Archive for the ‘Dental Crowns’ Category

I’m a grinder, and I want a smile makeover. How about Snap-on Smile?

Tuesday, June 21st, 2011

I am looking for an excellent cosmetic dentist. I am considering crowns for my front teeth. Since I grind my teeth, I don’t think porcelain veneers are a good option. I have seen some people with crowns however that appear grey at the gumline. I don’t want that at all. How do you feel about Snap-on Smile?
- Gerard from Ohio

Gerard,
Snap-on-Smile will not give you a beautiful smile. It may give an acceptable smile, but your teeth will be a little bulky, and you won’t have that natural translucency of real teeth, plus some other drawbacks. The Snap-on Smile is a low-cost option for a smile makeover. You need to have low expectations for the Snap-on Smile or you’ll be disappointed.

You do have to be really careful if you grind your teeth. You don’t need to rule out porcelain veneers, as long as you are going to an excellent cosmetic dentist who has a lot of experience with smile makeovers. The dentist may have to make them so that they stay out of the way of your grinding patterns. That can be done. And you may need to wear a night guard to protect the veneers at night. We have often worked with grinders and clenchers and they have a hard time believing that wearing this protection at night helps, because they say things always break during the day. But the stress and microcracks that are created at night weaken the teeth and the porcelain, and so the night guard can be excellent protection. But again, it depends on the patient, and each case needs to be handled individually. And you really need an excellent cosmetic dentist with a great deal of experience.

As far as porcelain crowns, that would also be an option for you. The dark line that is associated with crowns is only associated with porcelain fused to metal crowns. An expert cosmetic dentist with many years of experience, again, will be able to place these in such a way as to keep them from breaking. One disadvantage of crowns if you are a grinder or a clencher is that the front teeth are weakened at the neck of the tooth, and, again depending on your grinding patterns, it may make it so that the tooth is more susceptible to breaking off entirely.

You want a dentist with expertise in cosmetic dentistry and in occlusion, and a dentist who is older, say in his late 40s at least, because they will have more long-term experience in doing total smile makeovers. A dentist who has done smile makeovers but not over that long a time period hasn’t yet seen how these makeovers in patients who grind their teeth hold up over time.

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

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What if my CEREC bridge later needs a root canal treatment?

Thursday, May 26th, 2011

I have an existing metal/porcelain crown on a back molar, with a bridge (tooth removed) next to it and then a connection to the next tooth. Said connection has allowed decay underneath it to the point I need a root canal. I tried a new dentist (I live in a rural area so have to drive at least 1 1/2 hours to find options in health care) and he suggested a CEREC crown/bridge/crown situation after doing the root canal. My concern is the possibility of a need, later on, for cavity or root canal work to be done on the back tooth. Can a dentist drill through the Cerec crown to do the work without removing the crown/bridge/crown apparatus? If so, does the crown need to be refilled with something specific (like CEREC material) or is a “normal” filling going to work — i.e., would I need to go to a dentist that has the CEREC machinery and training if that back tooth needed further work after the crown was replaced with a CEREC one? Or should I go for the cheaper metal/porcelain option for the crown/bridge/crown fix, expecting at some point to have to remove the whole thing to get to that back molar?
- MA from Arizona

Dear MA,
CEREC is nice. It’s definitely nice not to have to deal with the temporary and the second appointment.

The CEREC material is difficult to drill through – it would probably require a diamond bur, and maybe more than one because CEREC is hard even on diamond burs. But if done right, a dentist should be able to get through it without damaging the bridge. And the filling material wouldn’t have to be anything special – just regular composite should do. So you wouldn’t need to go to a dentist with special CEREC technology to have additional work done.

But having said that, there is nothing higher quality about a CEREC bridge replacing a molar. (I use the word “bridge” to mean the entire restoration: two crowns with a false tooth, called a pontic, suspended between them.) In fact some dentists would be uneasy about that, that the extra chewing forces might be too much for a pure ceramic restoration and they would prefer the porcelain fused to metal bridge. I think in my mouth I would prefer the porcelain fused to metal in that situation. I’m confused about why the CEREC would cost more. The dentist, by using the CEREC technique, is eliminating the need for a dental laboratory technician, so the laboratory cost is zero. He does have to amortize the cost of the machine, but the idea there is that the costs should balance out.

In other words, don’t assume because the porcelain fused to metal is less expensive from your dentist that it is lower quality. If the metal is a semi-precious or a precious metal and not a base metal, the porcelain fused to metal bridge would be of equal or slightly higher quality, depending on the situation. And in other dental offices the fees would be similar, or in some cases the CEREC would even be less.

