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dentist pushing cerec crowns

I need a dental crown on a tooth in the front of my mouth. My dentist is really pushing for me to get a CEREC crown. I know he’s invested a lot in the machine and probably needs to recoup his money, but I want to make sure these crowns are just as good as the regular ones before getting it. It’s more of a big deal because I’m talking about a front tooth and don’t want to look stupid.

Kevin

Dear Kevin,

Block of porcelain for CEREC crowns
Cerec restorations are made of all-porcelain.

Trying something new can be exciting, but when it comes to your smile, you want to be certain the results will be something you won’t want to hide.

Advantage of CEREC Crowns

With traditional porcelain crowns, your dentist designs it and then send it off to a lab to be completed. This process takes about two weeks. In the meantime, you will be provided with a temporary crown. This is designed to protect the tooth.

They are designed to come off easily so some patients find it more challenging to eat with them on. They’re also a little less attractive than the final result will be because of their temporary nature.

With CEREC Crowns, you walk out of your appointment with your permanent crown in place. This is because it is milled right in the office.

That convenience is its biggest advantage. You don’t have to come back for a second appointment, which means there is no need to get additional time off work or find a babysitter for a second appointment.

Because they’re made of all porcelain, they are just as attractive as traditional crowns. There isn’t much of a cost difference either.

CEREC Crowns on Front Teeth

This issue of a front tooth is more an issue of the dentist than the type of crown. Matching a crown to a front tooth takes an expert cosmetic dentist, especially on a single front tooth.

In that case, I’d ask your dentist to show you images of results of crowns he’s done on front teeth. Ask specifically for an example of CEREC crowns as well. Because they’re milled out of a single block of porcelain, your dentist will really have to know his color theory.

If he doesn’t get beautiful results, you may be happier switching to a different dentist for this one procedure with a different dentist. You can still get a CEREC crown, but you’ll get it by a dentist with expertise in cosmetics. Ideally, you’d see a dentist who is accredited with the American Academy of Cosmetic Dentistry.

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

porcelain crowns turning yellow

I had some porcelain crowns done about six months ago. When I first received them, they were beautiful. I loved how they looked. Unfortunately, they are already turning yellow. I don’t think it is anything I’m doing. I do drink one cup of tea in the mornings, but water the remainder of the day and I brush regularly. Do you know what’s going on? I thought they were supposed to be stain resistant.

Elaine

Dear Elaine,

woman smiling with a dentist

Yes, porcelain is very stain resistant. That means, if you truly have porcelain crowns, something went wrong. I haven’t seen your crowns so it is hard for me to tell you exactly what happened. However, I can give you some possibilities.

If you see a general dentist who doesn’t do much cosmetic work, then it is possible the hygienist or the dentist did something to damage the glaze on your porcelain crowns. It’s been six months since the crowns were placed and that is about the time you would have gone in for a checkup and cleaning.

Some things which damage the porcelain include:

  • The hygienist using a power prophy jet during the cleaning process. This would feel fine at the end of your appointment, as well as look normal, but the glaze would be gone and you’d quickly begin to pick up stains regardless of how good your oral hygiene was.
  • Acidulated fluoride. Some dentists use this, but it will chemically eat away at your glaze.
  • If your dentist made any adjustments to the crown, he could have ground away some of the surfaces.

Get a Second Opinion from a Qualified Dentist

As I mentioned earlier, not all dentists are familiar with cosmetic work. Because of that, they may not even recognize what went wrong with your crowns.

I’m going to suggest you see an expert cosmetic dentist in order to get a knowledgeable second opinion. To find that level of expertise, I’d like you to go to the mynewsmile.com website. Any dentist they recommend, will have the knowledge you need to get to the bottom of what is going on with your crowns.

It’s important you follow some basic guidelines when getting a second opinion to make sure the dentist isn’t influenced in his or her decision. Dr. Hall has a post on porcelain crowns. In the last paragraph, he gives some tips on getting an unbiased second opinion.

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

Fixing long teeth

My two front teeth are insanely long. They also stick out a bit from the rest of my teeth. I feel like a beaver and hate all of my pictures. I’m trying to find a cosmetic solution but can’t find one. Do you think the only solution is for me to have my front teeth removed and have dental implants placed? I’m desperate.

Lucy

Dear Lucy,

Invisalign aligner
Invisalign can straighten teeth without anyone knowing.

