A great many people contemplating orthodontics are faced with the intriguing question of prior dental restorations such as crowns or bridges. Wanting a straighter smile, or even just a more aligned look, naturally comes with wondering if those previous dental procedures will make it harder to get braces or even stop one from doing so. Thankfully, in most cases, the presence of crowns or bridges does not void orthodontic treatment. Nonetheless, it requires a more specialized approach whereby the orthodontist and the general dental practitioner must work closely together. If you are looking for a straighter smile and have restorations, working with a professional in dentistry Vaughan can give you clarity for your situation.
Understanding the Basics: How Braces Function
Conventional braces exert continuous, gentle pressure on teeth for long periods of time to move them slowly but surely into their positions of comfort. This process is intrinsic to the capacity of the periodontal ligaments and the jawbone around the moving teeth to remodel themselves. Hence, with natural teeth, an orthodontist can fairly well predict how teeth will react to the forces of orthodontics. A predicament arises when a tooth is cushioned with a crown or is part of a fixed bridge because restoration aims to provide stability and may consequently not react to the forces in the same manner as natural tooth structure.
Braces on Dental Crowns
A dental crown is a cap that covers the entire visible portion of a tooth and, most commonly, is put on to restore a tooth that has been damaged or one that has suffered decay or weakening in some other way. With regard to orthodontic treatment, nevertheless, crowns on individual teeth are usually not a hindrance. In many instances, brackets can be bonded directly to the surface of porcelain or ceramic crowns, but do require special precautions and techniques to ensure secure bonding without damaging the crown surface.
One of the main concerns relates to the strength of the bond between the bracket and the crown material, which can prove to be more variable than bonding to natural enamel. Orthodontists will often use special bonding agents or even etching techniques intended to improve adhesion. In certain cases, if a crown is quite old or, more importantly, compromised, after orthodontic treatment your dentist might want to replace it to ensure the best long-term outcome of both the tooth itself and its new alignment. Through careful consideration and constant communication between both dental teams-the orthodontic and the restorative-it is possible to maintain the integrity of the crown throughout treatment.
Braces on Dental Bridges
Dental bridges replace one or more missing teeth by anchoring artificial teeth (pontics) to adjacent natural teeth or implants that are subsequently crowned. These create a fixed unit of connected teeth. The presence of a bridge introduces another dimension of complexity for orthodontic treatment when compared to separate crowns.
Since the teeth involved in the bridge are fused together and cannot be moved independently by braces, if the supporting teeth of the bridge require movement, the bridge will probably have to be removed or altered. In some cases, the orthodontist may consider moving the teeth on either side of the bridge or using specialized appliances to work around the fixed unit, whereas in other cases, if the bridge is situated in an area requiring little movement, it could be possible for the patient to proceed with braces while leaving the bridge intact. In any case, it depends heavily on the details of the specific tooth(s) to be aligned, on the location and dimension of the bridge, and on the overall oral health of the patient.
Need for a Thorough Assessment
A treatment plan should be in place following a thorough assessment aimed at before orthodontic treatment considering existing crowns and bridges. Comprehensive X-rays and imaging allow the evaluation of the existing bone structure along with root health condition and extant restorations, whereas clinical examinations concern the stability of crowns and the integrity of bridges, as well as oral health. And consultation with your general dentist will take place as well, with the orthodontist understanding exactly what the history of your restorations is, including types of material, for coordinated care. This kind of collaborative approach means everyone is looking at the whole health of your mouth to formulate a treatment plan that effectively aligns your teeth and protects the integrity of your existing dental work.
Suitable Braces Options
While the usual metal braces are always an available option, other types could be considered:
Ceramic Braces: These are similar to metal braces, except less obvious, and they can also be bonded to crowns with special techniques.
Lingual Braces: Placed on the inside surface of the teeth, these can be custom made and might be an option, but their application on crowns or bridges requires very specialized expertise.
Clear Aligners (Invisalign): These removable aligners might be an option for mild movement-your doctor will determine. These aligners produce pressure on the whole tooth surface, which sometimes can be gentler on restorations than bonded metal brackets. Attachments might still be bonded onto crowns, however, so these may require the same bonding techniques.
The choice of appliance used will largely depend on the complexity of your case, as well as the type of restorations present and the recommendations of your orthodontist.
Benefits and Potential Challenges
The benefits of well-aligned smiles are significant amendments to one’s aesthetics and oral hygiene abilities and, for those individuals with crowns or bridges, could really be life-changing.
The possible challenges, however, include:
Bonding Issues: Brackets will possibly not bond as well to certain crown materials.
Damage to Restorations: Though rare when using proper technique, there is some slight potential for damage to the crown or bridge during bracket placement or removal.
Treatment Time: It is also sometimes likely that cases involving restorations will require a slightly longer treatment time period.
Restoration Replacement: A crown or bridge might require replacement after orthodontic treatment in some cases to accommodate the perfect new alignment of the tooth.
Conclusion
The mere fact of slapping some crowns or bridges on your teeth is never going to disqualify you for orthodontic treatment. Today, given the much-improved materials and techniques used in orthodontics, a healthy, straight smile is achievable in most cases-an evaluation by an orthodontist along with a comprehensive treatment plan between their office and your general dentist. If you have initial restorations and are thinking about braces, it is strongly advised you set up a consultation with an accomplished orthodontist who can fully assess your particular situation and give you the best possible recommendation for treatment.
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