Archive for January, 2011

Should my CEREC crown feel smooth?

Wednesday, January 26th, 2011

Should a cerec crown feel smooth and “glass-like” similar to the feel of a real tooth? My story is, I had a cerec crown placed, but my dentist damaged it on the next visit and put a temp in, saying it was fine as he had stored the computer image and could just make another one. I finally had it put in this week (3 months after the original, due to diary constraints ,xmas etc), and it just feels a bit rough like a temp. Now it could be my imagination, but i’m pretty sure i remember when i had the 1st one placed that i marvelled at how natural it felt and how much it was like a real tooth, and enjoyed the feel on my tongue. Now with this new one, i just have a feeling of immense disappointment – it doesn’t have that glass like smooth shiny quality and feels slightly rough under my tongue. Is my memory just playing tricks on me, and I’m remembering the original cerec crown way better than it actually was? or is my dentist trying to pull a fast one and hasn’t actually placed cerec at all and just put the temp back in with a stronger bond?
- Carlon from London, England

Carlon,
Any crown should feel natural to the tongue – not rough, no sharp spots, comfortable – plus comfortable to the bite.

Your dentist must have adjusted it or done something after it came out of the CEREC machine to make it rough. When it is milled by the CEREC machine it is smooth.

But it shouldn’t be that complicated to polish it up again. Go complain and ask for it to be polished.
It isn’t just CEREC. Any crown could become rough if it is adjusted and not polished.

If you really have cause to question this dentist’s ethics and whether or not the CEREC ceramic was placed or just a temporary, then I would suggest getting a second opinion from another dentist. In asking for the second opinion, I would reveal as little as possible and just ask the dentist to tell you what he or she thinks this crown is made out of, without saying that you just got it, or anything about the history or what you were told. That’s the best assurance of getting an honest opinion.

This blog sponsored by Colorado Springs dentist Dr. Joseph Rota. Please see our page about CEREC crowns.

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Best way to replace missing lateral incisors

Saturday, January 15th, 2011

I am 46 and was born without my front lateral incisors. I have a space on the top sides of my mouth.

I am considering Invisalign or porcelain veneers. I am not sure if I would be a candidate for lumineers or another similar product. I know aging teeth may factor in whether I would be a good candidate for this procedure. I don’t want fake looking teeth. Which method of cosmetic treatment do you think would be best for me?
- Karen from Indiana

Karen,
I’m understanding that you are missing your upper lateral incisors, and you have spaces there right now. So you need teeth to fill in those spaces.

There are three good ways to put teeth in those spaces.

If the teeth surrounding the spaces are otherwise healthy and don’t have any large fillings, the best way to replace them would be with dental implants.You could have two implant fixtures placed in the bone in those spaces, wait a few weeks for it to heal, and then have teeth placed on them. If done by an excellent cosmetic dentist, the teeth would look real and would match the surrounding teeth so that no one could tell they aren’t real.

Another way to replace the teeth would be with dental bridges. You would have crowns placed on the teeth on either side of the space, and then the false tooth suspended between those crowns.

The cost of replacing these two teeth with either technique would be around $6000 to $10,000, if there are no complicating factors.

For a lot less money, you could get a temporary tooth replacement. For a couple hundred dollars, you could get a flipper partial. This is a plastic plate that fits up in the roof of your mouth and is fastened in with a couple of wire clips, and it would have the two false teeth attached to it.

I have seen some orthodontists and dentists that want to close the spaces by putting braces on the teeth or using Invisalign to move the canine teeth into the space of the lateral incisors. This never looks good. They figure they can put a crown or a porcelain veneer, or bonding on the canine to make it look like a lateral incisor. But the canine is a large tooth, and the lateral is quite a small tooth, so that’s like trying to put a disguise on chubby Santa Claus and getting him to look like skinny Peter Pan. It’ll never look quite right. Your teeth will never look quite natural doing it that way.

This blog sponsored by Colorado Springs dentist Dr. Joseph Rota.

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Posted in Dental Bridges, Dental Implants, Missing Teeth | Comments Off

Porcelain Veneers and Dental Cleaning

Monday, January 3rd, 2011

I recently had veneers placed on my front teeth (in September) in New York State. We recently moved to Florida and am scheduled for my first cleaning since getting the veneers. I am concerned that my dentist here will not clean them properly, so what should I be prepared for. I certainly don’t want them to harm the finish on the veneers. Will using a scaler harm the finish?
- Martha from Florida

Martha,
There are two big no-no’s that a dental hygienist can do to ruin your porcelain veneers. The first way is by using a power spray to clean the teeth. The Prophy-Jet by Dentsply, that sprays sodium bicarbonate on the teeth to clean them, will destroy the glaze, and it will be expensive to fix that. Many hygienists are oblivious to this damage because when they’re through with the appointment, the veneers look beautiful and clean. But with the glaze gone, porcelain veneers will start to pick up stain after the patient leaves the office, and they’re never the same again.

The second way is by administering a standard fluoride treatment. They usually give fluoride treatments only to children, but some hygienists like to give them to adults. The problem is that the standard fluoride used in these treatments is acidulated, meaning that it contains small amounts of hydrofluoric acid. While this greatly helps the teeth absorb the protective fluoride, it will etch porcelain, which again will break the glaze and cause it to stain more easily. It can also remove some tinting on the surface of the veneers, altering the color of the veneers. Dentists who know better will keep a supply of neutral fluoride on hand to avoid this problem.

Beyond that, it is always best, if you have porcelain veneers, to have them maintained by an office that does a lot of them. There are other smaller things that are important that will be carefully followed by offices where they are passionate about cosmetic dentistry. Scalers can be used, but ultrasonic scalers have the potential to chip the margins of the veneers. Coarse polishing pastes can cause extra wear on the bonding composite between the porcelain and the tooth. Those are finer points. The key thing is to stay away from any of the power sprays like Prophy-Jet or similar devices and the acidulated fluoride.

This is the blog of Colorado Springs dentist Dr. Joseph Rota.

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