A crown caps a tooth that has lost too much structure to hold a filling. A bridge replaces a missing tooth by anchoring to the teeth on either side of the gap. Both restore full chewing force and are colour-matched to the teeth around them.

Dr. Wes Prepchuk has placed thousands of crowns over the past ten years and plans each case from digital imaging taken here at the clinic. All three dentists at Springbank Hill Dental provide crowns and bridges.

A crown is the treatment when there is not enough sound tooth left to hold a filling reliably. Filling a tooth that has lost too much structure sets you up for a fracture, and a fractured tooth often cannot be saved at all.

The usual reasons:

• Decay too extensive for a filling
• A cracked tooth, where a crown holds the tooth together rather than wedging the crack wider as a filling can
• A fractured or heavily worn tooth
• A tooth that has had root canal treatment, which becomes brittle and usually needs cuspal coverage
• The visible portion of a dental implant

Crowns are sometimes used for purely cosmetic reasons, on a discoloured or poorly shaped tooth. We will usually talk you out of it. A crown means reducing the whole tooth, and a veneer or bonding achieves the same appearance while removing far less. We reserve crowns for teeth that need the structural protection.

A bridge replaces one or more missing teeth using the teeth on either side as anchors. A conventional three-unit bridge is two crowns, one on each neighbouring tooth, joined by a false tooth that sits in the gap. It is cemented in place and you do not remove it.

How many teeth a bridge can span depends on the health and root surface of the anchor teeth, not on a fixed number. Longer spans put more load on fewer roots, which is why some gaps are better restored with implants.

If you are missing a tooth, this is the real decision, and it deserves a straight answer.

A bridge requires cutting down the two healthy teeth either side of the gap so they can carry crowns. If those teeth already have large fillings or crowns, that costs you nothing you had not already lost. If they are pristine, you are permanently reducing two intact teeth to replace one missing one.

A dental implant does not touch the neighbouring teeth. It replaces the missing root with a titanium post placed into the jawbone, which also preserves the bone underneath that otherwise resorbs after tooth loss. It costs more up front and takes longer, usually three to nine months.

Dr. Prepchuk places Straumann implants and restores them here, so he has no reason to steer you toward one option or the other. He will tell you which your case actually favours, and what each costs, before you decide.

Assessment and planning

An examination and X-rays confirm what the tooth needs and whether the anchor teeth can support a bridge. We discuss the material options and what each costs before anything is prepared.

Choosing the material

Zirconia is strong and tooth-coloured, and it is the usual choice for back teeth. All-porcelain gives the best appearance and suits front teeth. Porcelain-fused-to-metal is durable but can show a dark line at the gum over time. Full metal is the strongest and least aesthetic, and still has a place on molars in heavy bites. Dr. Prepchuk will recommend based on where the tooth sits and how hard you chew, not just on price.

Preparing the tooth

The tooth is frozen, decay is removed, and the tooth is reduced to make room for the crown. A digital scan or impression is taken and sent to the lab.

Your temporary

You leave with a temporary crown or bridge and wear it for roughly two to three weeks while the lab makes the permanent one. Temporaries are cemented lightly so they can be removed, so avoid chewing gum and sticky foods on that side. If one comes off, call us; it is a quick fix, but do not leave the prepared tooth uncovered.

Fitting and cementing

At the second appointment we try the restoration in, check the fit at the gum margin, the contacts with the adjacent teeth, and the shade. Once it is right it is cemented, excess cement is cleared from around the gum, and your bite is adjusted. A crown left even slightly high is the most common cause of soreness and early failure, which is why the bite check is not a formality.

Most crowns and bridges last 10 to 15 years, and many last considerably longer. What ends them is usually not the restoration itself but decay at the margin where it meets the tooth, so brushing and flossing around the edge matters more than anything else.

A bridge needs cleaning underneath the false tooth, using floss threaders or an interdental brush. Your hygienist will show you how at the fitting appointment. Bridges that fail early nearly always fail because that area was not cleaned.

Springbank Hill Dental follows the Alberta Dental Association Fee Guide, which publishes a standard price for every procedure in the province, so you can compare what we charge against any clinic in the city. Material choice affects the price and we will show you the difference before you decide.

Crowns and bridges are usually partly covered by insurance, often at 50 percent and subject to your annual maximum. We submit a predetermination before booking so you know your exact out-of-pocket cost. Payment plans are available for larger cases.

Book an assessment at Springbank Hill Dental by calling (403) 454-4757 or booking online. We are at 133-7460 Springbank Blvd SW, open from 7:00 am Wednesday through Saturday and until 8:30 pm on Wednesdays and Thursdays. New patients are welcome, no referral is needed, and parking is free.