Tag Archives: Dental Crowns

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.

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.

family dentist versus cosmetic dentist

I had composite bonding done on a chipped tooth. The dentist who did them retired. My new dentist said they couldn’t replace the bonding and suggested a dental crown. He said because it was a front tooth the only way to get it to match was to do two crowns. I trusted. him. Now I have two crowns on healthy teeth and, while the match each other, they’re grayer than the rest of my teeth and look fake. What do I do?

Cameron

Dear Cameron,

a before and after picture of dental bonding for a chipped tooth.

The biggest problem you have here is you’ve got a family dentist who doesn’t understand cosmetic dentistry. You needed composite bonding repaired. He didn’t know how to do that. Instead of telling you that, he says it can’t be done and you need crowns. Why crowns? Because those are what he’s familiar with.

A second issue is the fact that he said you needed two crowns in order to get them to match. A skilled cosmetic dentist can match a single crown to a front tooth.

In your place, I’d suggest you do one of two things. First, tell your dentist you need these crowns re-done. But, only allow him to do it on some conditions.

  • He’ll need to use a temporary try in paste so you can see the crowns in your mouth to make sure they’ll match and you are pleased with them.
  • If you’re not thrilled with them, he needs to be willing to re-do them until you are happy with them.

If he doesn’t agree to that, then my second suggestion is you ask for a refund. He told you the teeth would match and they don’t. He also lied to you about the possibility of just getting the dental bonding repaired. You have the right to a refund.

Once you secure that, it is time to find a good cosmetic dentist to do this properly.

Finding an Expert Cosmetic Dentist

I’m going to suggest you look for an AACD accredited dentist. You can look them up for your area at aacd.com. These are in the top 1% of cosmetic dentists in the country. There aren’t many of them, so it may be hard to find one depending on where you live.

If that’s the case, there is a second resource. Look on mynewsmile.com . They screen cosmetic dentists for both their technical knowledge and training, as well as their artistic ability. Any of their recommended dentists can provide you with two gorgeous crowns

You may want to consider whitening your teeth if you are going to get the crowns replaced, this will essentially give you a bit of a smile makeover.

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

Doubling Invisalign Trays for Teeth Whitening

I’m getting Invisalign which I’m very excited about. My dentist also offers teeth whitening. It appears that the trays for teeth whitening and the trays for Invisalign are quite similar. I noticed that I can buy the gel online. This will allow me to get both procedures done for so much less. Could I use the aligners as whitening trays?

Miranda D.

Dear Miranda,

A woman placing in her Invisalign aligners

I’ll start by telling you that, yes, your Invisalign aligners can double as whitening trays. The caveat being, you need to make sure you’re a good candidate for teeth whitening. I would not recommend just purchasing whitening gel online to use in the aligners, especially if this is your first time whitening your teeth.

You’ll want to be under the observational care of your dentist during your first whitening because there are complications that could arise which you won’t know the warning signs for. He (or she) can spot them and take helpful steps before any complications become more serious.

Secondly, you have no way of knowing whether the gel you’re purchasing is reputable or even equally strong as the gel your dentist can provide. Even worse, it could be material that will damage your teeth.

Teeth Whitening Only Works on Natural Teeth

If you have dental work, such as fillings or dental crowns, they will not whiten with the whitening gel. Instead, your teeth will whiten and the dental work will remain the same color. So, if they’re visible when you smile, you’ll want to replace them when the procedure is done. The same goes for dental bonding.

You will likely find that once your Invisalign and Whitening are done, you will have a stunning smile. You’ll gain confidence and smile more. In turn, you’ll appear more positive and successful to others, which will bring you opportunities previously hidden.

Also, keep your final pair of aligners. Keep them clean and stored carefully, then once a year or so, you can ask your dentist for another tube of whitening gel for a touch-up. Many dentists are willing to provide that if you keep up regularly with your cleanings and check-ups.

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

What’s the Difference Between a Cosmetic Dentist and a General Dentist?

I can’t seem to figure out the difference between a general dentist and a cosmetic one. My dentist is a general dentist but he also does cosmetic things like teeth whitening and Lumineers. Is there a difference or do they just label themselves for the kinds of patients they want to draw and do both kinds of work?

Sandy M.

Dear Sandy,

A ugly cosmetic smile and a pretty cosmetic smile

There is no difference as far as a specialty. There isn’t a recognized specialty in Cosmetic Dentistry with the American Dental Association. Any Cosmetic Dentist is actually just a general dentist who also does cosmetic work.

That being said, there is a huge difference regarding quality and beauty that varies from dentist to dentist and it doesn’t matter which label they use. A good example of this is the image above. Both smiles are of the same woman and both smiles had the same type of dental work done. On the left, she had dental crowns. On the right, she had dental crowns. The only difference is the dentist.

The dentist on the left didn’t understand what materials to use to give her a natural looking smile. He technically knew how to make and bond dental crowns and is likely a decent general dentist. But, if you want anything appearance related it will take someone with both technical skill and artistry. That’s what the dentist on the right had.

