Archives for November 2020

Dentist Won’t Give Me a CEREC Crown on a Front Tooth

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I have to get a dental crown on a front tooth. My dentist has the CEREC machine but tells me he won’t use it for front teeth. I don’t understand that. Shouldn’t that be my choice? I’d really like to have it done in just one day.

Carol

Dear Carol,

porcelain block for CEREC crwons

I think what your dentist is trying to tell you is that it will not look the way you want if you do it on a front tooth. CEREC crowns are milled from a single block of porcelain. That means the crown will be uniform in color. If you look at your front teeth in the mirror, you will notice they are not uniform. The level of translucency changes as you go from the top to the bottom of the tooth.

More light hits your front teeth than others. This means all those subtle differences are more noticeable. If you want a beautiful front tooth, that matches the one next to it exactly, you will be better off letting your dentist do a traditional crown. These are made from several varieties of porcelain, which enables the dentist to shape it with all those varying changes in translucency.

Dental Crowns and Tooth Color

One other thing you need to be aware of is the permanency of color with dental crowns. While they can be made any color you’d like, the color is permanent. Your natural teeth may pick up stains, but the porcelain on your crowns is more stain resistant.
The color they are made is the color they’ll stay.

If you like the current color of your teeth, then no worries. You can move forward, confident you will be happy with the color your dental crown was made. However, if you are considering getting your teeth whitened, the time to do it is before you have your crown made.

If you decide to do teeth whitening later, your natural teeth will whiten, but the dental crown will not. The only way to get it to match your new color is to replace it. Having the whitening done ahead of time will save you money.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Can I Get Dental Implants Instead of Dentures?

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I finally have dental insurance. I’ve been working on getting my gums back to health. I’ve had advanced periodontal disease for a bit now, which has caused me to lose eight teeth. I have dentures right now, but really want to get dental implants. Is this possible?

Larry

Dear Larry,

You have made a great choice in wanting dental implants. They are far superior to dentures for several reasons:

  • They return your chewing capacity. Even the best fitting dentures will reduce your chewing capacity by 50%. With dental implants anchored to your dentures (called implant overdentures) you will be able to once again be able to eat anything you want.
  • Implant supported dentures do not move around. You will never have to worry about them moving or falling out.
  • They prevent facial collpase

Dentures and Facial Collapse

When your teeth were first removed, your body recognized that you no longer have teeth roots that need to be supported. As a result, it begins to resorb the minerals in your jawbone to use elsewhere in your body. While it does this in an effort to be as efficient as possible with your body’s resources, it has the unfortunate effect of shrinking your jawbone. After ten years, you will no longer be able to keep your dentures in place. Eventually, you won’t be able to wear them at all because your jawbone has virtually disappeared. This is known as facial collapse. Not only does it make it impossible for you to have teeth, but it also ages your appearance by decades.

Getting Dental Implants After Dentures

Once your gum disease is under control, you should be able to get dental implants. There is a possibility, depending on how much bone you have already lost, that you may need to have a bone grafting procedure done. This is because you need plenty of healthy bone to integrate with the implants. Without that, the procedure will fail. Once that is completed, you should be good to go.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.

Does Smile Direct Club Work?

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I know it probably seems weird that I am asking you, a dentist, about an online orthodontic service when you sell Invisalign. But, I live clear across the country from where you practice, so you won’t lose any business by telling me the truth. Hahaha. So here is my question. Every time I get on Facebook, I see an ad for Smile Direct Club. They do have quite a few good reviews. But, I thought before I invested in it I would like to get a real dentist’s opinion. Does Smile Direct work?

Rebekah

Dear Rebekah,

SmileDirectClub Advert

I’m glad you wrote. And don’t worry, you aren’t the first person to ask about this particular service. My duty is to ensure those who are seeking dental advice from us get the best and understand their options. So, never hesitate to write with questions. Yes, I am not surprised you see the ads a lot. They are heavily advertised. As for the good reviews, that doesn’t surprise me either, but not for the reasons you think.

Recent investigative journalism has uncovered Smile Direct Clubs’ habit of only offering refunds to unhappy clients if they sign a release saying they won’t post any negative reviews and will remove any negative content they have already placed. In other words, we won’t get a true picture of their reviews because patients with bad experiences don’t talk about it in order to get a refund.

However, let me just go into what we know for a certainty about how this program works.

Problem One: Missing Diagnostics

A good dentist will do a full mouth series of x-rays and a comprehensive dental examination. This would include looking for things such as signs of TMJ Disorder, tooth decay, and gum disease. Skipping this step can cause the patient a lifetime of pain and unnecessary dental work that could have been avoided. To me, it is inexcusable to skip this step.

Problem Two: DIY Impressions

In order to get a truly accurate treatment plan, it is imperative the impression is done carefully. That means there will be no bubbles, tears, or other defects. This step is so important that some dentists won’t even allow their assistants to take it. With Smile Direct, they just send you a kit to do your own impression at home. I find it doubtful this will give you the best orthodontic treatment.

Problem Three: Adding Space

Most cases of patients needing braces have crowded teeth. This means they will either need some shaving of a few teeth or some back teeth extracted. This needs to be done by a dentist invested in you and the case. Unfortunately, Smile Direct has a shortcut to this too and I worry about its impact on patients.

Problem Four: Inadequate Follow-Up

When you do a treatment, such as Invisalign through a dentist, you are getting follow up care every two weeks when you are given your new aligners. This prevents so many problems. While the treatment is pre-planned, sometimes our teeth don’t cooperate. Maybe teeth don’t turn the way they are supposed to or more space is needed than we originally thought. Without that follow up, your teeth could end up in a worse position than they were to begin with.

What does this mean for you? Well, you could try Smile Direct Club. It might turn out well for you and you’ll save some money. However, first I would get a complete examination from your dentist just to make sure you don’t have any underlying conditions that could cause a problem. But, you are taking chances. So go into it with eyes wide open.

This blog is brought to you by East Cobb Dentist Dr. Cristi Cheek.