All posts by goodtooth

Cosmetic Dentistry, Emergency Dentist

Is This Crack in my Crown an Emergency?

Hi,

When I got several porcelain crowns placed on my  front teeth, one of them had a defect that the others did not. There has always been this horizontal line towards the bottom of one of my crowns; it’s difficult to see unless you’re looking for it, so it never bothered me before. However, now I can see the fracture line clearly and I can feel it when I run my tongue over it. I’m afraid of it breaking while I’m talking. I’ve had the crowns for over fifteen years, so I’m open to replacing them. Do I need to be seen immediately at an emergency dentist? Or can this wait until my general dentist can see me?

Ross, from Calvin, North Dakota

 

Hi Ross,

This sounds like a cosmetic emergency, but unless you’re in pain or have lost the crown, you don’t necessarily need to see an emergency dentist for this problem. However, instead of going to your general dentist, you should go see a cosmetic dentist. An expert cosmetic dentist can replace the crown. You should try to do this before it breaks completely, because it most likely will in the future. If this happens, you should see an emergency dentist for a temporary crown.

Porcelain crowns often have horizontal “craze” lines, and they are usually undetectable and nothing to worry about. However, since you can now feel the defect, it means your crown has shifted and is in need of replacing.

Depending on the cosmetic dentist you see, they may recommend replacing all of your porcelain crowns due to their age. There is no rush to do this if there are no problems with your crowns. Be aware that it is difficult to color-match a new crown to the older ones unless you go see an expert ceramist.

This blog post is brought to you Gilbert emergency dentist, Dr. Matthew Roper. Please note that cosmetic dentistry is not a specialty recognized by the ADA, but dentists like Dr. Roper have received additional post-graduate training in restorative dentistry, and have the experience to help their patients with their aesthetic concerns.

CEREC crowns

Is My CEREC Crown Causing My Sensitivity?

Hi,

My dentist recommended a CEREC crown to replace one of my teeth. This tooth has had issues to sensitivity to hot and cold, and I thought getting a crown would solve this problem. My dentist did not think I needed a root canal. However, after getting my CEREC crown, I’m still having a lot of sensitivity and discomfort. My dentist said to wait a month or so my mouth to get used to the crown. In the meantime, I’ve experienced sharp, throbbing jaw pain. I have had to medicate it with pain killers for a few weeks. I’ve had the crown for over a month, but it feels nothing like the other porcelain crowns I have. Am I correct in thinking the CEREC crown the source of my pain?  And what should I do?

Thank you,

Magnus, from Alberta, Canada

 

Hi Magnus,

Your issue is not likely caused by the CEREC crown, but rather the tooth itself. Tooth sensitivity to hot and cold is caused by irritation, and getting a crown can cause more irritation. Other options instead of a crown would include removing any current fillings or decay, and then filled the tooth with a bonding material to create a new core. If the new core did not reduce or eliminate the pain, then an x-ray and root canal may be needed.

CEREC crowns are more likely to fit better than traditional porcelain crowns, as they are milled by a computer based on a digital scan of your mouth. However, any crown you put over a sensitive tooth is unlikely to stop the issue.

When a tooth is infected, it will often feel worse before it feels better. If it suddenly starts to feel better, that means the pulp inside of your tooth has died, and a root canal is needed to clear it out.

Your best option is to get a second opinion about whether you need a root canal. You don’t need to go back to your same dentist who made the crown.

This blog is brought to you by Gilbert CEREC provider, Dr. Matthew Roper, of Vistadorada Dental.

Sedation Dentistry

Can You Get Sick from Dental Sedation?

Hi,

I started seeing a gentle dentist for my dental anxiety. Sedation is supposed to calm your nerves, but I’m worried about getting it at my upcoming dentist’s appointment. I’ve heard it causes nausea, and the painkillers you get afterwards can cause drowsiness. Those two side-effects mixed together is a recipe for disaster. I’ve never had any adverse reactions to medications before, but I’m still worried. Is choking on your own vomit a risk after dental sedation? Or am I overthinking this?

Samira, Sterling, Colorado

 

Hi there Samira,

There are different levels of sedation and medication a dentist can provide.

The first is nitrous oxide, Also known as laughing gas. This is the sedation of choice for gentle dentists, because it works fast and wears off quickly afterwards, before you even leave the office. You may experience some nausea afterwards, but not necessarily vomiting. Most procedures using nitrous are relatively short, but the longer you are under sedation, however, the amount of nausea you may experience increases. To reduce this risk, don’t eat before your appointment.

The second is oral conscious sedation (OCS): This method uses nitrous oxide and an oral medication (like a sedative, anti-anxiety medication, or anti-histamine) prescribed by your dentist. The type of medication prescribed will depend on your dentist’s personal preference and which one best suits your needs; for instance, at Dr. Roper’s office, he prescribes Triazolam, a safe method of oral sedation.

