Category Archives: CEREC

Dentist Said No to CEREC Crowns

My dentist has a CEREC machine. We’ve used it for a crown before, but on a tooth on my bottom arch. Now I need one on my top front tooth and he’s saying “No”. He said they don’t look good on front teeth. I truly liked the convenience. Plus, he wants to crown both front teeth to make them match. Is this legitimate?

Anna

Dear Anna,

Block of porcelain for CEREC crowns

You should be aware that only the top cosmetic dentists in the world can match a single crown to a front tooth. That is even more challenging when it comes to using CEREC. If convenience is what you’re after, go with the two crowns and traditional crowns. I’ll explain why in a moment. If you want gorgeous front teeth with just one crown, you’ll need to find an expert cosmetic dentist.

Matching a Single Crown to a Front Tooth

Your front teeth are right next to each other and much more exposed to the light. Even the slightest deviations will be very noticeable. It will be quite obvious your teeth won’t match.

With even the best dentists, it will take a few try-ins before it matches perfectly. That could go faster with CEREC crowns because it’s milled right there and not sent to a lab. It will still likely take more than one try. This method will take even more skill.

With a CEREC crown, that’s even harder because they are milled from a single block of porcelain. Traditional porcelain crowns use several blocks with variations in opacity. Your dentist would have to be very versed in color theory skills which are not taught in dental school. It’s obvious your dentist doesn’t have that training.

It’s actually showing his integrity that he’s being honest with you. He could have bluffed his way through and given sad looking results.

Finding the Cosmetic Dentist Who Can Do Gorgeous CEREC Crowns

Truthfully, because of the difficulty of this type of case, to get a beautiful, natural looking result which will match your other front tooth, you’ll need to go to a dentist accredited with the American Academy of Cosmetic Dentistry.

AACD accredited dentists have gone through stringent oral and written exams as well as proven their artistry with a large number of cases they’ve done and provided evidence for. All of them have gone through extensive training in advanced cosmetic procedures after graduating dental school.

What it boils down to in this particular case is what’s more important to you— a convenient, fast result, or a natural looking attractive result.

It is definitely your smile and your choice. Don’t feel pressured to go a way you don’t want.

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

Help! Which Crown Should I Get?

I need to get a dental crown on a tooth. My dentist threw all these options at me. While he did explain everything, it was all so fast I can’t remember. I told him I’d let him know this week. I tried to do some research but everything is so confusing. Help!

Lacey

Dear Lacey,

CEREC Crown being placed on a tooth

Sometimes dentists think you can understand everything in 5 minutes that they studied all the way through dental school. Sounds easy, right?

It’s good that you’re doing some research. It’s important to go into these type of decisions informed. One thing to be aware of is that you should always feel free to tell your dentist to slow down and to repeat himself if necessary. You should never feel rushed.

To help, I’ll go over the three most common types of dental crowns.

Three Most Common Dental Crowns

The first has been in place for many years and it’s been a staple in the dental diet. These are conventional crowns, also known as porcelain-fused-to-metal crowns. As their name implies, these have porcelain on top and a metal base underneath. These are best used for back teeth because of the amount of biting force we use with our back teeth. If you have a metal allergy, there are metal-free options.

The second type is all-porcelain crowns. These have porcelain all the way through, even as it’s underside. These are especially useful for front teeth because they look more natural than their metal-based counterparts. With front teeth, there is a completely different biting force and these can withstand the pressure.

Thirdly, there are CEREC crowns. These are also all-porcelain. The biggest differences are they are milled by machine using a single block of porcelain. As a result, they’re able to be done in just one appointment. Be aware, unless you have a highly skilled cosmetic dentist, these won’t have the same subtleties that the non-machine milled crowns will have which are made from several different blocks that have different shades.

There’s really not a horrible choice, though I never recommend metal-based crowns on front teeth. You won’t like the results. I hope this helps.

