Category Archives: CEREC

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.

CEREC

CEREC Crown is Too Bulky

I had a dental crown break after three years. I needed to replace it but have been quite busy lately. Because of that, I went to a different dentist who advertised same day crowns using a CEREC machine. However, the tooth with the CEREC crown is way too bulky. It’s uncomfortable, doesn’t line up with my other teeth, and I find myself biting my tongue unintentionally because the crown is “in the way”. The dentist has tried filing it a couple of times, but it hasn’t really improved much. Where do I go from here?

Madeline

Dear Madeline,

porcelain block for CEREC crown
CEREC restoration

This must be so frustrating for you. Here you were trying to save time and it has ended up even more of a hassle. I have two concerns here, beginning with your original crown. It should not have broken after a few years. These are designed to protect the tooth underneath and keep them from breaking. As a result, they should last you many years. Your dentist should have recognized that and offered to replace it. Hopefully, it was a matter of flawed material, which can happen to the best of dentists, and not that he was incompetent in how he placed it.

As for the CEREC crown, it sounds to me like your dentist is new with this software. Usually, the dentist would take images of your tooth that needs to be crowned and the CEREC software would build-up an excellently fitted tooth from there. However, you didn’t have the original tooth because your need was to replace a damaged crown.

There are ways to build up a tooth from scratch that will fit perfectly using the software, but it seems to have been beyond the scope of your dentist’s knowledge.

This crown does need to be replaced. The issues you listed can lead to serous problems, including tumors on your gum where you keep biting it, gum disease from a crown iritating the area, and even TMJ Disorder from your bit getting thrown off.

Have your dentist replace this crown at his or her expense. However, I don’t think they are going to be able to get the results you want with her understanding of the software. I think you are going to have to go the “traditional” route and have this porcelain crown made in a dental laboratory.

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

CEREC

CEREC Crown Disaster

I’d been hearing how wonderful CEREC crowns were. You could get them done in one appointment and they’d fit perfectly, designed to your tooth. I have experienced something quite different.

First, she said my tooth was in such bad shape that she had to take a generic image off the database. Then, it didn’t fit . She spent three hours grinding down on the sides and top of the crown so much that the top of the crown is flat and shorter than the rest of the teeth. Additionally, the gums are super sore where the crown is. It’s been over a week.

Is this normal?

Katelyn

Dear Katelyn,

porcelain block for CEREC crown

No , this is not normal. I’m a bit thrown off by her saying she had to get a generic image from the database because your tooth was in bad shape. Of course it was in bad shape. That’s why you needed a crown.

The CEREC Crown software is designed to build up a tooth. Your dentist starts by telling it which tooth needs to be crowned. In turn, it builds up what that tooth should look like. Then, your dentist adds the information for the remainder of your bite and the software designs the perfect dimensions.

It sounds to me that one of two things is going on: either your dentist didn’t know what she was doing with the software or there is information she didn’t pass on about your case, such your gums bleeding so much she wasn’t able to get a clear image.

Either way, her decisions after that give me some doubts about her skill with dental crowns as a whole. I’m going to suggest you get a second opinion from another dentist. If it is as bad I think, it will need replacing. In that case, don’t ask for a refund. Instead, have your current dentist pay for the repairs. It will likely cost more to get it re-done than you were originally charged.

Tips for Getting a Second Opinion

When you go to get your second opinion, don’t tell them who the original dentist is. The dental world is a small one. Often dentists are friends with one another. He or she may have a bit of difficulty saying something negative about a friend’s work.

Instead, just tell him you want his opinion, without any previous information, as to what he thinks about the CEREC crown.

Thinking Ahead

Normally, your dentist would have already relayed the information I’m about to give you, but I don’t have the highest confidence in your dentist at the moment.

You didn’t say where they CEREC crown was being placed. If it is in a place that is visible when you smile, you will want to make sure your teeth are the color you want in the long term.

While the CEREC crown can be made any color you want, the color will be permanent. If you’re not completely happy with the color of your teeth, you may want to get your teeth whitened before the crown is made. This way you will be sure to have the color you want for the long term.

Otherwise, if you don’t and decide later to whiten, the crown will have to be replaced again in order to get it to match the new color.

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

CEREC

Is a CEREC Crown falling Off an Essential treatment?

I had a CEREC crown placed right before the lockdown for COVID-19.. Today, it just fell out. Our governor said you can only go to the dentist for essential treatment. How do I know if this is essential? Do I go in or wait until the quarantine is over?

Mark

Dear Mark,

porcelain block for CEREC crown
Block of porcelain for a CEREC crown

In most cases, because of COVID-19 and how easily it transmits, the CDC and Governors of many states are asking us to forego routine treatments until we have a handle on the virus. That would mostly include things like cleanings, checkups, and elective cosmetic procedures such as teeth whitening and smile makeovers.

Essential appointments are things like emergency dental care, such as you’d have with a tooth infection or other types of repairs. Your case is one of those. If a dental crown falls off, which by itself should be unusal, it is important it gets re-bonded.

If you wait until the quarantine is over, the adjacent teeth will begin to shift into the space left open. This will mean by the time you are able to contact the dentist for the re-bonding, your CEREC crown will no longer fit and you’ll have to get an entirely new one.

Don’t wait. Call your dentist.

One other thing, as I said earlier, it is highly unusual for a dental crown to fall out, especially a CEREC crown. They are milled by a computer so they are usually a tighter, more accurate fit. If your dentist rebonds this and it falls out again, I’d recommend you see a different dentist.

This blog is brought to you by Lafayette Dentist Dr. Mike Malone.

CEREC

cerec crowns on front teeth

I was in a car accident and damaged both my front teeth. I need to get crowns on them. I am trying to decide between regular crowns and CEREC crowns. Is one better than the other?

Benjamin

Dear Benjamin,

porcelain block for CEREC crown

CEREC crowns are made out of single block of porcelain. This will give it a very uniform look. This works fine on most teeth. However, our front teeth are much more visible and exposed to light.

Natural teeth aren’t uniform. Look at this image of a tooth directly below. There are varying levels of translucency and opaqueness depending on where you are on the tooth.

image of a tooth

When a dentist does a traditional crown, it is built in layers with varying shades of porcelain. This can make a crown look more natural. However, even then, you’d need an expert cosmetic dentist because this takes a high level of skill.

If you really want a CEREC crown, then having an expert cosmetic dentist is even more important. They need to have a high level of skill in color theory so they can use various stains to give it that variated look while keeping that natural translucency.

Cosmetic Considerations with Dental Crowns

The dental crown can be made to match your teeth exactly. However, the color is permanent. If you are happy with the color of your teeth, then you do not need to take any further steps. However, if you want your teeth any whiter, the time to take care of that is before having the crowns designed.

In that case, your first step is to have your teeth whitened. You can do that in one appointment if you see a dentist who does Zoom Whitening.

Then, give it a couple of weeks for the color to calm down. That’s when your dentist can match the permanent color for you.

When you’re talking about front teeth, whether you get a traditional or CEREC crown, you will need a dentist capable of the skills required. I suggest you see an AACD accredited dentist.

This blog is brought to you by Louisiana Cosmetic Dentist Dr. Mike Malone.