It’s also recommended you have someone take you to your appointment and check in with you for a few hours after the appointment. Again, to combat nausea, your dentist will schedule you for a morning appointment, and instruct you to not eat the night before or morning of your appointment. Even with this stronger sedation, no cases of asphyxiation during sleep have occurred, so please do not worry.

In summation, nausea is a common side-effect of sedation, but vomiting is not. Talk to your doctor about your fears, and they should be able to give you advice on how to minimize your experience with side-effects.

This blog post is brought to you by Gilbert sedation dentist, Dr. Matthew Roper.

CEREC crowns

My CEREC Crown Doesn’t Feel Right

Hello,
I recently broke one of my crowns. I wanted to get it replaced ASAP, so I opted for a same-day CEREC crown.

My new CEREC crown feels too thick and doesn’t fit right.  Even after my dentist filed it down, it still isn’t fitting properly. None of my other crowns ever felt like this. I don’t think it’s going to get any better. I thought CEREC was the way to go, but now I’m regretting getting one. Is my crown salvageable? Or should I scrap it?

Thank you,

-Adrian, Tallahassee, Florida

Hi Adrian,

Thank you for your message. Unfortunately, it sounds like your dentist just wasn’t that comfortable using the CEREC software; if they had been, your problem should have been avoided. CEREC crowns are made using a high-tech machine. This machine’s software scans the tooth prior to milling the crown from ceramic. The result is a strong, long-lasting ceramic crown, so it’s disappointing to hear you had such a bad experience.

Even without using your previous crown or original tooth as a baseline, your dentist should have been able to properly guide the machine to create a crown contoured to your gums. If the crown doesn’t fit right at the gum line, food can get trapped underneath it, and that can lead to gum disease.

Crowns are designed to fit so seamlessly in your gums that you would not notice them. Ill-fitting crowns can cause you to bite your lip, cheeks, or tongue, especially while you sleep. Aside from being painful and annoying, this biting and chewing could lead to the growth of a tumor.

I’m glad you tried to take care of this problem, as it can become more serious. However, now that the crown is cemented in your mouth, it is likely too late to salvage it. Your best bet is to ask your dentist to remove the crown. If you want another CEREC crown, find a more experienced cosmetic dentist. Otherwise, have your dentist send the crown to a dental lab to be remade. A new, properly-fitting crown will feel so much better than what you have now.

This blog post is brought to you by Gilbert CEREC crown provider, Dr. Matthew Roper.

Emergency Dentist

Emergency Dentist Won’t Fix Crown

Several months ago, I had a crown placed. Shortly after, approximately 3-4 months, a portion of the porcelain broke completely off. Not only was I bothered that the piece fell off so soon after the crown was placed, but it has been bothering me ever since. I returned to the dentist a few times for adjustments, but nothing really improved the issue.

I still need to address the problem, but have zero interest in returning to the same dentist. It is causing me pain and discomfort, so I sought out an emergency dentist who saw me quickly. Unfortunately, the dentist would not correct the current crown issues, stating that, instead, it needed to be completely replaced.

A new crown is not in my budget, especially since the crown should not have broken. Do you have any suggestions?

Thanks,
Mike

Dear Mike,

It is understandable that you are frustrated after experiencing these issues. However, it is important to understand that different dentists have different opinions when it comes to treatments and ways to address issues.

You mentioned your crown was broken. It’s possible that there is no way to save the crown and a new one needs placed. If this is the case, it would be good to return to the dentist who originally placed it, to at least attempt treatment, as it would cost less for you.

Dentists have varying opinions on the length of time a treatment should last. For example, a crown should last at least five years. If a repair to the crown is needed, or a crown needs replaced, the dentist should not charge the patient, or at minimum, charge a reduced fee. You should expect that your dentist will stand behind his or her work.

This blog is sponsored by the office of Gilbert emergency dentist, Dr. Matthew Roper.

 

Affordable Dentistry

Finding a Trustworthy Affordable Dentist

I’ve had a cavity for quite some time. I knew I needed to visit a dentist and address it, but I couldn’t afford the expense. Within a matter of a few weeks, the tooth in which the cavity had developed began to cause me pain. So I started to look for a dentist that could help me. A crown was going to cost more money than I had, so I focused my search on a dentist who was affordable.

I landed on a dentist who was going to charge over $100 less than the others I’d consulted. That is a huge savings to me, so I moved forward with the appointment.

After examining my mouth, the dentist told me that my needs were greater than the amount he’d originally quoted me and that I needed a crown.

I feel like he lured me in with his low pricing in an unethical manner. Seeking a second opinion is what I should do, I know. However, I can’t afford the extra cost I will incur with another appointment if what this dentist is suggesting I need is accurate. I have no idea if he is being honest and sincere in his diagnosis. Is there a way I can tell without incurring the costs of another dentist?

