Category Archives: CEREC

CEREC

Dental Crown Keeps Falling Off

I have a dental crown that has fallen off four times. It was this last time that the dentist mentioned that we’ll need to do a gingivectomy in order for there to be enough tooth to keep on the crown. Is this legitimate? I’m frustrated about this crown and don’t really want to mess up my gums in the process.

Evan

Dear Evan,

Porcelain crown being placed on a tooth

 

I’m not keen on your dentist. I’ll tell you right away that most dentists go their entire career without a dental crown falling off, but to have the same one fall off four times…

As to the gingivectomy, this is done by removing some of the gum tissue in order to expose more of the tooth structure. While this is sometimes needed, I’m curious as to why he would not have noticed the need for it before he did the first crown.  That he is just noticing this now tells me that he is either incompetent, or you don’t really need the procedure and he’s using that as an excuse to make you a new crown.

The first thing I recommend is that you ask for a refund for both yourself as well as the insurance company if any of it was billed to them. This should not be an issue because you don’t have a functioning dental crown. Keeping it in your mouth should be the minimum standard.

Then, I want you to get a second opinion about your dental crown from another dentist  Don’t tell them what your original dentist said. Let them give their unbiased diagnosis.

I think another dentist should be able to get this straightened out fairly easily.

This blog is brought to you by the gentle dentists of Lafayette, LA, Drs. Foreman and Thimmesch.
Click here to learn about one-visit crowns.

 

CEREC

Can the Hygienist Damage My CEREC Crown?

I am worried that my hygienist is going to damage my CEREC crowns. I went in to have my teeth cleaned. I have three CEREC crowns . I didn’t want her using a Cavitron on them.  She got angry and, though she didn’t use the Cavitron, when she scaled my crowns,  she was so rough that I was in a lot of pain and I was worried she was going to break them.  Are CERECs stronger than regular crowns? If not, how do you recommend I protect them?

Richard

Dear Richard,

Porcelain crown being placed on a tooth

 

Both CEREC crowns and traditional crowns are about the same strength. That isn’t the problem. My concern is twofold. The first is the attitude of your dental hygienist.

Hygienists often get special requests and there have been quite a bit lately about not using the Cavitron. Though there have been some instances of its use resulting in damage, in careful hands it is safe and does a great job. That is also beside the point.

A hygienist is there to perform a service and taking requests like this is part of that.  Whenever possible, it is best if the hygienists honor these. To act like you are an inconvenience is unacceptable. Yes, she had to work a little harder but it is part of her job.

My second concern is the roughness she went about doing the job. Doing the scaling the way she did could nick the margins of your dental work. It can even cause some problems to your natural teeth or gums.

I wouldn’t let a hygienist like that near my teeth. I would tell the clinic you are not okay working with that hygienist. Tell them why. If they’re not okay with you choosing to use a different one, I’d switch dentists. The health of your teeth and dental restorations should be prioritized, as well as your comfort in the dental chair.

This blog is brought to you by  compassionate dentists in Lafayette, Drs. Foreman and Thimmesch.

 

CEREC

Something Is Off About My Dental Crowns

I have had same=day crowns before with no problems. They always matched fine. However I recently had one placed on a front tooth and something is off about it. The color is the same… sort of. It looks a bit flat and weird though. I don’t know how to quite describe it and my dentist thinks they look fine. What do I do?

Amelia

Dear Amelia,

Block of porcelain for a CEREC crown

 

My guess is that your dentist is a fine general dentist but does not do a lot of cosmetic dental work. Using same-day crowns are fine on teeth that aren’t front teeth. However, they don’t work as well on front teeth unless your dentist is an expert in color theory.

The reason for it is because CEREC crowns are milled from a single block of porcelain. Traditional crowns, on the other hand, are milled from several different blocks of porcelain so that they can mimic the natural changes in opacity that your teeth have.

When you are not talking about a front tooth, that is not as urgent. However, your front teeth are directly exposed to light when you smile, so then the differences become quite clear.

