If you’re an adult looking to get braces, chances are you’ve had some dental work done over the years. Aside from fillings, you may have a crown or more on your teeth, and you’re wondering if braces are still possible for you.
Having crowns or veneers on your teeth shouldn’t prevent you from getting braces or aligners. Braces stick to crowns easily thanks to a special bonding technique. While the risks of damaging your crown with braces are low, it may still need replacing if it no longer fits properly after treatment.
Crowns, veneers, and bridges are expensive prosthetic work, so I perfectly understand your concern, but there are a few things you should know. Learn about how teeth move with crowns, the risks involved, and what to plan for in this article.
Can you get braces if you have crowns?
Crowns are tooth-shaped caps placed on top of damaged teeth. They can be made of porcelain, porcelain fused to metal, zirconia, e.max, composite, and even old-school gold.
Reasons for getting crowns include: teeth that are too damaged from cavities and root canals, cracked or chipped teeth, and teeth with odd shapes and sizes.
If you already have a crown, you’re probably familiar with all this, so here’s what you need to know about how braces work:
Bonding braces on crowns
When we bond braces on natural teeth, we use a combination of an etching gel, a bonding agent, and a composite paste to make everything stick together. The etching gel creates temporary holes inside the enamel’s structure, allowing the bonding liquid to flow in and fill all those holes.
Bonding braces on porcelain crowns follows a similar process, but the materials are different. We need a certain type of etching gel to penetrate the strong layers of ceramics, a liquid called silane, a bonding liquid, and finally, the composite paste.
Before applying these materials to the crown, studies have shown it’s best to roughen the crown’s surface. Orthodontists often use a micro-etcher to do this. Roughening the crown’s surface gets rid of that glazed finish so that the bonding liquids can better penetrate the crown.
We can easily bond metal braces, ceramic braces, or attachments for aligners on crowns with positive, predictable results.
How teeth move with crowns
If your crown is placed on a natural tooth, know that braces will work on it almost as they would on a normal tooth. Braces will follow the same principle as moving a tooth that has a band on it.
This means that a crown can be moved up or down, left and right, and back and forth. While this is a good thing for aligning purposes, it also means that when changing positions, your crown may no longer fit the same.
Your crown, if moved, may not close the gingival margins properly, or it may interfere with your bite. This means you’ll be getting a new crown at the end of orthodontic treatment – an expense you should know about in advance.
However, if your crown is placed on an implant, it can’t be moved, since the implant itself is fused to the bone. But we can still use it as an ‘anchor’ for other orthodontic movements. But more on implants and braces in another article.
Removing braces from crowns
The bonding process I described above creates a very powerful adhesion between the crown and the bracket, strong enough to create damage when the bracket needs to be removed.
While there’s a small risk of your crown coming off or breaking, this rarely happens. We use a special bracket-removing plier and a torquing movement to quickly pop the bracket off with no issues.
Sometimes, there’s residual glue left on the crown that we need to clean using a fine bur. In the end, your crown should be good as new.
Keep in mind, though, that the roughening process may have left your crown with a matte surface that’s no longer glazed and shiny. Chairside polishing procedures can get rid of minor scratches and restore some shine, but if it’s a front tooth crown, you may notice a difference and want it replaced.
Depending on the situation, you may need a new crown after orthodontic treatment. Here’s a recap of all the things you need to consider before deciding braces are worth it for you:
The RISKS of applying braces on crowns
- The bracket may come off more often, as the bond isn’t as strong as on natural teeth;
- The crown may no longer fit properly (especially at gum level);
- The crown may come off during bracket debonding, or it could break, but the risks are low;
- The crown may lose its shine because of the bonding procedures and no longer be shiny.
Can you get braces if you have veneers?
Veneers are thin, tooth-colored porcelain or composite shells that are custom-made and placed over teeth to enhance their beauty or correct defects.
Veneers are often used instead of braces in cases of minor tooth imperfections to achieve an instant ideal smile.
If you have veneers, you probably know how delicate they are. Even though the bond between veneers and teeth is very strong, they’re still fragile, so you need to be more self-aware when you bite into hard food, brush, or floss.
While it’s possible to bond braces on top of veneers, as we described above, it’s not a good idea. Since veneers don’t surround the teeth 180°, pulling on them could cause them to come off. This means that orthodontic movements and forces applied during debonding could damage your veneer or debond it.
Roughening a veneer so a bracket can stick to it will cause it to lose its shine, which is another disadvantage of bonding traditional braces.
Because of all these issues, it’s best to get clear aligners instead of braces or refrain from veneers altogether until after orthodontic treatment.
Can you get braces if you have bridges?
If you’re dealing with missing teeth, you might have a bridge, also called a pontic. A bridge is a group of crowns that fill in the gap and restore the missing tooth’s function. The crown (or crowns) in the middle replace the missing tooth or teeth, while the marginal crowns sit on top of natural teeth or implant abutments.
Getting a bridge cemented on your teeth isn’t cheap or easy, so when we see patients with bridges we try to work around it as much as possible. While we can bond braces to bridges (just like we would on crowns), there’s no point in doing so.
Bridges don’t move, so during orthodontic treatment, we may only use them as an anchor. This is not to say you can’t get braces if you have bridges, you just have to understand that we are somewhat limited in what we can do in that area.
Your bridge will most likely be fine after braces, but if your case is more challenging and needs a massive change in your bite, that bridge may need to be replaced to fit the new bite situation.
Getting crowns, veneers, or bridges is a multi-step costly process at the dentist’s office. It’s perfectly understandable if you don’t want all that hard work to go to waste.
If you can wait, it would be better to postpone all major dental work until after orthodontic treatment. Some teeth may be damaged and still need crowns, in which case we’ll resort to temporary crowns.
If you already have a permanent crown or veneer in place, we’ll try our best to work with what we have, but in some situations, it’s best to replace that crown or veneer with a new one.
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