooth and the surrounding teeth is taken to send to a dental laboratory.
• 4. A temporary crown or bridge made of plastic or resin is placed over the prepared tooth to protect it while the permanent one is being made — this usually takes one to two weeks.
• 5. At a second appointment, the temporary crown is removed and the permanent crown or bridge is checked for fit and colour.
• 6. If the fit is satisfactory, the permanent crown or bridge is cemented into place using dental cement.
• 7. The bite is checked and minor adjustments are made if needed before you leave.

Most patients leave the dental clinic on the same day and can return to normal daily activities fairly quickly. Some soreness and sensitivity are expected in the first few days, but these usually ease on their own. How well the crown or bridge holds up over the years depends largely on daily care at home and regular dental check-ups.

• Avoid chewing very hard, sticky, or crunchy foods on the newly crowned tooth for at least the first 24 hours after cementation, and be cautious with these foods long-term to avoid chipping the crown.
• If a temporary crown is in place, be especially careful — temporaries are not as strong and can come off if you eat sticky foods like caramel or hard foods like nuts.
• Brush twice a day as normal, but use gentle strokes around the crown margin (the edge where crown meets gum).
• Use dental floss daily; for a bridge, a floss threader or interdental brush (a small brush that fits between teeth) is used to clean under the artificial tooth, as you cannot floss between the anchor teeth in the usual way.
• Contact your dentist if the crown or bridge feels loose, if your bite feels off, if you notice sensitivity that does not improve after a few weeks, or if the gum around the crown becomes swollen or bleeds persistently.
• Attend regular dental check-ups as advised — your dentist will check the crown margins, the health of the gum around it, and the underlying tooth at these visits.
• If you grind your teeth at night, your dentist may recommend a night guard (a protective plate worn over the teeth during sleep) to protect the crown.
• With proper care, a well-fitted crown or bridge can last for many years, though its lifespan varies depending on the material used, the position of the tooth, and how well it is maintained.