The only way you are going to get this particular crown to look right is to replace it. You will need an expert cosmetic dentist to do this. You’ll want someone who is AACD accredited. They can either provide you with a traditional crown or give you a new CEREC crown if that is what you want.

Don’t be surprised if even with an expert cosmetic dentist it takes a few tries to get it right. Because of that, they will need to try the crown in with a temporary try-in paste and allow you to examine the match in several different types of lighting in order to make certain that you have a perfect match. If it is not, they can redo them. This is a common procedure with a crown on a front tooth.

This blog is brought to you by Lafayette, LA Dentists Drs. Forman and Thimesch.

CEREC

CEREC Crown Nightmare

I decided to go through a holistic dentist because I not only wanted to replace a metal based crown with an all porcelain one, but also replace a mercury-filled filling. I thought a holistic dentist would be the best one to do that. She suggested that we use a CEREC crown because I could get it the same day without needing a temporary crown. I will admit to being very excited about that idea. However, things did not turn out quite as planned. First, she casually mentioned that she thought my crown was too big. I should have been concerned about the comment because that crown had never bothered me. The second issue that should have warned me is that she bonded the dental crown in without even doing a try-in. I could tell right away that something was wrong. My dentist went ahead and and sanded it down some and sent me home. It just became harder to eat, so I went back. Then she checked some things and told me my bite on that side was hitting too hard, so she ground down a different molar that had never before bothered me. I could hardly chew after that, and my bite was all thrown off so much that my front teeth were banging into my other teeth. That had never happened before. I felt I was much worse off before having this crown replaced. When I called the dentist again, she said that she has done all that she could for me and maybe I need orthodontics. I didn’t need orthodontics before this! I went to get a second opinion and they said that my new crown was too small and high. My choices were to have this crown redone or to get orthodontics. Is this because she used the CEREC thing? Is there a way for me to get my money back?

Tim

Dear Tim,

CEREC Machine

The CEREC machine is not the problem, your dentist is. When used properly, the CEREC crown machine will actually provide you with a better fitting crown. It sounds like your dentist is not sure how to use the machine. Maybe she was new at it, but that is no excuse. She should have done a temporary try in. She should have kept working on it until it felt completely normal again.

She has violated the standard of care. You are definitely entitled to a refund, probably a little more than that given the suffering you’ve endured. You’ve probably missed some work too because of this. If she’s unwilling to refund your money, you have a very good case for a lawsuit. Let her know that. I wouldn’t just ask for a refund. I would ask for her to pay for the repairs by a dentist of your choosing. She did a significant amount of damage to your bite and it is going to require more than just replacing your crown to fix it. I want you to find a highly skilled dentist to fix this. In fact, look for a skilled cosmetic dentist.

By the way, you won’t need a holistic dentist to switch out your silver filling. You could get equally “holistic” care by going to a mercury-free dentist.

This blog is brought to you by Lafayette, LA Cosmetic Dentists Drs. Foreman and Thimmesch.

CEREC

Are Computerized Crowns as Safe as the Regular Ones?

I had a dental crown made by a computer in 2017. I think my dentist said it was a CEREC something or other. It had always bothered me. This year I went to a different dentist and they said that the crown wasn’t fit properly and would need to be redone. This dentist also wants to use the computer crowns. She also said that my old dentist removed the post by drilling and she should have vibrated it out with sonics. Here are my questions:

  1. Are the computer crowns as good as the old fashioned ones?
  2. Did my old dentist damage the bone by drilling out the post?

Aimee

Dear Aimee,

Block of porcelain for a CEREC crown

I’m going to start with your second question. It is always nice when you can get a post out by vibration, but that is not always possible. Drilling them out is also common and will not damage the bone. If you think about it, dentists are drilling on teeth all the time and they do no damage to the bone.

I am a bit curious about your dentist saying that the crown “wasn’t fit properly.” Did she give you any other specifics? Were their open margins?