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

CEREC Crowns and Thyroid Issues

I have severe thyroid issues and find it important to make sure my dental work is metal free, as well as containing no lithium. I’m considering CEREC crown. I asked my dentist about these issues and he said my information is false and there’s no point in even answering the question. This annoyed me and made me wonder if it was safe for me to get one. Do you have information for me?

Alyssa

Dear Alyssa,

Block of porcelain for CEREC crowns

Before we start, I’m going to let you know this isn’t the best dentist for you. While I won’t say you’ll need a holistic dentist, you will need a dentist who will be willing to care about your concerns. This one obviously doesn’t.

CEREC Crowns are Metal-Free

Because CEREC crowns are milled from a single block of porcelain, you don’t have to worry about a metal base. Though you can get all-porcelain crowns even with traditional crowns, there are also some that have a metal base, so if you ever get a traditional crown, make sure to specify you want an all-porcelain crown.

CEREC Crowns can be Lithium Free

Dentists have quite a few options in the types of tooth-colored materials available in block form. Only one of them is lithium disilicate-based. There haven’t been any studies to date on this lithium with the thyroid. The lithium which is under scrutiny for leading to hypothyroidism is the lithium prescribed to bipolar patients.

However, for your own peace of mind, it’s best if you let your dentist know of your concerns ahead of time. It’s simple enough for him to avoid that one type for your sake. Just give him a head’s up.

Dentists should factor in the concerns of their patients. Though many try to assume they know more because “they’re the professional who has the dental degree”, it’s your body. No one knows your body better than you do.

Additionally, neither dentists nor doctors have accumulated the sum of all knowledge and understanding when it comes to medical care. We’re still developing knowledge. Therefore, if a patient feels a type of material has a negative impact on them, we should listen.

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

Are CEREC Crowns Better for Anxious Patients?

I have never been crazy about going to the dentist. I had a toothache and decided to go in because it means something is wrong. It turns out I have a large cavity. Now I have to have a dental crown. I’m really nervous about this. What can I expect?

Belinda

Dear Belinda,

A tooth receiving a CEREC crown

It’s good that you went in. The fact that you did despite your dental anxiety means you are courageous. If you’d allowed your fear to get the better of you, you would have ended up with a dental infection. That would have meant an additional procedure of a root canal treatment. Or, possibly your tooth would not be able to be saved and you’d need to have it extracted and replaced. To get a great replacement, like a dental implant, requires surgery. Obviously, you made the right decision.

What to expect depends on the type of dental crown you’re getting. Did your dentist mention whether you’re getting a traditional crown or a CEREC crown?

What to Expect with a Traditional Crown

If you’re getting a traditional crown, it takes two visits. First, your dentist will have to remove any decay as well as grind down enough tooth structure to make room for the dental crown. You can see how small your natural tooth has to be in the image above. After that, your dentist will make an impression of your teeth and fit you with a temporary crown. The impression will be sent to the lab to make your permanent crown.

It takes a couple of weeks for the permanent crown to be made and sent to your dental office. Then your dentist will call you, fit you with the permanent crown and bond it on.

What to Expect with a CEREC Crown

Given your anxiety, this will be a better option for you. First, they can be done in just one appointment. That minimizes how often you have to come in. Second, many patients hate having to do impressions. The goo is messy and bad tasting. With CEREC crowns, you just have a digital image made and a computer designs the crown. Not only is this less nerve-racking, but it’s also faster and more accurate.

While you’re at the office, the computer will mill the crown immediately and your dentist can then bond it on before you leave.

This is a must simpler procedure. Plus, if you’re still nervous, it’s very compatible with a sedation such as nitrous oxide which can relax you.

A Front Tooth Requires an Expert Cosmetic Dentist

You didn’t mention which tooth is being crowned. If it’s a front tooth, there’s an additional consideration. It’s very challenging to match a single crown to a front tooth. You will need to find a dentist with both technical expertise and artistry.

In your place, I’d look for a dentist who has reached accreditation with the American Academy of Cosmetic Dentistry. Simply go to aacd.com and look for an AACD accredited dentist in your area. They can give you a beautiful crown that blends in perfectly with your other front tooth.

