Dental crowns and bridges in Skopje

What dental crowns and bridges can do

Dental crowns and bridges are custom-made and fixed: your dentist cements them in place and, unlike a denture, you do not take them out. If you are considering dental crowns in Skopje, here is what to expect.

A crown is a tooth-shaped cap that covers the whole visible part of a tooth. It restores a damaged tooth’s shape, strength and appearance.

A dental bridge replaces one or more missing teeth, most often one to three in a row. A conventional bridge consists of crowns on the teeth either side of the gap, which act as anchors, with a false tooth joined between them.

A bridge makes chewing and speaking easier, helps maintain your bite and stops neighbouring teeth drifting into the gap.

Types of bridge

• Conventional bridge: supported by the teeth on both sides of the gap, which must be reshaped.
• Cantilever bridge: supported on one side only, and not as strong.
• Resin-bonded (Maryland) bridge: thin ‘wings’ are bonded to the back of the neighbouring teeth, with very little drilling.
• Implant-supported bridge: usually considered when three or more teeth are missing.

Materials: porcelain bonded to metal, zirconia and ceramic

• Porcelain bonded to metal (metal-ceramic): a metal base covered with tooth-coloured porcelain. The porcelain can chip, and metal can sometimes show at the edge.
• All-ceramic (zirconia, lithium disilicate): often called ‘zirconia crowns’ or ‘porcelain crowns’. An option if you are allergic to metal.
• Metal (gold or other alloys): rarely chips and needs the least reshaping, but its colour usually limits it to back teeth.

Do you need a crown or a bridge?

A crown or bridge is usually considered when:

• a large filling or decay leaves too little healthy tooth for a new filling
• a tooth is broken, cracked or badly worn
• a tooth that has had root canal treatment is weakened by a large filling
• a front tooth is badly discoloured or misshapen
• one to three teeth in a row are missing, and the neighbouring teeth, gums and bone are healthy

When it may be better to wait or choose something else

• Gum disease, frequent decay or difficulty keeping your teeth clean: these are brought under control first.
• Clenching or grinding: this raises the risk of breakage, so a stronger material or a night guard may be recommended.
• A mostly healthy tooth: a crown means permanently removing some healthy tooth. A filling, an onlay (a partial crown) or a resin-bonded bridge may be a better choice.
• Weak neighbouring teeth: a conventional bridge needs strong anchor teeth.
• Young patients: a crown or bridge is not always suitable.
• Recent extractions: the gum and bone need to heal before a bridge is made, usually a few months, sometimes around six. A temporary replacement can be worn until then.

Smoking shortens the life of crowns and bridges. Please tell us if you smoke, have diabetes or are pregnant, and which medicines you take.

Getting a crown or bridge, step by step

A conventional crown or bridge usually takes two visits, about two to four weeks apart.

1. Examination and plan. The tooth is examined and X-rayed if needed. Any decay, gum disease or root canal problems are treated first. You then receive a written plan.
2. Preparation (first visit). Under local anaesthetic, the tooth is reshaped to make room for the crown; for a bridge, the anchor teeth are reshaped. A badly damaged tooth is built up first, and a root-filled tooth sometimes also needs a post in the root. An impression (mould) is taken, the shade is chosen and a temporary crown or bridge is fitted.
3. Made in the laboratory. A crown is usually ready in two to three weeks and a bridge in two to four, sometimes longer.
4. Fitting (second visit). The fit, bite, shape and colour are checked before the crown or bridge is cemented in place.

Any root canal or gum treatment needed first adds time. For an implant-supported bridge, the implant first has to heal into the bone, which typically takes three to six months.

Does it hurt? Anaesthesia and comfort

Before reshaping begins, the tooth and the gum around it are numbed with a local anaesthetic. If you feel any pain, tell us: more anaesthetic can be given.

Afterwards, the tooth may be sensitive to hot and cold for around two weeks, and the gum sore for a few days. Over-the-counter painkillers such as paracetamol or ibuprofen are usually enough, if you can take them.

If you feel anxious about dental visits, tell us when you book. We will explain each step before it happens. See also: Your first visit.

Recovery and caring for your crown or bridge

Most people return to their normal routine straight away. The teeth and gums around a bridge usually settle within one to two weeks, sometimes longer.

• With a temporary crown, avoid sticky and very hard foods.
• Brush twice a day for two minutes with fluoride toothpaste.
• Clean between your teeth daily, and under the false tooth of a bridge with a floss threader or interdental brushes.
• Have sugary foods less often: decay can start at the edge of a crown.
• Avoid biting on ice, hard nuts, pens or your nails.
• If you clench or grind, ask about a custom-made night guard.
• Keep up regular check-ups and scale and polish (teeth cleaning) appointments.

Call us if your crown or bridge feels loose, comes off, cracks or has a sharp edge, or if it hurts when you chew. More advice: How to brush and clean between your teeth properly.

Risks, limitations and alternatives

• Reshaping cannot be undone: the part of the tooth that is removed does not grow back.
• Nerve problems: a small proportion of teeth under crowns or bridges later need root canal treatment, sometimes years later and often through the crown itself.
• Decay at the edge: the tooth under a crown can still decay if plaque builds up.
• Chipping and loosening: ceramic can chip, and a crown or bridge can come loose.
• Gum recession: thin gums can recede over time and show the edge of the crown.
• Anchor teeth: weak anchor teeth can fracture, and a bridge removed to treat a tooth underneath can be damaged.

Alternatives for a damaged tooth

If the damage is limited, a white (composite) filling or an onlay may be enough. For cosmetic changes to front teeth, veneers are another option. To compare them, read Veneers vs composite bonding vs crowns: how to choose.

Alternatives for a missing tooth

You can also leave the gap, after talking through what that means: neighbouring teeth may drift and your bite may change.

What affects the cost of dental crowns and bridges

The cost of a dental crown or bridge depends on:

• the type of restoration and, for a bridge, the number of teeth
• the material: porcelain bonded to metal, all-ceramic or metal
• treatment needed first: fillings, a core build-up, a post, root canal or gum treatment, extractions
• the laboratory work, and possible repairs or replacement over the years

After your examination and before treatment, you receive a written plan with a cost estimate. More on how pricing works: Prices.

Dental crowns in Skopje: why Dr. Milanovski?

‘Save the tooth’ is the practice’s motto: keeping your natural teeth comes first. So before suggesting a crown, we check whether a filling would be enough, and before an extraction, whether the tooth can be saved.

On its Instagram profile, the practice shows root-filled teeth restored with a titanium post and a metal-ceramic crown. More on this approach: when root canal treatment is better than extraction.

Dr Kiril Milanovski talks you through your options before you decide. He is a dentist under contract with the Health Insurance Fund (FZO), so if you are insured with the Fund, you can register with him as your chosen dentist (izbran stomatolog).

Crowns and bridges: frequently asked questions

Do you have a broken tooth or a gap where a tooth used to be? Book an appointment and we will look at your options together.