Fixing Botched Cosmetic Dental Work—A New Industry

Most patients would be surprised how much business comes to high-quality cosmetic dentists, like Dr. Mike Malone, because they are fixing botched cosmetic cases. I suspect your dentist isn’t a high-quality dentist. The only reason I’m saying that without seeing examples of his work is his reliance on Lumineers. These are generally marketed to inexperienced cosmetic dentists as being easy to place. But, the results are often opaque and bulky. So, how do you not end up with a smile makeover disaster?

If I were in the market for a complete smile makeover with porcelain veneers, I’d look for a dentist who’s reached accreditation level with the American Academy of Cosmetic Dentistry (AACD). There is a difference between being a member of the AACD and an accredited member. Any dentist can pay the fee to join. But, to become accredited, you have to pass stringent oral and written exams as well as demonstrate your artistry in many, many recent cases.

They’re among the top 1% of cosmetic dentists in the country. If you’re looking for a beautiful smile, they’ll create one for you. In fact, many of them have a beautiful smile guarantee.

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

Dentist Refuses to Fix Son’s Tooth with Veneers or Crowns

I’m really frustrated. My 9-year-old took a bad fall. When he did, he lost half his front tooth. I want his repair to be stable. My first thought was a porcelain veneer but my dentist said no. Then I suggested a crown. The dentist said no. I don’t know what to do. Why won’t they treat him?

Laura K.

Dear Laura,

Porcelain Veneer being placed on a tooth

I know you’re frustrated. You want the absolute best for your son and it seems like your pediatric dentist isn’t cooperating. He may not be explaining things well, but he’s not wrong. Though, he should have told you what solutions would work.

With a child, their jaws and bite are in an almost constant state of flux. He will outgrow both the porcelain veneers and dental crowns so fast it could mess up a lot of things about his bite. Not to mention the fact that it would cost you a fortune to constantly replace them.

Alternative to Porcelain Veneers for a Child

The best solution at this point would be to have dental bonding done to make the tooth look completely natural. It’s much less expensive than veneers or crowns anyway. Then, when his jaw has fully developed you can look for a more permanent solution.

I’m assuming at this point the dentist checked for trauma to his nerves and such and that the tooth is safe. If he hadn’t, I’d go see an emergency dentist just to have his teeth looked at and make sure no permanent damage is done where he’ll need a root canal treatment.

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

I Want an Implant and My Dentist Wants Me to Get a Bridge

I have two teeth that need work. They’re right next to each other. One needs a crown. The other needs to be extracted. I want to do a dental implant and a crown. My dentist wants to do a bridge. I’d think he’d be more excited about a dental implant because they’re more expensive, but he seems pretty insistent about a bridge.  Is there a real medical reason for this?  I’m not too excited about the idea of a bridge.

Brenda C. – Michigan

Brenda,

My guess is your dentist isn’t comfortable with dental implants.  It’s an extremely advanced procedure. I wouldn’t push your dentist if that’s the case. When it’s not done perfectly, there can be serious complications.  It’s a credit to your dentist that he’s not just taking your money and doing the procedure halfway.

A bridge is fine in your case. You already need work on one of the adjacent teeth, so it’s like getting two procedures knocked out in one—no pun intended. However, your other tooth is healthy so you might not want to grind down healthy tooth structure. I understand your desire to go with an implant and crown.

My suggestion would be to get the implant and crown, but with another dentist. I’m not saying leave your current dentist, just have this particular procedure done with someone else. Then, you can continue with your current dentist for general treatments and cleanings afterward.

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

Having Pain With My Porcelain Veneers

I got porcelain veneers. When my dentist put in the temporaries they felt okay. But, now that the real ones are in they’re giving me some pain. My dentist looked at them and said the bite is off just a bit. He adjusted them a few times, but it’s still hurting when I bite down. Do I keep going back or have them removed?

Sandy – Georgia

Sandy,

I don’t think what you have is porcelain veneers. If you had temporaries, and your dentist has adjusted them, and he’s saying your bite is off, that sounds more like porcelain crowns.

Your dentist needs to fix this or it will cause severe problems, including TMJ. If adjusting them doesn’t improve things, you may have an infection and that is what is causing the pain.  Have the dentist do the x-ray.

I’m a little concerned that you thought you had porcelain veneers. Was that what your dentist told you? Maybe have another dentist look at your bill and the work you had done.

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

Pain with a CEREC crown

I had four CEREC crowns put on back teeth. One of them is causing horrible pain when I bite. I’ve been back to my dentist a couple of times.  He shaved it, but it didn’t get any better. He thinks it is because of the way I chew.  Wouldn’t that have been causing pain before I had the crown put in? Isn’t it more likely that it is because I got a CEREC crown instead of a regular one?

Dennis L. – Maine

Dennis,

I don’t think it is because of your bite or because of the CEREC crown. In fact, because CEREC crowns are milled by a computer, there is less chance of the crown being a problem.  When you have pain when biting a crown, there are generally one or two reasons that is the cause:

1. The bite can be too high. I don’t suspect this is your case because you’ve already been back twice. Surely your dentist would have noticed that. I’m sure he’s adjusted your bite.

2. The other reason is an infection. Your dentist can do an x-ray and it will tell you if that is the case.

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