Some dentists will accuse the previous dentist of doing shoddy work in order to get the patient to re-do the work and give them some business. I am not saying that your dentist did that, but I would recommend getting a second opinion before re-doing your crown.

As for CEREC crowns, they were developed several decades ago. In the early days after their development there were some issues of problems with the fit. However, those bugs have been worked out of the software and, if the dentist knows how to use the software, you will get a more accurate fit than you would with a traditional porcelain crown.

Start by getting that second opinion.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

CEREC

CEREC Crown on a Front Tooth

I needed a dental crown on a front tooth. My dentist recently got this new CEREC machine and told me that it would give me the crown in just one appointment. We were close to the holidays so I thought that would be a good idea. It was going okay until the next day. I was going to a friends house and the crown literally just fell off as I parked my car. I was absolutely frantic. My friend called her dentist who worked with CEREC crowns. He got me in right away and said that the crown wasn’t bonded on properly. Once it was bonded on, I noticed it is slightly longer than my other front tooth. The color is a bit off as well. I went in to see my dentist the following day and he told me he’d redo the whole thing free of charge. My question is should I trust him or should I just ask for a refund and get this done by someone else?

Patricia

Dear Patricia,

Block of porcelain for a CEREC crown

It would be hard to answer that question precisely because I don’t know anything about your dentist and his specific training. I can tell you the matching a crown on a front tooth is exceptionally difficult even for skilled cosmetic dentists, so I am not surprised it does not match correctly in just one go. Often, it takes several try ins and tweeks before a front tooth is the exact shade you need.

This is even harder with CEREC crowns because these are milled out of a single block of porcelain. A dentist will need advanced skills in working in stains.

Your dentist has offered to redo the crown. This tells me he is honest and cares more about getting it right than getting money. That is a good sign. Wanting to get it right is not always enough though. If you want to give him a second chance on this, I recommend that you tell him you only want h im to place it with a temporary try in paste so you can be sure you are pleased wtih the results before it is permanetely bonded again.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesh.

CEREC

Matching My CEREC Crown

I needed a dental crown and thought this would be a good chance to try my dentist’s new CEREC machine. I knew it would save me some time. At the appointment, we never really discussed the color. It felt fine and I assumed everything else would be as well. It was not until I got home that I saw the color discrepancy. Now, it is all I notice about my smile and I feel like the tooth looks fake. I don’t know what to do. I have tried using over the counter whitening products in order to get my other teeth as white as the CEREC crown, but thus far, no luck. Is it crazy to ask my dentist to darken it?

Sandra

Dear Sandra,

Block of porcelain for a CEREC crown

I do not think it is crazy at all to want your teeth to match one another. I can already tell you that your dentist has no real expertise in cosmetic dentistry. A true cosmetic dentist would have let you get a good look at the crown to make certain you approved of them before permanently bonding them on. It is possible that he noticed the color difference and didn’t want to have to redo them.

CEREC crowns are very convenient, but if you are having one placed on a front tooth, it will be important that the dentist have real cosmetic expertise. CERECs are milled from a single block of porcelain. This makes them look rather flat and bright. However, there are stains and tints a skilled cosmetic dentist can use in order to make them blend in well with the remainder of your teeth. Unfortunately, these have to be baked into the crowns before they are completed.

You have a couple of choices here. You can give your dentist another opportunity to get these right or you can ask for a refund and get this done properly elsewhere. Whichever you decide, make certain they let you see the crown with a temporary try-in paste first so you can get a good look at them in several lights and give your approval or disapproval to get it permanently bonded on.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

CEREC

Are CEREC Veneers Risky?

I plan on getting CEREC veneers, but I have not exactly used this dentist before. He told me that he generally makes porcelain veneers 1.55 mm. I have done some research and that seems a little thick to me. Should I reconsider? I understand that the dentist who does the veneers could affect the outcome so I’ll tell you ahead of time, his name is [ name withheld ].

