Tag Archives: Lafayette CEREC crowns

Dental crown looks fake

I’ve had dental crowns before but they’ve always been on back teeth. This is my first one on a front tooth. My dentist did a CEREC crown which was very convenient. I liked that, but for some reason it looks really fake compared to the tooth next to it. It almsot has a painted, dull appearance. Is this typical of crowns? Is there a way to get them to look natural?

Dana

Dear Dana,

CEREC Crown being placed on a tooth
Whether or Not a Crown Looks Natural Depends on Two Things

A crown on a front tooth can look natural and blend in naturally. Whether or not that happens depends on two things:

  • The cosmetic skill of the dentist
  • The materials used

Getting a Beautiful Dental CEREC Crown

CEREC crowns are made of all-porcelain, which is great. Porcelain mimics the appearance of natural teeth by reflecting light. When you get traditional porcelain veneers, they are milled from several different blocks of porcelain.

Our natural teeth aren’t the same all the way down. If you look closely at your front teeth the bottom parts of your upper front teeth are more translucent than the middle parts of your teeth.

Even though it still requires an expert cosmetic dentist to place a dental crown on your front teeth, traditional all porcelain crowns are a little easier simply because they’re milled from several block of porcelain making it easier to get the different levels of opacity versus translucency.

With CEREC crowns, this is more challenging. They are milled from a single block of porcelain. That makes it harder to show the subtle differences in color. Dentists have to be very familiar with color theory and stains to get a front CEREC crown to look natural.

Without that, you end up with a flat looking front tooth as you’re experiencing.

Which Dentists Can Place a Crown on a Front Tooth?

Front teeth are more exposed, making it imperative the dentist has the right skills to match and blend the crown with the adjacent teeth exactly. In your place, I’d only use an AACD accredited cosmetic dentist. Dentists who’ve reached accreditation are the top cosmetic dentists in the world. You can go to aacd.com to find one in a reasonable distance to you.

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

3 Unexpected facts about CEREC crowns

If you’re considering same day crowns, that’s great. They’re useful and convenient. Here are three things your dentist may not have told you yet.

Block of porcelain for CEREC crowns

They are Not Billed Any Differently

When dentists bill your insurance, they use codes. The codes for crowns, whether you are using traditional crowns or same-day crowns, they’re billed by the material used, not the brand.

While your dentist spent a small fortune on the machine, he is making up on lab fees by having it milled right in the office. This means you shouldn’t have to pay more for a CEREC crown than a traditional crown.

Only the BEST Cosmetic Dentists Can Place Them on Front Teeth

Because they’re milled from a single block of porcelain, they don’t have all the subtleties your natural teeth have. A dentist has to be very versed in color theory and have exceptional skills.

If your dentist is recommending a CEREC crown on an anterior (front) tooth, you need to check their qualifications. Ask to see samples of CEREC work they’ve done on front teeth.

If it’s important to you to have the crown done on the same day, you’ll want to take the precaution of going to a dentist who has achieved accreditation with the American Academy of Cosmetic Dentistry. AACD accredited dentists are the top of their field.

They Don’t Whiten

Often patients decide they want their teeth whiter at a certain point. However, the color made on your dental crowns (CEREC or traditional) is meant to be permanent.

The whitening gel used even in professional teeth whitening only works on natural tooth structure. It saves you money in the long run to whiten your teeth beforeĀ having your dental crown made. This way when the dentist does do it, you’ll have it match the color you’ll be proud of.

It’s not required, of course. You can whiten later. It just means you’ll have to have your crown re-made to match.

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

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.

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.

CEREC vs. Traditional Crowns

I’m considering getting a CEREC crown. Are they as good as their traditional counterparts?

Matt.

Dear Matt,

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

In one corner we have traditional porcelain crowns. Tried. True. Proven. Strong. Beautiful (with the right dentist). Though, they do take a couple of appointments. They’re milled from more than one block of porcelain.

In the other corner are the CEREC crowns. Tried. True. Proven. Strong. Beautiful (with the right dentist). Made in one appointment. Though, they’re milled from one solid block of porcelain.

Each time I type “Though”, I’m showing the downside of that particular type of crown. While two appointments aren’t horrible, it is definitely more convenient to have it done in one. You miss less work. You use less time. You have your permanent crown from the beginning. So, it would seem that the CEREC crown would be the better bargain. After all, the other features seem to be the same.

So, what’s the big deal about the “Though” for CEREC crowns? Why does it matter if you mill a crown from one block of porcelain or more than one block?

The difference comes from a cosmetic standpoint. Your teeth aren’t of identical translucency from top to bottom. The edges, especially at the bottom, are less opaque than the rest of the tooth. It seems to “thin out” a bit as you move down. There’s also a whiter color in the center than you’d find as you move down.

When you mill from a single block of porcelain, the crown will seem the same from top to bottom. They can look a little flatter because there aren’t those subtle varieties.

When a dentist can draw from more than one block and craft them together, you get the subtleties that reflect light a smidge better in natural teeth.

When to NOT Get CEREC Crowns

In most cases, CEREC crowns are fantastic. They’ll still look beautiful. They’ll still match your teeth. They’ll still hold up to the stresses of daily use. The one exception is on a very front tooth. If you’re getting a crown on one of your very visible front teeth, that’s when I would opt for a traditional crown. This will allow the dentist to use his artistry and make sure every subtle variety of light and color comes through.

Other than in that case, you will get a gorgeous crown with CEREC AND save yourself an additional appointment.

One word of caution. No matter which you decide on, once the crown is completed and bonded on, the color cannot be changed. If you’re going to get your teeth whitened, do it before getting your crown designed.

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.