Thank you,
Julie

Dear Julie,

Your budget constraints are understandable. However, when you approach the search by looking for the cheapest dental provider, you’re bound to run into some problems. A dentist who promotes him or herself by their cheap rates is a red flag. There are certainly ways to land on a quality dentist without breaking the bank if you keep a few points in mind.

Finding an Affordable Dentist

One of the first approaches to finding a quality affordable dentist to to look for someone who will customize your treatment plan. Seek out a dentist who will listen to you and your budgetary needs, in addition to your dental needs. Many times, there are multiple solutions at different price points.

Another option is to consider a dentist who offers payment plans. Typically, you won’t find an office who will offer an in-house payment plan, but many offices accept CareCredit. CareCredit is a payment service which usually has no finance charges for a specific period of time.

A dental office that offers discounts is also an option to consider. If you aren’t working with insurance and plan to pay for your services on your own, some offices will provide discounts for patients who are paying in cash up-front.

Seek a Second Opinion From a Trustworthy Dentist

Often times, when we have a gut instinct, it is right. You will likely kick yourself if you move forward with this treatment plan, without seeking a second opinion. One option for saving on the second appointment is to ask the original dentist for a copy of the x-ray to take with you to the next dentist.

It is important to find a dentist whom you trust. Ask questions, visit the office, read reviews. If you genuinely trust the provider, you won’t question the care you are receiving. You’ll be confident that you are being given the best care, and that they dentist is doing everything they can to give you quality service and treatment, and also keeping their work within your budget.

This article is sponsored by the office of Gilbert affordable dentist, Dr. Matthew Roper.

CEREC crowns

What is a cerec crown?

If you are in need of a crown, but haven’t considered a CEREC crown, or are unsure of what they are, it’s important to take time to understand the science behind them, and why they are exceptional.

What is a CEREC Crown?

Many dental offices have technology which enables them to provide “computer-assisted design-computer-assisted manufacture”, or CAD-CAM crowns. CEREC is the company that is most known for this technology. This type of crown is created by a computer to perfectly fit your tooth, which prevents the need for the lab involvement in manufacturing the crown.

This technology allows the all-ceramic crown to be made while you wait, thus there is no need for a second appointment or temporary crown.

Facts About CEREC Crowns

  1. No single brand of same-day crowns. Though many people ask for same-day crowns by asking for CEREC crowns, this is an brand of same-day crowns, similar to Zoom Whitening, which is a brand of teeth whitening, but there is not a single brand of teeth whitening. CEREC means “Chairside Economical Restoration of Esthetic Ceramics”, but is not the only brand of same-day crowns. Often, the brand will use the phrase “same-day crowns”, or “crowns-in-day,” but these phrases are part of the marketing for the brand. However, the overall idea is the same with all restorations which take place in one dental visit. The office uses CAD/CAM technology to create it.
  2. CEREC crowns are billed the same as traditional crowns. Many people think the CEREC crown costs more than a traditional one. However, the opposite is true. For billing purposes, all dental procedures have billing codes. The billing code is the same for a CEREC crown and a traditional crown, therefore they cannot be billed any differently.
  3. They’re high-tech. CAD/CAM means a computer assists in the design. The program takes a picture of your mouth and plots out every detail. The measurements are exact. Then, the crowns are carved out by a machine in the office, with each new tooth starting out as a piece of material, oftentimes composite, zirconia, ceramic, or acrylic polymer, which is the same base for traditional crowns.

When operated and placed by an experienced cosmetic dentist, CAD/CAM crowns are a quick and efficient way to improve your smile, while maintaining a natural look and feel.

This article is provided by the office of Gilbert CEREC Crown provider, Dr. Matthew Roper.\


Sedation Dentistry

Do i have to see an oral surgeon for my tooth extraction?

I have a strong apprehension to dentist offices. Therefore, I have not maintained a practice of attending regular dental check-ups. Then, a few years ago I lost a filling. I put off taking care of this and later that tooth broke. I prolonged having this looked at until the pain from the broken tooth became too much to bear.

When I finally saw the dentist, I learned that I needed a root canal. Following the root canal, the dentist did not follow up with me. However, because the pain had decreased for the most part, I did not follow-up either. I also did not have a cap put on the temporary filling. Therefore the temporary filling later fell out and an infection developed.

When I saw a different dentist about this, I learned the remaining part of the tooth needed extracted. In addition, because of the tooth’s poor condition, it was going to be quite invasive, involving the gums down to the bone. The dentist recommended I see an oral surgeon for the procedure and be under anesthesia. This is not something I can afford. Is an oral surgeon my only option, or can a general dentist conduct the procedure?

