FAMILY MEDICINE® COLUMN

By John C. Wolf, D.O.Associate Professor of Family Medicine Ohio University College of Osteopathic Medicine

HOW TEETH ARE CAPPED AND THE MYSTERIES OF ASPIRIN EXPLAINED

[Editor's Note: I'M ANSWERING TWO QUESTIONS IN THIS WEEK'S COLUMN RATHER THAN THE USUAL ONE. THEY HAVE NO CONNECTION OTHER THAN THEIR ANSWERS ARE RELATIVELY SHORT. -- JCW]

Question: When and how are teeth capped?

Answer: A cap, what your dentist probably calls a crown, is a metal (typically gold), porcelain or plastic covering of a tooth. This cap is fitted to hold together a tooth that has been damaged, or to help hold another dental appliance, or for cosmetic purposes. The most common reason for a cap, however, is to restore a damaged tooth to useful service.

A tooth can be damaged sufficiently to require a crown in several ways. It might be broken or chipped, damaged by a single, very large cavity or multiple smaller ones, or weakened by disease. While there are other possibilities, these are the most common. The cap or crown restores the tooth to a near normal shape and size that is also strong enough for the biting and grinding tasks of eating. 

In order to prepare a tooth for a crown, the dentist first grinds down the sides and top of the existing tooth. This does several important things. It removes decayed or weakened parts of the tooth and reduces its size so that the crown, when placed over the tooth, will have the same external dimensions as the original tooth. The preparation also roughens the tooth, thereby making a better surface for the cement to bond the crown and tooth together. 

The process of getting a crown requires at least two visits to the dentist. In the first visit the damaged tooth is prepared for the crown, then a mold is made of that part of the mouth. A temporary cap is fitted to the prepared tooth. Between the first and second visit to the dentist, a permanent crown is made utilizing the mold of the mouth. At the second visit the temporary crown is removed and the permanent one is installed. 

A crown is a permanent dental fixture, although it can occasionally come lose or wear out. I still have mine from the repair of the front tooth I broke in third grade -- almost 50 years ago. That is close to "permanent." 

Question: How does the aspirin I take know to go to my head when I have a headache? 

Answer: Aspirin makes your headache better, and because it causes no other symptoms, you assumed that it "went to your head." Actually, all medicines are absorbed from the digestive tract and carried by the blood to other areas of the body. As an example, the antibiotic you take for a urinary tract infection will clear up that problem, but it also goes to your sinuses and will help your body eradicate any infection there as well. In a few days both infections will be better. 

Aspirin is certainly a "wonder drug," but it isn't an intelligent one. It doesn't know to go to your headache. Instead, it goes to all parts of your body. The good news is that your headache gets better regardless of how it happens.

"Family Medicine" is a weekly column.

To submit questions, write to: John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.

Past columns are available online at http://www.FamilyMedicineNews.org.