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

Which Dentists Do CEREC Crowns on Front Teeth?

I keep hearing no CEREC crowns on front teeth, but surely there have to be dentists who do it. Is there a way to go about finding those dentists?

May

Dear May,

Machine for CEREC Crowns
Can you get beautiful crowns from a CEREC machine?

Great question! You can certainly find a dentist who will give you a CEREC crown on your front teeth, but what you want is a dentist who can do it well. The first thing you need to look for is a top-notch cosmetic dentist. The best of the best are dentists who’ve reached accreditation level with the American Academy of Cosmetic Dentistry. AACD accredited dentists are among the top 1% of dentists in the country.

If it’s milled by machine, why does the dentist need to be so artistic? Another great question. It’s specifically because they’re milled by machine. Until recently, CEREC machines would only mill from a single block of porcelain. There are new machines which can mill with gradients. But, many dentists just finished investing in the older CEREC machines and aren’t able to scrap it for the new one. They don’t come cheap.

That doesn’t mean they can’t create you a gorgeous crown. With expertise in color theory, they can create the gradient with the way they color the tooth. But again, only the best of the best can do that.

Consideration When Getting Crowns on Front Teeth

When you’re talking about the most visible part of your smile, you want it to be as beautiful as possible. Once the crown is created, the color on it cannot be changed. You not only want the tooth to look natural and beautiful, but to match the surrounding teeth as well.

So, if your teeth are in need of a little brightening, the time to do it is before your crown is created. Teeth whitening is a quick and easy way to give your smile a boost. If you want, you can even do it in just one appointment using in-office Zoom Whitening.

Once you have the color you’re pleased with, your dentist can match the CEREC crown to it exactly.

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

Pain with CEREC Crown

I had three crowns put on back teeth. I’ve had one other crown in the past without issue. This is the first time I’ve gotten CEREC crowns. Every time I bite down it’s a nightmare. I feel as if a knife is going through my jaw. Is it because it’s CEREC crowns or something else?

Olivia

Dear Olivia,

A tooth receiving a CEREC crown

I don’t think it’s the fact you received CEREC crowns this time which is causing the problem. When there is a pain on biting with dental crowns, whether traditional or CEREC, there is usually one of two causes.

Do You Have a Lingering Infection?

People often get dental crowns because of a tooth infection and root canal treatment. There are many canals in our teeth and some of them do a pretty good job of hiding from the dentist, even when they do everything right in the procedure. If he or she missed a canal it would explain the pain. You can have an x-ray done to see if there is still some ick left.

Your CEREC Crown Could be Seated too High

Because the pain is when you’re biting down, it leads me to believe the crown may be seated too high. Generally, when we bite down the force is absorbed by all of our teeth. But, if your crown is seated higher than your other teeth, it’s taking on the full force of your bite, which would cause quite a “zing” of pain. If that’s the case, a simple adjustment by your dentist should do the trick.

When NOT to get a CEREC Crown

CEREC crowns are wonderful. They generally have a better chance of fitting perfectly because they’re milled by computer. They’re also incredibly convenient because you get it the same day and don’t need to bother with a temporary crown and second appointment. All that being said, there is one time I do not recommend a CEREC crown. Instead, you’d need the traditional all-porcelain crowns.

CEREC crowns are milled out of a single block of porcelain. That limits the variation and subtle color changes you’d normally be able to achieve when getting a traditional all-porcelain crown. On back teeth, that’s no big deal, but when you’re talking about your front teeth that’s a totally different story.

Your front teeth are exposed when you smile and the light hits them which reveals their secrets even more. You’ll want a skilled cosmetic dentist to make sure you get a crown crafted with all the color and translucency changes you’d get with your natural teeth so they blend in beautifully.

This blog is brought to you by AACD accredited dentist Dr. Mike Malone.

Do CEREC Crowns Break Easily?