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

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Sore gums around a new crown

Saturday, May 21st, 2011

In February, a root canal was completed on #14 (upper left first molar). In April, I got a core buildup and a crown on the tooth. Since getting the crown, I have been very uncomfortable and unable to chew on that side. Within two weeks of getting the crown, I started noticing bad breath and a chemical taste coming from the crown, more noticeable after eating. I also feel the gum inflamed and tender when I wake up every morning.

I’ve been back to my dentist. He said it was gum inflammation and that I probably was not flossing the area correctly. He said the bad taste I felt was probably blood, eventhough I never noticed any when flossing or brushing. He gave me peridex, and I also got a professional cleaning. Last week, I decided to visit a Periodontist for an evaluation. He said the crown was sealed properly, but too close to the bone, perhaps. On the xray he did not see any bone loss, but he warned me that if I get a gum infection, I could lose the tooth! He recommended a crown lengthening procedure. I just don’t understand how, when my general dentist who did the crown said I had plenty of tooth structure. I am very frustrated, because the events leading to the root canal were not pleasant, and now six months later cannot believe I am feeling even worse. Not only that, after using Peridex, I still see a brown film on my tongue and teeth, eventhough I only used it for 5 days (two weeks ago). The film on my tongue keeps re-appearing after brushing, so could it be blood oozing out of the gum? I feel that this crown is ruining my otherwise healthy mouth. Other than this crown lengthening procedure, what other alternatives do I have? Thank you for any advice or information you may have.
- Cindy from Florida

Cindy,
It sounds like the dentist may have made the crown to go too far under the gum. It could be that the tooth was decayed down that far. There isn’t really much you can do when you have a situation like that other than the crown lengthening that the periodontist is recommending.

I really doubt that the bad taste you had after getting the crown was from blood. When you have gum inflammation like that, it creates a festering pocket with a localized infection, and that would be the most likely cause of the bad taste. And, of course, you realize now that the gum inflammation isn’t caused by a problem with your flossing but because the crown was violating what we call the biologic width of the tooth – the crown is too close to the periodontal ligament, which is the ligament that attaches your tooth to the bone. The brown film you are seeing is from the Peridex mouth rinse, and there are only two ways I know of to get that off – with a professional cleaning, or with Supersmile toothpaste that will dissolve away that film.

This blog sponsored by Colorado Springs dentist Dr. Joseph Rota

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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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All the dental work is different colors.

Monday, November 29th, 2010

I recently had root canals and 7 porcelain with metal crowns done on my upper teeth, in addition to upper and lower valplast with metal removable partial dentures. I told my dentist that tooth #7 looked slanted and she used a tool to reshape the bottom of the tooth. She also did tooth #8. I told her that the two teeth now feel rough, not smooth. A very uncomfortable feeling.

Then on tooth #10 the crown is wider, shorter and whiter than my other front tooth. She sold me a zoom whitening pen to whiten my natural front tooth. 2 months later and no change in color, she tells me I lost enamel on that tooth and wants to do a porcelain crown. With the work that was done on my front teeth, they don’t match in shade or shape. My partials are also a different shade. Can they be redone without a extra charge? 10 months later and I have 3 different shades of teeth when I smile. I contacted my insurance company and they said she was already paid for the work. Any advice on how to correct the work that has been done?

Thank you.
- Catherine from Brooklyn

Catherine,
I’m not sure I’m following everything that’s wrong with your case. Depending on exactly what’s wrong, there may not be a lot you can do about your situation.

If your dentist can’t match colors well, or the teeth she makes have funny shapes, that’s not something you can force – you can’t make her get it right.

Here’s the problem. Dentists are trained to fix things. And the whole profession is concentrated on fixing things so they work. The problems you are mentioning are mostly issues you have with how the work LOOKS. But if the work she did is functional, then it’s generally considered to be within the standard of care and you have little legal recourse.

For most dentists, appearance-related issues aren’t critical. If your teeth are basically white and lined up basically straight, then for many dentists that is good enough.

What you seem to be telling me is that you want your smile to be beautiful. But to get beautiful cosmetic dentistry, you have to pick a dentist that is on your same wavelength and for whom the appearance of the work is a high priority. In other words, you want an artistically-inclined dentist, a cosmetic dentist. Once the work is done, you really don’t have any legal ability to force the dentist to make it be beautiful.

Then, being in Brooklyn, I’m not sure there are any excellent cosmetic dentists in Brooklyn. There are some excellent ones in Manhattan, and some in Queens, but for some reason, the good cosmetic dentists may not want to open practices in Brooklyn.

Now, as far as your particular problems. The smoothness shouldn’t be a big issue. It isn’t really hard to polish porcelain, though it’s possible your dentist doesn’t know how to do that. I would start by asking her to do that, if she can.

