Category Archives: 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 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.

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 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.

should I have gotten a cerec crown?

I had a crown placed which led to pretty severe gum inflammation. My dentist couldn’t figure out why so he sent me to a periodontist. She couldn’t figure out what the cause was either. Off I go to a prosthodontist. This doctor thinks it is because the dentist placed the crown too deep. He also said if I don’t have it treated I will develop gum disease. But, he said the surgery will likely lead to cosmetic damage to the gum area. I feel stuck. I don’t want gum disease, but I don’t want a cosmetic issue either. What do I do? Would this have happened if I’d gotten a CEREC crown instead?

Mary

Dear Mary,

CEREC Crown being placed on a tooth
Sometimes a dentist gets in over their head

It’s a shame this happened to you. I think your dentist should help cover this as his actions led to the problem. One thing that worries me is the prosthodontist acting like if you treat your gum disease, you’ll end up a cosmetic freak.

The truth is, whatever damage was done to your gums cosmetically speaking, is already done. Now your choices are repair this to help you prevent gum disease or leave it and end up with gum disease. It’s pretty much a no-brainer, but they didn’t put it to you that way..

Maybe they said it that way so you wouldn’t think they botched something after the procedure.

In the meantime, I’m going to suggest you rinse with an antibacterial rinse, like Peridex. This will help you with the gum inflammation.

CEREC Crowns Versus Traditional

You asked if this would have happened if you’d had a CEREC crown instead of a traditional crown. In reality, while CEREC crowns are milled by computer, which does make the fit as accurate as possible, the placement of the crown is still done by the dentist. If he placed a traditional crown improperly, he’d likely do the same with a CEREC.

The only other advantage to getting a CEREC crown would be having it done in one appointment instead of needing a temporary crown and two appointments. The dentist really matters more than the type of crown.

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

can I fix the color of my cerec crowns?

I had a CEREC crown done on one of my canine teeth about three weeks ago. We never really discussed the shade while I was in the office, but as soon as I got home, I realized that it was a bit lighter than the rest of my teeth. Well, once I saw it, I couldn’t un-see it, and now every time I look at myself, all I see is that darn tooth. It looks fake.

I didn’t want to bother my dentist with this at first, so I started playing around with at-home whitening products to try to get the rest of my teeth to match, but I’m just not getting them as bright as that CEREC crown. This probably sounds crazy, but I’m starting to wonder if he can darken it just a bit, so it’s a better match. Is that even possible?

Thanks,

Stan

Dear Stan,

CEREC crown restorations and materials

There are a couple of things about your case that give away that your dentist isn’t really what I would call a cosmetic dentist. Every dentist who is serious about cosmetic dentistry, when they place a crown on a front tooth, will make sure you get a good look at it before it is permanently bonded on. He didn’t do that.

The other problem is that it is a CEREC crown. The CEREC material is a block of material that is a set shade. Unless the dentist is an advanced cosmetic dentist, he won’t know how to use color theory and stains to match a front tooth.

To match a front tooth, a true cosmetic dentist has the ability to customize the shade. Each tooth in your mouth has differences in color from the neck of the tooth to the tip, and it is quite a process to mix different materials to get a crown to match the surrounding teeth.

Tints and Stains Exist

There are tints and stains that can be applied to the CEREC to customize the shade. But on a ceramic, that has to be baked into the crown, so that has to be done before the crown is put in your mouth, obviously.

Sounds Like You Will Have to Have Your CEREC Crown Replaced

You deserve to be happy with your smile and he biffed the color. Hopefully, your dentist will agree to re-doing the crown. However, this time, make sure you get to look at it BEFORE they cement it. Check it out under various lighting conditions—seriously. Look at it in the chair. Get up and go into the bathroom and check it there. Venture to an outside window and view it in natural sunlight. If it isn’t right, don’t let them cement it.