Please don’t remove your front teeth!! There are always solutions. I am going to make a suggestion, but want to preface it with the precaution that I haven’t examined you. This is a solution based on my understanding of your description.

Your front teeth can be trimmed by an expert cosmetic dentist using diamond burrs and diamond strips. They can be filed down on the sides to narrow them and on the biting surfaces to make them smaller.

Once they’re a size you’re pleased with, Invisalign can be used to align them properly. An added benefit of Invisalign is the aligners can double as teeth whitening trays. This lets you get a mini smile makeover.

Depending on how much structure has to be removed, you may need porcelain veneers to cover any exposed dentin.

You Need an Expert Cosmetic Dentist

None of my suggestions matter, though. You need to see an expert cosmetic dentist and let them tell you what is the best solution. They’ll give you a smile you’ll be proud to share.

The best cosmetic dentists in the country are accredited by the American Academy of Cosmetic Dentistry. These are the top cosmetic dentists in the country.

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

dental filling disaster

I had never had a cavity until I switched dentists. My insurance changed so we needed to go to a different practice. On my very first appointment, he said I had a cavity, which surprised me. I went ahead and had it filled. The filling caused continual pain even after he adjusted it. It got to the point where he said I’d adjust to it. I waited out the full year with my insurance than switched to one that allowed me to go back to my old dentist.

When I did, he said I likely didn’t even need the filling at all. He said there’d been a spot on my x-ray for years that hadn’t changed. He said he’d replace the filling to make it better. The pain was instantly better, but the filling was uneven I guess and food would get trapped in it.

He decided to adjust that because he said it would become an issue. Since he’s adjusted it I’ve had problems with a serious sensitivity to hot and cold. Now my dentist is talking about extracting the tooth. I don’t want that so I’m afraid to go back. Is there anything I can do?

Betty

Dear Betty,

A blonde woman hodling her left cheek and jaw in pain

It’s unusual for a dentist to fake diagnose a single filling. It’s not a financial gain for him or her. In all honesty, it is more of a hassle. So, I don’t think you were taken for a ride by the new dentist. I’m actually more concerned that your original dentist saw a spot on your x-ray for years and never even mentioned it.

The trouble I’m seeing here is you have two incompetent dentists working on your teeth. The dentist who did your filling couldn’t do it correctly and rather than repair it he said, “You’ll adjust”. That’s dental speak for, “I don’t know what to do.”

When a dental filling is done right, you don’t even notice it.

Then, when you went back to your original dentist, he couldn’t get the filling right either. Now he’s talking about extracting the tooth?! I don’t think so.

My guess is your insurance has a preferred provider list. They do that to keep the fees cheap. But, the better dentists won’t sign on to plans like that. So often (not always) preferred provider means less than adequate dentist.

I’m going to suggest you go to an out of network dentist who has good reviews. You need this fixed. Don’t let your dentist extract your tooth.

The last thing you need after all of this is another expensive procedure and, believe me, tooth replacements cost a pretty penny.

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

porcelain veneers during pregnancy

I’ve been saving up for a smile makeover. I just reached the amount I needed and I found out I was pregnant. Am I able to move forward wtih the porcelain veneers or do I need to wait until after the baby is born?

Melinda

Dear Melinda,

A single porcelain veneer being placed on a tooth

Congratulations on your new little one! While there are so many things you’ll have to protect your new child from, porcelain veneers won’t be one of them.

There are some cosmetic procedures which are not recommended during pregnancy, such as teeth whitening. This is because, especially during the first trimester, when the baby is most vulnerable you don’t want them ingesting any unsafe chemicals.

Fortunately, porcelain veneers do not have anything which could endanger your baby. The only chemical used would be lidocaine which has already been proven safe in pregnancy.

It is up to you at this point. Some women struggle with intense nausea during their first trimester. That may make having your mouth messed with a challenge. Because of that, you may want to wait and see how your body reacts to this new baby first. If you seem to be fine, you can move forward. If not, there is no harm in waiting.

Who Should Do Your Porcelain Veneers?

You don’t want just anyone doing your smile makeover, though. This is a once in a lifetime procedure and you’ll want it done right. Because there isn’t a recognized specialty in cosmetic dentistry, there is no real way to know if the dentist doing your procedure has had enough additional training to do the job well.

In your place, I’d look for a dentist who has attained accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country.

They’ve passed stringent oral and written exams to prove their technical knowledge. Additionally, they had to provide visual evidence on a large number of cases they’ve done to show they are also artistic.

