Crowns, Caps, and Fixed Bridges

The following information has been designed to help you properly care for your teeth and mouth following crown and/or bridge treatment.

Cementation Visit
FEELING: If anesthesia was used during the cementation, this numbness will begin to wear off in 30 minutes to 2 hours. Until that time, avoid all hot foods or liquids, and do not chew. "This is to prevent accidentally burning or biting the lips, cheeks, or tongue until the feeling has returned.

SENSATIONS: It is common to experience sensitivity to hot, cold, or chewing pressure for a period of time after cementation. This is due to the inflammation created in the pulp of the tooth from the extensive treatment. This will normally disappear within 6 to 8 weeks following Final cementation.

MEDICATIONS: The sensitivity and mild discomfort that is common after crown and bridge treatment is usually easily controlled by the use of over-the-counter pain medications. Anti-inflammatory medications, such as aspirin and ibuprofen, are excellent for reducing post-treatment soreness and sensitivity. A desensitizing toothpaste, such as Denquel, Sensodyne, Thermodent, etc. , may be helpful in reducing the sensitivity around the edge of the crown. If the need for a stronger pain medication or more potent anti-inflammatory therapy is anticipated, prescriptions for these medications will be provided.

RINSES: The gums may be tender and inflamed from having had the temporary crown in place for the previous 2 to 3 weeks. Warm salt water rinses (1/2 to I tsp. salt in 8 oz. glass warm water) can be swished vigorously every 10 to 20 minutes for the first 2 to 6 hours. (Do not use if you are on a salt-restricted diet. )

DIET: Avoid extremely hard foods in the area of the permanent crown. There are certain foods and habits that should be avoided, such as: ice, popcorn, chewing gum, hard candy, mints, lozenges, nuts, peanut brittle, and biting on pens, pencils, and fingernails. Failure to follow these guidelines may result in fracture, dislodgement, or loss of the permanent crown. In addition, a regular diet of highly acidic foods, such as lemons, limes, oranges, etc. , should be avoided. Frequent exposure of the dental porcelain to high acidity can cause a decrease in the luster of the restoration.

ORAL HYGIENE: Crowns and bridges do not render the teeth resistant to decay. Decay at the junction of the restoration and the tooth can eventually cause loss of the tooth. Therefore, good brushing and flossing, in combination with a neutral fluoride solution, will greatly extend the lifespan of your crown and/or bridge. Bridges must be flossed using a floss threader and/or an interproximal brush. This is the only way to adequately clean under the bridge.

QUESTIONS / COMPLICATIONS: The following are complications commonly seen following crown and bridge treatments:

• Sensitivity to temperature or pressure for an extended period of time may be an aggravating problem following such extensive treatment. This sensitivity will normally diminish over a period of a few weeks, but in some cases may linger for months. If the sensitivity increases or if spontaneous pain occurs, this may indicate irreversible pulpal damage in the tooth. Additional treatment, possibly involving root canal therapy may be required to eliminate the problem.
• Discoloration of the gum area around the crown may become evident after a period of time. This is sometimes due to a sensitivity or tissue reaction to the metal substructure of the permanent crown. Unfortunately, this discoloration is usually permanent. In some cases, replacement of the crown with a metal-free restoration in combination with various forms of special gum treatment can lessen the severity of the discoloration.
• Dislodgement or loosening of the crown or bridge may occur after a period of time. Sticky foods, such as taffy, caramel, etc. , can cause loosening of the restoration. If any looseness or mobility is ever detected, it is very important that you call the office immediately for an evaluation. In most cases, the crown or bridge can simply be cemented.