Thank you,
Jessica

Dear Jessica,

Your dilemma is an understandable one. First, it is important that you understand the reasons to see an oral surgeon for a procedure like this one. It would also be a good idea for you to develop questions to ask your dentist, to help you determine if an oral surgeon is the best route for you, even considering the cost.

Reasons to See an Oral Surgeon for Tooth Extraction

It could be that the dentist you say is not comfortable doing such an invasive extraction. He may be suggesting you seek out an oral surgeon to prevent himself from getting into trouble by taking on a procedure like this if it is outside his realm of experience.

Secondly, the procedure may be a traumatic experience for you, the patient. Therefore, he is suggesting seeing an oral surgeon in order for you to be under anesthesia, in order for the procedure to be easier on you.

Dental Anxiety Can Be Costly

As you are learning, the anxiety that sometimes accompanies dental visits and procedures can be quite expensive. If you had immediately replaced your filling after it fell out, there would not have been a need for the root canal you had. In addition, if the dental crown would have been placed quickly following the root canal, the tooth would not have needed extracted. And, if the tooth does get extracted, you may later need it replaced in order to keep your bite from collapsing.

Therefore, the idea of moving forward with the extraction procedure being done by an oral surgeon will prevent you from having a traumatic experience, which would just further amplify your dental anxiety and cause future dental issues for yourself.

Questions to Ask Dentist About Tooth Extraction

It is important to develop specific questions for your dentist, in order to help yourself better answer your question. Try asking how comfortable your dentist feels doing performing a procedure like this. Also consider asking if he has performed extractions like this before. It would be a good idea to find out if there is nitrous oxide available to help with your comfort level. Understanding if your roots are straight or tapered, or twisted with knobs on the end, would also be helpful.

From what you’re describing, it does sound like your dentist is sharing his fair and honest opinion with you, so place significant value in that while making your decision.

This blog post is sponsored by the office of Gilbert sedation dentist, Dr. Matthew Roper.

Emergency Dentist

Should my husband have received a root canal at emergency dentist?

My husband had a tooth that was causing him a great deal of pain for over a year. Throughout that time, I would periodically remind him that it was likely going to result in a root canal if he did not have it checked out. As I had warned him, he ended up dealing with a terrible toothache and had to make a trip to an emergency dentist. However, the emergency dentist only treated him with a crown. Should he have had a root canal?

Thank you,

Karen

Dear Karen,

There are many causes of tooth pain. A cavity, cracked tooth, infection, and numerous other problems can cause pain. Typically, when the decay reaches the center of a tooth, or is near a nerve, it causes the nerve to send signals of distress in the form on pain or discomfort. They can also be necessary if a tooth becomes infected or dead. Needless to say, tooth pain doesn’t always equal a root canal, as different causes of pain need to be treated in different ways.

The emergency dentist should have explained the diagnosis to you, so you knew what was occurring and why. If he failed to do so, you could call the office and find out exactly what was wrong with the tooth.

Something else to learn from this experience is that you can’t waste any time when it comes to tooth problems. The quicker a problem is addressed, the less treatment is typically needed.

This post was brought to you by Gilbert emergency dentist, Dr. Matt Roper.

CEREC crowns

My crown keeps falling off

I had a CEREC crown placed. However, it has come out several times within the last year. Finally, after the fourth time, I consulted a different dentist, who replaced the crown with a zirconia porcelain crown, but it, too, has come out several times. The dentist suggested a full porcelain crown, stating that the cement is adhering to my tooth, but not the crown. He indicated that the all-porcelain crown is rough of the underneath and would, therefore, bond to the cement more effectively. I’m unsure of what my next step should be, but I am tired of the trouble these crowns have caused. What do you suggest I do?

Thank you,
Kodi

Kodi,

The CEREC crown, or same-day crown, is created by a computer in the dental office, the day of your appointment. When prepared and adhesed correctly, the crown will remain permanently affixed to the tooth. The material of which your crown is made is not indicative of how permanent the bond will be. Whether your crown is porcelain, gold, CEREC, or zirconia, all are made to stay permanently.

However, there are two factors that can determine if a crown will stay on permanently or not. They are the bonding strength of the cement, and the shape of the prepared tooth. The most important of these is the shape. If the tooth is prepared with little taper, a crown can be adhered with a weak cement, and it will stay permanently affixed. However, if there is a lot of taper, even some of the strongest cements will have difficulty staying on.

This is not implying that getting a solid bond between the crown and tooth would not solve your problem. The cement’s strength is important. But, when a tooth is prepared with good retention form, the crown will not fall off multiple times in one year. This indicates that your tooth may have been prepared with retention form that is insufficient.

To move forward, it would be a good idea to consult a dentist experienced in placing crowns that will stay on.

This article was brought to you by Gilbert CEREC Crown provider, Dr. Matthew Roper.