Dental Crowns: Preserve Your Tooth Structure!

A dental crown consists of a thin, tooth-shaped cap which is fitted over your tooth, replacing its chewing surface. Crowns can be made of several materials, but most commonly at the West Hartford and New Britain dental office of Dr. Elzbieta W. Basil, DMD, I use porcelain, which gives a beautiful, natural result. The purpose of a dental crown is to cover and protect a tooth which has been damaged, or sometimes to act as anchors for a dental bridge. Your tooth is trimmed down to make room for the crown; images are taken of the remaining tooth structure; and a crown is created to fit perfectly over the tooth.

Some of the reasons we use Dental Crowns

• Binding up Cracks: Preserving as much as possible of your natural tooth structure is one way to ensure the ongoing health of your mouth. Sometimes, when a tooth is severely cracked or split, a cap can be used to hold it together and keep the break from growing larger. This will help reduce the pain of a cracked tooth and relieve the pressure on it, while allowing the tooth to stay in your mouth rather than extracting and replacing it.

• Finishing a Root Canal: After root canal therapy or cleaning a large cavity, the tooth can be left open and vulnerable to further infection. To protect the tooth and restore its function, the opening is filled and a dental crown is applied to keep it securely covered. This has the added benefit of strengthening the newly weakened tooth, so you can use it without fear of further damage.

• Bridging a Gap: If you are missing one or more teeth, a bridge or partial denture may be used to replace them. In many cases, this bridge is fixed to healthy teeth, known as abutment teeth, on either side of the gap. Crown-supported bridges allow for a natural look and a sturdy feel, without the need for invasive surgery like dental implants would require.

• To give you a Perfect Smile: In some cases, dental crowns may be applied for cosmetic reasons, when a tooth is chipped or has an undesirable shape. Crowns are one of several possible choices in these cases, and we would be happy to discuss your options with you during a consultation.

My Dental Crown Philosophy: Preserve Tooth Structure 

When I was in dental school my least favorite instructor thought I was “timid” about prepping teeth for crowns. One day he took me aside and prepped a tooth for me. He had a heavy hand and he over prepped teeth when he crowned them, but his preps had no undercuts and his crowns tended to fit beautifully.

Nevertheless, I have always believed that while creating beautiful crown preps was desirable, it could be done while preserving tooth structure—which is even more important when considering the longtime viability of my crown and bridge restorations. Leaving sound and strong tooth structure correlated with my ability to provide my patients with long lasting restorations that helped preserve the teeth that supported them. This is especially true for restorations on premolars and anterior teeth, since they are more narrow in comparison to molar teeth.

Fast forward to the present day and now I strive to preserve tooth structure when at all possible. With over 25 years of dental experience in the USA and Poland, I have had the opportunity to fabricate thousands of crowns and have monitored their success and longevity. Most of my crowns from 20 years ago are still going strong.

While nothing lasts forever (and the patient plays a big role in crown longevity), all things being equal, the teeth that I prepped "conservatively" ended up being stronger over time and were less prone to fracture. If a tooth preparation has a small undercut I will not prep it out, but instead try to fix the preparation with bonding or miracle mix so that I will not remove any extra tooth structure. After all tooth preservation is my primary directive since my patients will want to keep their teeth for their entire lives . Furthermore, even my best restorations probably will eventually need to be replaced. When that time comes, if my preps were conservatively performed, and the teeth restored with well fitting crowns, it makes it more likely that the dentist following me will have an easier time fixing these teeth afterwards.

To find out more from Dr. Basil, you can click here to make an appointment at our West Hartford Center dental office, or our Downtown New Britain dental office, or call us at 860-561-2121 to schedule a free consultation.

Keep smiling,  

Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121

New Research: How Gum Disease Can Lead To Cancer

I’ve written before about the link of oral health and systemic diseases. But, is oral health even more important than we thought? New research from Finland has pointed to a strong link between gum disease and the development of some cancers. And even worse, it has been linked to the risk of cancer-related death.

Periodontitis, or gum disease, is characterized by the inflammation of the tissue surrounding the base of the teeth, or the gums. As the disease advances, periodontitis can lead to the deterioration of the gums and even begin to attack the bone that holds teeth in place.

According to the Center for Disease Control and Prevention (CDC), 47.2 percent of adults who are over 30 years of age in the United States have some type of periodontitis. With age, this rate increases, so that 70.1 percent of U.S. adults over 65 years old have this disease.

As if living with the symptoms of periodontitis wasn't difficult enough, researchers from the University of Helsinki and Helsinki University Hospital, both in Finland, in collaboration with colleagues from the Karolinska Institutet in Sweden, have shown that the bacteria to blame for this disease might also be able to cause certain types of cancer — specifically pancreatic cancer.

In November 2017, Timo Sorsa — at the University of Helsinki — and team published a study in the British Journal of Cancer showing that Treponema denticola, which is the bacterium that causes periodontitis, may also be responsible for the development of some types of cancer.

They noted that Treponema denticola and some gastrointestinal cancers, such as pancreatic cancer, share an enzyme: Treponema denticola chymotrypsin-like proteinase (Td-CTLP). This enzyme, which was identified in certain cancerous tumors, is typically found in the mouth and acts as the main "boosting" agent in the development of gum disease.

Next, the researchers investigated what biological mechanisms were involved that might explain the link between the bacteria responsible for periodontitis and the development of cancer tumors elsewhere in the body. They found that Td-CTLP can activate other enzymes — pro-MMP-8 and pro-MMP-9 — that cancer cells use as a vehicle to invade previously healthy cells.

"In addition," the authors write, "our in vitro experiments provide evidence that Td-CTLP shows immunomodulatory activity that can have a crucial role in promoting and regulating carcinogenesis." Translation: The same enzyme that is responsible for gum disease is also a central player in the development of cancer.

Additionally, Sorsa and another team of researchers conducted a related study, this time investigating the link between the incidence of gum disease and the rates of cancer-related death. The new research — published last week in the International Journal of Cancer — discovered a positive association between the two.

For the purpose of this study, Sorsa and colleagues analyzed data sourced from 68,273 adults over a period of 10 years. What they found was a strong association between a gum disease diagnosis and death caused by pancreatic cancer.

Looking at the two studies, the team concludes that the inflammation characteristic of gum disease may make it easier for harmful bacteria to travel to other parts of the body, allowing their virulence factors — such as CTLP — to act as a "booster" for cancer cells.

"These studies have demonstrated for the first time that the virulence factors of the central pathogenic bacteria underlying gum disease are able to spread from the mouth to other parts of the body, most likely in conjunction with the bacteria, and take part in central mechanisms of tissue destruction related to cancer." Timo Sorsa

For these reasons, we encourage people to pay more attention to their oral health, since prevention of oral diseases may also mean prevention of more serious health outcomes such as cancer.

In the long run, not only is your oral health beneficial to your speaking, eating, and appearance, it is an extremely cost-effective way to prevent catastrophic disease.

To find out more from Dr. Basil, you can click here to make an appointment at our West Hartford Center dental office, or our Downtown New Britain dental office, or call us at 860-561-2121 to schedule a free consultation.

Keep smiling,  

Dr.Elzbieta W. Basil, DMD is a private practice dentist with offices in West Hartford Center and Downtown New Britain, Connecticut.  She is a Clinical Instructor at the UConn School of Dental Medicine, and has won several awards naming her regional “Best Dentist” and “Top Dentist.” She is an active member of the Connecticut State Dental Association and the American Dental Association. Tel: 860-561-2121