I’ve had crowns before and have never had any problems. My previous crowns were with a different dentist and were always the result of an infection gone mad which required a root canal treatment. This time, I decided to try to get treatment before an infection developed. Unfortunately, the new dentist said the cavity is too large for a traditional filling and will still need a crown (well, at least I don’t also need a root canal). It’s a step up. He told me he could give me a CEREC crown in just one day. I liked the idea of not missing more work and agreed, but after just two weeks it broke. I called the office and he offered to replace it for free. I’m hesitant to do so if it will just break again. Are CERECs weaker than other crowns?

Olivia

Dear Olivia,

Machine for CEREC Crowns
CEREC Crowns are Milled by Computer

CEREC crowns are just as strong as traditional crowns. What happened in your situation is incredibly unusual. As you’ve had several crowns before, did you notice anything which felt unusual about this one? Maybe your crown hit your teeth before the rest of your teeth or possibly tooth pain when you bit down? I could see a crown breaking if it sat way too high, but even then it would take some flaws in the materials for it to break that soon after it was placed.

In general CEREC crowns have less of a chance of having a problem because they’re designed by a sophisticated software program and milled by machine. They should fit perfectly. You didn’t mention pain, which again makes me wonder about something being off with the materials.

Redoing Your CEREC Crown

Going forward, I’d give your dentist an opportunity to fix this. It’s so unusual for this to happen so I doubt it would again. If it does, the dentist would be the problem. If you happen to look up your dentist’s reviews and see this is a regular thing, then my suggestion would be to find another dentist. It probably wouldn’t matter what type of crown he gave you.

In that case, you may want to see an emergency dentist in your area. They can help you get a crown and get you back on your way. You won’t want to wait too long because your teeth will shift into the open space left by the broken crown.

I’m NOT saying this is what happened, but be careful about dentists whose prices are significantly lower than other dentists in the area. There is a huge difference between an affordable dentist and a cheap dentist. Our area was hit hard economically, so it’s tempting for patients to go for the cheapest. It’s also tempting for some (less ethical) dentists to draw in patients by lowering their prices, then buying subpar materials which helps them make up their profits.

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

Can a CEREC Crown Look Natural?

I’ve had a CEREC crown before, but only on a bottom tooth which wasn’t very visible. I didn’t really care what it looked like. Now I’ve got a front tooth which needs a crown. I like the convenience of a CEREC crown, but want something that looks natural and will match the adjacent tooth very well. Can a CEREC crown do that?

Anthony

Dear Antony,

A tooth receiving a CEREC crown
Which is better for a Front Tooth a CEREC or Traditional Crown?

So, this is a mixed bag. CEREC crowns are great and Dr. Malone does them as well. They’re made of all-porcelain. While porcelain looks very natural and does a great job mimicking natural tooth structure. However, a CEREC crown is milled out of a single block of porcelain. That won’t have the same subtleties as a traditional crown which can be milled from various blocks which, with the right dentist can make it look exactly like the tooth it’s replacing.

If you’re talking about one of your two center front teeth, then I’d go with a traditional crown. A front tooth further back you could get away with using a CEREC crown. It’s still porcelain and the convenience of one appointment is generally worth it.

Teeth Whitening and CEREC Crowns

If you’re planning on getting any kind of dental crown on your front tooth you may want to consider whitening your teeth first. Once the crowns are made, the color can’t be changed. If you’re perfectly happy with the color of your teeth, there’s no need to do anything. But, if you’ve considered getting them whitened doing it before the crown is made saves you money.

It’s also okay if you want to do it, but just not now. In the future, you can get them whitened. You’ll just want to change the crown after you do. It’s completely up to you when and even if you do it. I just wanted to let you know in case this could save you money in the long run.

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

Can’t Get CEREC Crowns from My Dentist

I’m so sick of temporary crowns that fall off all the time. Every time I’ve gotten a crown it’s been a disaster from the get-go. I get a temporary and it falls off at every meal. It’s impossible to deal with. Now I find out I need another crown. I told my dentist I want a CEREC crown so I don’t have to deal with a temporary. He insists they’re not as good. I’m seriously considering switching dentists over this. What do you think?