Patricia,

Dear Patricia,

porcelain veneer being placed on a tooth

I am very glad you wrote. Instead of saying “the dentist could affect the outcome”, I would say the dentist determines the outcome. He or she would be the key to the outcome of your smile makeover.

Doing CEREC veneers is much harder than doing traditional porcelain veneers using a master ceramist. In that case, the skill and training of the dentist becomes even more important. I looked up the dentist you mentioned to me. I started by looking at his website and I saw nothing that indicated any cosmetic training. That was a red flag. But, I went ahead and did some extra work and looked up the institutions that do the type of training he would need. He is listed on none of their alumni lists. Because of that, I am going to recommend you go a different direction.

If you are set on CEREC veneers then I suggest you go to a practice that has an AACD accredited dentist on their staff. Nothing less than that would give you the outcome that I believe you want.

Let’s say you go to a dentist to get a smile makeover and he or she does a terrible job. You will have no recourse. The standard of care is that it the results of the procedure are functional, not attractive. This is not what you are going for when you want a smile makeover. Therefore, you as a patient, as to be proactive and find the dentist who will not only care that you have a beautiful smile, but has the training and skills to provide them for you.

This blog is brought to you by Lafayette, LA Dentists Drs. Forman and Thimmesch.

CEREC

CEREC Crowns on Front Teeth

I had an accident that damaged my front teeth. I am in a hurry to get this fixed and asked my dentist to do CEREC Crowns, but he said he does not do them on front teeth. Should I see a different dentist who does or just spend extra time getting the old fashioned crowns?

Dave

Dear Dave,

Unless your dentist is one of the top cosmetic dentists in the country, I would go with the traditional crowns. CEREC crowns are milled from a single block of porcelain, which will look very uniform or flat. Our natural teeth are varied. They’ll be more opaque in some parts and more translucent in others.

Unless your dentist understands advanced staining and color theory, the teeth will end up looking fake. In this case, it is better to invest the extra time and do the traditional crowns.

A ceramist building crowns with the traditional method can use different blocks of porcelain in order to mimic that natural variation found in your teeth. This will allow the crowns to look perfectly natural.

One other tip. While dental crowns can be made to match any color, once that color is set, it is permanent. If you plan on whitening your teeth, the time to do it is before your dental crowns are completed. This way they can be made to match your new permanent color. If you are in a hurry, Zoom whitening can do it in just one appointment.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.

CEREC

Problem with CEREC Crown

I went to my dentist because of pain with pressure and sensitivity to hot and cold. My dentist suggested a crown and we decided on a CEREC crown for the first time on a back tooth. I’d had other crowns before so I wasn’t new to the gig. I like how fast it went and having the crown that day. A few days later though, I still had the same problem. I went back to see the dentist and he checked to make sure it was on right. He felt it was and told me to give it eight weeks. That was discouraging because I was going on vacation, but what else could I do? I bought some pain meds and left town. I was in so much pain and practically lived on those pain meds. At about the eight-week mark, it did start to get better. That’s a lot of pain to go through with a crown. Normally, I have the pain go away with immediate relief. Is this a pattern with a CEREC crown?

Morgan

Dear Morgan,

Block of porcelain for a CEREC crown

I would like you to see a different dentist and have this looked at, including an x-ray. CEREC crowns are equally effective as traditional crowns. The biggest difference is the same-day service. When there is the type of pain you were having, just crowning the tooth will not necessarily solve the problem on its own. The fact that it was still hurting afterward bears this out in your case.

With it gradually getting better over that length of time, it sounds more to me like the pulp of your tooth was dying. I’d like to know if the original problem was some type of dental infection.

Usually, when there is a sensitive tooth that also needs a crown, the first thing to do is remove any old fillings or decay. Then place some glass isomer or bonded build-up material and give it a bit of time. This is to see if the tooth settles down. If it doesn’t and the pain persists, that is a signal the tooth needs a root canal treatment.

Have this looked at elsewhere so you don’t risk an infection flaring back up.

This blog is brought to you by Lafayette, LA Dentists Drs. Foreman and Thimmesch.