Request a Lab-Made Restoration if All Else Fails

There are crowns that have a core that is made like a CEREC crown and then have porcelain baked over the top. If you want a natural-looking crown on a front tooth, this is the way to go. Although you’ll have to wait two weeks for the lab to make it, the lab technician will be able to tint the crown to match your existing teeth. But the dentist also needs to have a good eye for color and the ability to describe the color variations in your tooth, and your dentist doesn’t sound like he is that much into that. For the best results, you’d really want to switch to someone who specializes in cosmetic dentistry for these sorts of things, but you’ve already started with him, so as long as you’re keen to continue, give him the chance to fix his work too.

If he can’t, look for a dentist who has been accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country.

This blog is sponsored by Lafayette, LA Dentist Dr. Mike Malone.

Cerec crown is too big

I had a dental crown that was about five years old. It broke and I needed to replace it. I decided to get a CEREC crown to speed up the procedure and get a crown as quickly as possible. I’ve had crowns before. But, this one has been a problem. It feels huge in my mouth. So big that it was hurting and causing problems with my speech and gums. It’s also causing me to bite my tongue at night in my sleep. I went back to my dentist and she tried filing it down but I’m still having problems. I though the CEREC crown would fit better.

Kathy

Dear Kathy,

Block of porcelain for CEREC crowns

It seems to me as if you’ve had two dud dentists recently. Dental crowns shouldn’t break. Normally, with a CEREC crown, a tooth is scanned before it is prepared for the crown. Then they use the shape of the tooth in the software to design the crown.

Without that, the dentist can use the software to form the crown, but it sounds like your dentist doesn’t know how to do that yet. I wouldn’t ask her to fix it with her CEREC machine.

Instead, I would ask her to give you a traditional crown which is done at a lab. It will take a little longer, but you need a well-fitted crown. CEREC is capable of doing that. In fact, the software can design a precise crown. Your problem is the dentist.

Do not settle for a crown where you are biting any part of your mouth. This can lead to tumors. A crown should not be noticeable at all.

Turning this Into a Benefit

If you’re going to have to have the crown re-done, I would look at it as an opportunity to improve your smile. This isn’t at all necessary but could be something beneficial.

One of the first things people notice about us is our smile. A great and inexpensive way to make your smile look years younger is with teeth whitening.

Now I don’t know where this crown is, but if it is at all in a visible part of your smile you should consider whitening your teeth before having the permanent crown made so it can be made to match.

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

dentist pushing cerec crowns

I need a dental crown on a tooth in the front of my mouth. My dentist is really pushing for me to get a CEREC crown. I know he’s invested a lot in the machine and probably needs to recoup his money, but I want to make sure these crowns are just as good as the regular ones before getting it. It’s more of a big deal because I’m talking about a front tooth and don’t want to look stupid.

Kevin

Dear Kevin,

Block of porcelain for CEREC crowns
Cerec restorations are made of all-porcelain.

Trying something new can be exciting, but when it comes to your smile, you want to be certain the results will be something you won’t want to hide.

Advantage of CEREC Crowns

With traditional porcelain crowns, your dentist designs it and then send it off to a lab to be completed. This process takes about two weeks. In the meantime, you will be provided with a temporary crown. This is designed to protect the tooth.

They are designed to come off easily so some patients find it more challenging to eat with them on. They’re also a little less attractive than the final result will be because of their temporary nature.

With CEREC Crowns, you walk out of your appointment with your permanent crown in place. This is because it is milled right in the office.

That convenience is its biggest advantage. You don’t have to come back for a second appointment, which means there is no need to get additional time off work or find a babysitter for a second appointment.

Because they’re made of all porcelain, they are just as attractive as traditional crowns. There isn’t much of a cost difference either.

CEREC Crowns on Front Teeth

This issue of a front tooth is more an issue of the dentist than the type of crown. Matching a crown to a front tooth takes an expert cosmetic dentist, especially on a single front tooth.

In that case, I’d ask your dentist to show you images of results of crowns he’s done on front teeth. Ask specifically for an example of CEREC crowns as well. Because they’re milled out of a single block of porcelain, your dentist will really have to know his color theory.

If he doesn’t get beautiful results, you may be happier switching to a different dentist for this one procedure with a different dentist. You can still get a CEREC crown, but you’ll get it by a dentist with expertise in cosmetics. Ideally, you’d see a dentist who is accredited with the American Academy of Cosmetic Dentistry.