In summary, I would recommend that you get a second opinion from an excellent cosmetic dentist in Queens, Manhattan, or on Long Island, letting them take a look, and tell you what can be done to fix what you have. I’d check with the website www.mynewsmile.com – they recommend cosmetic dentists all over the country. It may be that another dentist can work with you to persuade your dentist to give some kind of refund or partial refund, and you can have some of this work re-done. From what you’ve told me, I don’t have a lot of hope that this dentist of yours can make this work beautiful. Some dentists simply can’t.

Links: Read about getting porcelain crowns in Colorado.

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Porcelain crowns for front teeth are causing lots of trouble.

Tuesday, September 21st, 2010

Well my sr. year i saved enough money to get my teeth fixed. one of my teeth in the front was cracked. my two front teeth are porcelain crowns all the way around. my dentist put in the normal crowns at first but this wasnt what we had discussed so he replaced them with the porcelain all around. well now after 8 months my teeth underneath them are dead. could the reason my teeth are dead be from the dentist? i take pride in my teeth i had braces for 5 years and i brush and floss my teeth everyday. i havent had any problems before. i’m afraid i wont be able to pay for what is a head for my teeth.
- Kendra from Kentucky

Kendra,
Ooooh, this sounds like a tough situation.

Yes, the reason your teeth died is undoubtedly because of the crowns. Now you need root canals, and you should also have glass fiber posts placed inside the teeth to strengthen them, because the next problem you could be facing down the road is that the teeth will just break off at the gumline and then you’ll need to go to implants. Not metal posts. Glass fiber posts. This is important. If your dentist is one whose first thought would be to put porcelain fused to metal crowns on two front teeth, he may not be very familiar with glass fiber posts. A glass fiber post will flex with the tooth and thus will reduce the risk of later root fracture.

If you’re around age twenty or younger, your front teeth would have large pulps. When you do a crown on a front tooth, you have to remove quite a bit of tooth structure, and there is a risk of getting close to the pulp and damaging the pulp. And if you had the crown procedures done twice, that would increase the risk of damage. That’s not to say that the dentist did anything wrong, but at a minimum, you should have been warned that this was a risk.

Another factor in your case is that your dentist clearly didn’t feel comfortable doing all porcelain crowns. Dentists that know how to do all porcelain crowns will far prefer them for front teeth, because they are so beautiful and natural looking compared to the porcelain fused to metal crowns. So this suggests to me that maybe he wasn’t all that familiar with the proper bonding procedures for this type of crown. So maybe, just maybe, something wasn’t done right in bonding them.

I think this would be something that this dentist should take responsibility for. Approach him with that, explain how your finances are limited, and ask him to help with this.

And, if he is the one to do this followup work, be careful about the posts. Ask how many glass fiber posts he has placed. Pin him down. If he doesn’t use this type of post routinely, I would have another dentist do that part – a dentist who does a lot of cosmetic dentistry. If he has placed a couple dozen or more, to me that would indicate a satisfactory comfort level with this type of post.

I wish you the best. Take these next steps carefully, because you’re a long way from out of the woods on this.

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Porcelain crowns in front don’t match

Monday, April 12th, 2010

I had recently all-porcelain crowns placed on my 4 front upper teeth and one of them looks darker. I had root canal done on that tooth long time ago and it was dark. My dentist knew that I wanted to make it lighter and I thought that what I’ll get by placing crown on it. The only thing she mentioned was that that tooth might be a little darker at the gum line because i had root canal done. Was there any way to cover that darkness?

Thank you,
Vicki from Ohio

Vicki,
Yes, there is a way that the crown on this root canal tooth could have been made light enough to match the other front teeth. But this is probably beyond the skill level of your dentist. There are opaquers that can be incorporated into the porcelain, or that the dentist can use underneath the porcelain. For cases like this, where there is a strong mis-match of the underlying color, we like to create a base on the dark tooth that was the same color as the other teeth, and then we wouldn’t have to worry about the laboratory technician knowing just how much opaquer to use in the porcelain. Other cosmetic dentists simply take a photograph of the prepared teeth, showing the color discrepancy, forward that photo to the lab technician, and rely on the technician to block out that undesirable color.

Dentists are generally trained to fix things that are broken and aren’t artists. And most dentists simply aren’t that passionate about making their work look beautiful and absolutely natural.

There is a website that recommends cosmetic dentists all over the country, mynewsmile.com, and they are very picky about who they list. Dr. Rota is their recommended Colorado Springs cosmetic dentist. If it’s important enough to you, you could go to one of the expert cosmetic dentists on their list. Otherwise, you’ll need to live with the result until the crowns fail. Most dental insurance plans give crowns a minimum lifespan of five years before they will consider helping to pay for a replacement crown.

Colorado Springs Dentist

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