Fanny,

Dear Fanny,
A tooth receiving a CEREC crown

I can understand your frustration. While temporary crowns do occasionally fall out (after all, they’re meant to be temporary) what you’ve experienced is way beyond normal. It says a bit about the skill of your dentist. I wouldn’t normally suggest switching dentists simply because you want a one-day crown, but it seems like your dentist lacks skill.

I’m not sure why he means they’re not as good. They’re just as strong as their traditional counterparts. The biggest difference and the only weakness I can see in comparison is CEREC crowns are milled out of a single block of porcelain. Some dentists feel that for your very front teeth it would look better for you to have a traditionally made crown so the dentist can craft it from several blocks of porcelain giving it more natural variety.

Cerec Crowns and Teeth Whitening

One other thing to consider. Hopefully, your dentist told you that once crowns are milled, their color is permanent. If you want your teeth whitened, you should do it before getting this latest crown if it is in a visible part of your smile.

That way your dentist will match your crown to the new color. Of course, if any of your old crowns are visible, those will need to be re-done to match. If they’re on back teeth which don’t show while you smile, I wouldn’t bother changing them though.

Picking a New Dentist

If you do decide to switch dentists over this issue. May I suggest you consider every type of procedure you may want, even future. If it’s just a good general dentist you want, who keeps up with the latest technology, that won’t be too hard to find.

If, however, you have more cosmetic interests in your future you’ll want to find a highly skilled cosmetic dentist. If they keep up with the advances in cosmetic work, you can be almost positive they keep up with the general side as well. So, how do you find an expert cosmetic dentist in your area? I’d check the American Academy of Cosmetic Dentistry’s website. You’ll want to be certain to get a dentist who’s reached accreditation level.

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

Do CEREC Crowns Last Longer than Regular Crowns?

My dentist told me I need three crowns. I was shocked because my last checkup didn’t show any decay. He wants me to get CEREC crowns. I like the fact that they can be done in one appointment. But, my insurance only covers the older crowns. Is it worth the extra cost? Do they last longer than the regular crowns?

Elliot

Dear Elliot

Machine for CEREC Crowns
CEREC Crowns are Milled by Computer

When you’re talking about the longevity of crowns, it’s not as much whether you use CEREC or traditional. The length of time any crown lasts, regardless of the kind, depends on two factors—the skill of the dentist and the habits of the patient.

On the patient end, it’s important you keep up with your home care. Regular brushing and flossing are a must. The dentist has several responsibilities. They have to choose the right materials. They have to know the proper techniques for attaching the crown. Traditional crowns are cemented. CEREC crowns are bonded, which is a completely different (and more involved) technique.

Two dentists can make the same crown. One will last five years; the other will last ten. It wasn’t a difference between the type of crown as much as the skill of the dentist. Don’t hesitate to ask your dentist how long his crowns typically last.

The Differences Between CEREC and Traditional Crowns

There are two advantages to CEREC crowns. The most obvious one is you can have all three of your crowns completed in one visit. Second, they’re milled by a computer which generally helps with their fit. They’re actually great for side teeth. Some cosmetic dentists don’t like placing them on front teeth because they’re milled from a single block of porcelain. In that case, they feel they can craft them better traditionally.

Another weakness for CEREC crowns AND traditional all-porcelain crowns are on back teeth. They can’t always hold up to the pressure of the biting forces your molars have to take. In that case, you’d want either a metal-based crown or a zirconia crown if you have any metal sensitivities.

No matter what crown you choose. Once the crown is made, the color is permanent, so if you’ve been considering teeth whitening be sure to do it before you get your crowns if they’re in a visible place. If they’re all back teeth, that won’t matter. You can get your crowns and then whiten later.

Consider a Second Opinion

One thing you said bothered me. You mentioned your last checkup showed no signs of decay and suddenly you need three crowns. That sounds just a bit hinky to me. While it’s possible that you could have decay that spread quickly, if you get regular cleanings there should have been some sign of decay.

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