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

dentist pushing a cerec crown

I need to a get a dental crown. I’ve always gotten the regular kind so I was expecting that again. Instead, my dentist wants me to get a CEREC crown by a machine. Before I commit, I want to make sure they’re okay. I’d rather have it made by a human, but if they’re okay I guess I’ll go ahead.

Paul

Dear Paul,

Block of porcelain for CEREC crowns

You are fine getting a CEREC crown, with one possible exception which we’ll talk about in a moment. Using the CEREC machine to mill the crown, you will get a great fit. It uses sophisticated software to make sure your crown is precisely cut.

Because they are all-porcelain, they will have the same translucency as your natural teeth. They will look beautiful if your dentist knows how to use the machine well.

Their biggest benefit, though, is you can get your dental crown in just one visit.

The one exception to this would be for front teeth. These are trickier. When your teeth are milled by a CEREC machine it uses a single block of porcelain.

Our natural teeth are not the same level of depth all the way down. Some parts are more opaque than others. Because of this you need a dentist with expertise in color theory and staining in order to mimic the different levels of color needed for front teeth.

Finding a Dentist to Do CEREC Crowns on Front Teeth

Only about 1-2% of dentists will know how to do this correctly. If your crown is needed on another tooth, you should be fine, but with a front tooth, I’d look for an AACD accredited dentist.

Dentists who’ve been accredited with the American Academy of Cosmetic Dentistry have done extensive training. In order to reach accreditation they have to pass oral and written exams as well as demonstrate their artistry .

Any dentist who has reached accreditation can give you a gorgeous crown, even on a front tooth.

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

CEREC or Regular Veneers

I told my dentist I wanted to get a smile makeover. He’s suggesting we do CEREC veneers. Are those as good as the porcelain veneers? I want to make sure I get the right material. Which would you recommend?

Olivia

Dear Olivia,

Block of porcelain for CEREC crowns

It is great that you’re trying to do research ahead of time. I wish more patients did that. I’m going to shift what you are researching though. The materials used do not matter nearly as much as the dentist who is working with the materials. Think of it this way. If two artists were given a block of the same type of marble and told to make a statue of the same person, would the statues turn out exactly the same? Of course not! One artist will definitely be superior to the other. Whether your dentist is creating CEREC veneers or traditional porcelain veneers, what matters most is his skill.

What I’d like you to look at is whether or not your dentist has the technical skill and artistry to pull this off. Doing a smile makeover using the CEREC veneers can be done, but only by top of the line cosmetic dentists. The reason for this is a CEREC machine mills your veneers or porcelain crowns out of a single block of porcelain. However, our teeth don’t have uniform levels of translucency.

In order for a cosmetic dentist to get these to look both beautiful and natural, he or she will need to know a lot of color theory and understand how the different stains available can manipulate the level of translucency and opaqueness in a tooth. Without that, you could end up with teeth that look fake and flat.

Is Your Dentist Good Enough to Do CEREC Veneers?

Before moving forward, I want you to ask your dentist for two things:

1. Ask him to see before and after pictures of recent CEREC veneers cases he’s personally done. If he doesn’t have any, find another dentist. If he does have some and you love the results, you will likely be okay to go ahead as long as he agrees to the second point. If you don’t love the results, find another dentist.

2. Make sure he’s willing to stand behind his work with a form of a beautiful smile guarantee. This should mean that he’ll put the veneers on with a try-in paste when he’s done and let you look at them in several different lightings. If you are not over the moon thrilled with them, he’ll re-do them. No veneers should be permanently bonded until you are ecstatic.

If these two things can’t be met. You need to find a better cosmetic dentist.

Finding an Expert Cosmetic Dentist

If I were getting a smile makeover, I”d want one of the best of the best cosmetic dentists. The easiest way to find those is to go to aacd.com. They have a “Find a dentist” link. You want to look for a cosmetic dentist in your area who has reached accreditation. They have a box you can check for accredited.

AACD accredited dentists have passed stringent oral and written exams as well as demonstrated their artistry on a large number of cases. Any one of them can give you a stunning smile.

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