Any one of them can give you a stunning smile.

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

lumineers trouble

I had Lumineers placed on both my top and bottom teeth. The top ones did absolutely fine. It’s the bottom ones I am having trouble with. They’re in massive pain and I’ve already lost one tooth when a root canal didn’t help. My dentist is going to put on a bridge free of charge. He doesn’t know why there is so much pain. He’s trying to help but I’m living on pain killers right now. I don’t want this to be the rest of my life, especially knowing how addictive they are. Can you help? Have you heard of this happening before?

Margie

Dear Margie,

There are a couple of things going on here. First, Lumineers are often advertised to inexperienced cosmetic dentists as being easy to place. That gets many well-intentioned dentists in over their heads.

A lot of this is because the Lumineers’ company promotes them as being no prep. Sometimes that can work out well on top teeth, though not always. Many patients complain about them being bulky. The bottom teeth, however, are a completely different story.

Second, when you’re talking about a no-prep technique, the teeth are about two millimeters longer as well as sticking out a tad. On bottom teeth, this can throw your teeth out of their proper occlusion and cause lots of pain for you.

That is likely what is going on in your case.

Cosmetic Work on Bottom Teeth

When it comes to smile makeovers, unless there is something which needs to change structurally with your bottom teeth, we’ll put porcelain veneers on the top teeth, but only whiten the bottom arch. Though, there are times veneers make sense. In those cases, however, tooth prep is necessary.

It does sound like your dentist is trying to take responsibility and make things right for you. That’s a sign you have an ethical dentist who just happened to do a procedure he wasn’t ready for. Don’t be too hard on him. We all start somewhere with procedures that are new to us. It’s a good sign that he’s stretching himself and adding to his field of knowledge.

Make sure you are out of pain before the bridge is placed. If he’s having trouble with that, you can suggest he talks to an expert cosmetic dentist, who’s studied occlusion as well. I’d look for an AACD accredited dentist in that case. Feel free to show him this post.

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

dentist pushing a cerec crown

I need to a get a dental crown. I’ve always gotten the regular kind so I was expecting that again. Instead, my dentist wants me to get a CEREC crown by a machine. Before I commit, I want to make sure they’re okay. I’d rather have it made by a human, but if they’re okay I guess I’ll go ahead.

Paul

Dear Paul,

Block of porcelain for CEREC crowns

You are fine getting a CEREC crown, with one possible exception which we’ll talk about in a moment. Using the CEREC machine to mill the crown, you will get a great fit. It uses sophisticated software to make sure your crown is precisely cut.

Because they are all-porcelain, they will have the same translucency as your natural teeth. They will look beautiful if your dentist knows how to use the machine well.

Their biggest benefit, though, is you can get your dental crown in just one visit.

The one exception to this would be for front teeth. These are trickier. When your teeth are milled by a CEREC machine it uses a single block of porcelain.

Our natural teeth are not the same level of depth all the way down. Some parts are more opaque than others. Because of this you need a dentist with expertise in color theory and staining in order to mimic the different levels of color needed for front teeth.

Finding a Dentist to Do CEREC Crowns on Front Teeth

Only about 1-2% of dentists will know how to do this correctly. If your crown is needed on another tooth, you should be fine, but with a front tooth, I’d look for an AACD accredited dentist.

Dentists who’ve been accredited with the American Academy of Cosmetic Dentistry have done extensive training. In order to reach accreditation they have to pass oral and written exams as well as demonstrate their artistry .

Any dentist who has reached accreditation can give you a gorgeous crown, even on a front tooth.

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

porcelain veneers & invisalign?

I’m hoping you can help me make a decision. I want to whiten my teeth and I have two crooked front teeth. I was thinking I could fix both getting porcelain veneers. I spoke to my dentist about it and he said that would be fine, but he’d like me to straighten the front teeth first. I was hoping not to have to do orthodontics because they’re so unattractive and take forever. Is it really necessary?

Kathryn

Dear Kathryn,

Invisalign aligner
You can now straighten your teeth invisibly

First, please understand that I haven’t seen your teeth and can only go by your description. Unless there is something your dentist hasn’t explained to you, I’m puzzled why you would need both as well.

Generally, a patient will either do porcelain veneers or orthodontics, not both. There could be an exception if you have either a serious bite problem or overly crowded teeth. In those unusual cases, it would be helpful to have orthodontics first. Other than that, you can just have porcelain veneers placed and it will make your front teeth appear to be straight.

