Archives for September 2021

CEREC Crown is Bulky

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I recently had a crown break after 4 years. Obviously, I had to get it fixed and I wanted it done right away. My dentist doesn’t do same-day crowns, so I went to another dentist. I have had seven other crowns so I know what they should feel like. Maybe this is a CEREC thing. This one is way too bulky. It feels like I’ve got a wad of something stuck on a back tooth.  I am even biting my tongue with it. She’s filed it, but it still is a problem. Should I have her keep filing it?

Brandon

Dear Brandon,

Block of porcelain for a CEREC crown

 

It is not because it is a CEREC crown. These should actually fit better because they are milled more by a computer, which increases the precision. The problem you are facing here is the dentist. Don’t let her do any more grinding of your teeth. It really just needs to be replaced. Aside from being uncomfortable,  it can cause problems. Consistently biting your tongue can lead to a developing tumor.

Here is what I think happened. In most cases, the CEREC software is used when the tooth is already intact. It will scan the existing tooth to determine how to build the new one. Because you had already had a crown and it was broken, she didn’t have that. The software is able to be used to build one from scratch. However, she doesn’t seem to know how to do that. This crown needs to be reshaped. Don’t let her try to do this while it is cemented in your mouth. It is nearly impossible to do it correctly that way. For example, how will she shape the between your teeth?

What needs to happen is she needs to remove this one and make another one. I’ll be honest, I don’t think she is capable of doing this properly with the CEREC software. She doesn’t have the knowledge and skill with it yet. You need to ask her to do this the traditional way. I know it will take longer. You’re probably thinking you could have just stayed with your original dentist and gotten a traditional crown. While that is true, I will say, your crown that broke should have lasted MANY more years than it did, so I have little confidence in that dentist as well.

My advice, give this dentist a chance to get it right the traditional way. If she can’t, get a refund and find a better dentist who can.

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

Do You Have to Choose Between Form over Function?

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I have a horrible tooth grinding habit. Six or so years ago, my dentist crowned all my teeth because they were ground down to nubs. Unfortunately, the crowns were not placed correctly. My bite was a bit slanted and now I’ve worn them out again and my bite is even worse. I’m in a lot of pain. Something I haven’t mentioned is how ugly the crowns were. I just don’t know what to do. Is it possible to have a correct bite and it look good? Where do I find a dentist who can fix this correctly? It has already cost me a fortune.

Jane

Dear Jane,

Woman holding her jaw in pain from TMJ disorder

 

One thing you may have figured out already is that there is not a recognized specialty for TMJ dentists. It is up to the dentist whether or not they get training. It is obvious your dentist did not have the training necessary to do this correctly. He’s caused more problems than he solved. Additionally, knowing that you had a tooth grinding habit he did nothing to protect your new dental crowns from the grinding, which were equally at risk as your natural teeth were. A simple nightguard would have solved the issue. That of course, would only be a great solution if you’d have had this repaired correctly.

To answer your question, you do not have to choose between form and function. However, it will take doing some research. First, you want to make a list of dentists in your area who have TMJ Training. Then, go down your list looking for one who also has great cosmetic skills. You should look at their smile galleries to get an idea of what type of results they get.

A smile gallery is a page on their website that shows before and after photos of cosmetic procedures. If they don’t have a smile gallery on their site, you can be fairly certain they do not do great cosmetic work. For those who do have beautiful before and after images, you want to make certain they are actual cases the dentist has done and not just stock photos.

Finally, whenever you have any type of cosmetic work done, make certain the dentist only does a temporary try-in at first. You should be allowed to look at the work in your mouth BEFORE  it is permanently bonded, then if you don’t love the work they should be willing to send it back to the lab making the changes you want. If the dentist doesn’t agree to that, don’t let him work on you. They should be confident in their ability to get it right.

This blog is brought to you by Marietta Dentist Dr. Christi Cheek.
Click here to learn more about our Free Virtual Smile Consult.

 

What Else is Needed with Porcelain Veneers?

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I had planned on getting a smile makeover with porcelain veneers but my dentist keeps adding other procedures I need before I can get the veneers. Getting a full checkup and cleaning I understood. Getting Invisalign and teeth whitening seems excessive. Are these really necessary? I was under the impression that porcelain veneers can make your teeth look straight. The only thing I have that could “possibly”  need some orthodontics is one canine tooth that is a little in front of the adjacent tooth. It seems unnecessarily expensive to do that for one tooth.

Letticia

Dear Letticia,

porcelain veneers

 

I’m glad you wrote and can help give you some direction here. Let’s start with the teeth whitening. How much of this you need will depend on how many porcelain veneers you plan on getting as well as how wide your smile is. Let us say, just as an example, that you only plan on getting four porcelain veneers. However, when you smile, you can see ten teeth. If the veneers are very white, but your natural teeth are more of a taupe it will be very obvious that you have four “fake” teeth on your front teeth. If however, you whiten your teeth first, then the adjacent teeth will blend more naturally with your new smile makeover. If you are getting plenty of porcelain veneers on your top teeth, then the only teeth you may want to whiten is your bottom arch so it is not a stark contrast to your top arch. This is much more affordable.

The Invisalign is a completely different story. Based on what you described to me, you should not have to have any orthodontics before getting porcelain veneers. Your understanding of a smile makeover and what porcelain veneers can do is more solid than your dentist’s. The fact that your dentist does not know how to make those teeth look straight tells me he is not skilled enough in porcelain veneers. Don’t force him to do this. You will be unhappy with the results. Instead, find a dentist with more expertise. Look at some before and after pictures of work they’ve done to ensure you would be happy to have those results.

This blog is brought to you by East Cobb Dentist Dr. Christi Cheek.
Click here to learn about our free virtual smile makeover consult.