If you are in that position, then I have some helpful news for you. You can completely straighten your teeth without anyone knowing. Invisalign uses clear aligners. You can see an image of one of the aligners above. When you are wearing them, they are completely invisible, even at a conversational distance.

The best part is they have the benefit of being able to whiten your teeth simultaneously. The aligners used to straighten your teeth can also double as teeth whitening trays.

Invisalign or Porcelain Veneers

If you have the choice and all you want to do is whiten and straighten your teeth, you would save a lot of money using Invisalign. However, if there are other things about your smile you want to change, such as the shape or length, then porcelain veneers are the way to go.

These are the go-to for a complete smile makeover. One word of caution. They require technical expertise as well as an artistic eye. Not every dentist can do a smile makeover with porcelain veneers. There are countless cosmetic dentistry horror stories to back this up.

If you decide to go that route, you will want a dentist who has been accredited with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top cosmetic dentists in the country.

If you go the Invisalign/teeth whitening route, just about any family dentist can do it.

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

problems with my porcelain veneers

I need some advice about my porcelain veneers. Things haven’t gone well for me with this. My dentist did ceramic veneers. The first time they came in they were way too white for the adjacent visible teeth (and even for my personal taste). II told him I wanted them to match the other teeth (which we determined was an A2) asked him to redo them and he did. When they came back the second time he bonded them on without me getting to look at them. When I did see them, they were again too white. I’m assuming I’m stuck with that color now and am hoping to get the teeth next to them to match so I don’t feel foolish. My other problem is one of them broke in half horizontally. My dentist is replacing it and said he would do so for 3 years. Should I be worried they won’t last longer than that? I did pay a pretty penny. Would I have been better off getting porcelain veneers? Are they stronger?

Mandy

Dear Mandy,

A single porcelain veneer being placed on a tooth

Let’s start with the longevity and breaking of your porcelain veneers. These are tiny wafers, whether made of porcelain or ceramic. You could easily crush them in your fingers. Their strength comes from the bonding procedure, which your dentist obviously hasn’t mastered.

If you’d approved of the porcelain veneers before he bonded them, then yes, you’d be stuck with that color. The easiest solution to get the adjacent teeth to match is teeth whitening. Fortunately, only your natural tooth structure will whiten. It will have no real effect on your porcelain veneers.

That being said, I don’t think you have to accept the color you’ve been given. He bonded them on without your permission. Informed consent is the cornerstone of any practice–medical or dental. Without that, he committed malpractice. You have the right to a refund.

Getting Your Porcelain Veneers Done Right

When you have this case redone, I want you to have an expert cosmetic dentist do it. This way you will get a smile you’re not just satisfied with but proud of.

A true cosmetic dentist would never place a smile unless you are thrilled with it. Most of them have a beautiful smile guarantee.

Look on the website of the American Academy of Cosmetic Dentistry (aacd.com). They have a link to find a cosmetic dentist. When you do the search, make sure you place a check mark on accredited. You want an accredited cosmetic dentist. These are the ones who can give you the right smile.

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

dentist ruined this man’s bite

I’m worried I made a horrible mistake having a gap closed. I had a large gap between my two front teeth. To fix it, my dentist did six dental crowns. Ever since then, I’ve been in a lot of pain, I can’t speak properly, and my mouth is dry all the time. Can I put the gap back? Would that fix this?

Peter

Dear Peter,

CEREC Crown being placed on a tooth
Sometimes a dentist gets in over their head

Your problem isn’t because the gap was closed. These large gaps can be fixed without any negative repercussions. Instead, I think your porcelain crowns were not done properly. This case was probably too challenging for your dentist. As a result, he has inadvertently damaged your bite.

This is rather serious and needs to be addressed right away. My suspicion is your dentist made your dental crowns too thick, which opened your bite too much. This led to the pain you are experiencing as well as lip incompetence.

When your crowns are too thick, it leads to your mouth staying agape. That will cause the dry mouth you are struggling with. It is absolutely imperative your mouth closes naturally. Without that, you won’t have enough saliva in your mouth. Saliva is a key component in fighting decay because of its bacteria fighting minerals.

Pain is also a result of a bite being opened too far. This can lead to problems with TMJ Disorder. Though, pain is enough of a reason to have this fixed.

Your dentist appears to have been in over his head fixing this gap. I want you to see an AACD accredited cosmetic dentist. They’ll have the expertise you need to fix this. They can also help you secure a refund from your dentist.

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