Posts for category: Dental Procedures
Modern restorations for severely damaged or missing teeth are truly remarkable. Although the type of restoration may differ — dental implant, bridge, or veneer — the end result is a life-like facsimile that matches the shape and color of your natural teeth.
To achieve this result, though, the new crown or veneer requires fabrication in a dental laboratory, a meticulous process that may take a few weeks. In the interim, we often install temporary crowns. These help in a number of ways: because we’ve prepared the teeth for final restoration by removing some of the tooth structure, the temporary crown protects and stabilizes the teeth, reduces sensitivity and helps maintain gum health. Temporary crowns also enable the patient to present a more natural smile while waiting for the permanent restoration.
Temporary crowns are typically manufactured to fit a wide range of patients, similar to an “off-the-rack” suit from a clothing store. In recent years, though, customized “tailored” temporary crowns designed specifically for an individual patient have grown in popularity among dental professionals as well as patients.
In creating a customized temporary crown, we first perform a smile analysis similar to one used for a permanent restoration. After a careful assessment of your mouth, we would then make recommendations about the elements to include in the temporary crown, including shape and color. We would also factor in your desires and concerns into the final design. Working together with the dental laboratory, we would then have the temporary crowns produced and ready to apply as soon as we complete the preparatory work.
Customized temporary crowns also serve another important purpose as a kind of “dress rehearsal” for the permanent restoration. This gives you an opportunity to “try out” the smile you’ll have with the permanent restoration in your daily life. We can then use your experience to make adjustments to the permanent crowns before final production.
While customized temporary crowns involve more effort and expense than the traditional, the benefits are worth the added cost, especially if you’re involved with an extensive “smile makeover” procedure. Not only will you look better while your permanent restoration is under construction, your temporary look will give you added confidence that your future smile is right for you.
If you would like more information on temporary and permanent dental restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Concepts of Temporary Restorations.”
Dental crowns are an essential means for restoring damaged or unattractive teeth. A well-crafted crown not only functions well, it looks and blends seamlessly with the rest of the natural teeth.
Crowns are artificial caps that cover an entire visible tooth, often used for heavily decayed or damaged teeth or as added protection after a root canal treatment. Most crowns are produced by a dental lab, but some dentists are now creating them in-office with computer-based milling equipment. On the whole, the various crowns now available function adequately as teeth—but they can vary in their appearance quality.
In the early to mid 20th Century the all-metal crown was the standard; but while durable, it could be less than eye-pleasing. Although more life-like dental porcelain existed at the time, it tended to be brittle and could easily shatter under chewing stress.
Dentists then developed a crown that combined the strength of metal with the attractiveness of porcelain: the porcelain fused to metal or PFM crown. The PFM crown had a hollow, metal substructure that was cemented over the tooth. To this metal base was fused an outer shell of porcelain that gave the crown an attractive finish.
The PFM reigned as the most widely used crown until the mid 2000s. By then improved forms of porcelain reinforced with stronger materials like Lucite had made possible an all-ceramic crown. They’re now the most common crown used today, beautifully life-like yet durable without the need for a metal base.
All-ceramics may be the most common type of crown installed today, but past favorites’ metal and PFM are still available and sometimes used. So depending on the type and location of the tooth and your own expectations, there’s a right crown for you.
However, not all crowns even among all-ceramic have the same level of aesthetic quality or cost—the more life-like, the more expensive. If you have dental insurance, your plan’s benefits might be based on a utilitarian but less attractive crown. You may have to pay more out of pocket for the crown you and your dentist believe is best for you.
Whatever you choose, though, your modern dental crown will do an admirable, functional job. And it can certainly improve your natural tooth’s appearance.
If we could go back in time, we all probably have a few things we wish we could change. Recently, Dr. Travis Stork, emergency room physician and host of the syndicated TV show The Doctors, shared one of his do-over dreams with Dear Doctor magazine: “If I [could have] gone back and told myself as a teenager what to do, I would have worn a mouthguard, not only to protect my teeth but also to help potentially reduce risk of concussion.”
What prompted this wish? The fact that as a teenage basketball player, Stork received an elbow to the mouth that caused his two front teeth to be knocked out of place. The teeth were put back in position, but they soon became darker and began to hurt. Eventually, both were successfully restored with dental crowns. Still, it was a painful (and costly) injury — and one that could have been avoided.
You might not realize it, but when it comes to dental injuries, basketball ranks among the riskier sports. Yet it’s far from the only one. In fact, according to the American Dental Association (ADA), there are some two dozen others — including baseball, hockey, surfing and bicycling — that carry a heightened risk of dental injury. Whenever you’re playing those sports, the ADA recommends you wear a high-quality mouth guard.
Mouthguards have come a long way since they were introduced as protective equipment for boxers in the early 1900’s. Today, three different types are widely available: stock “off-the-shelf” types that come in just a few sizes; mouth-formed “boil-and-bite” types that you adapt to the general contours of your mouth; and custom-made high-quality mouthguards that are made just for you at the dental office.
Of all three types, the dentist-made mouthguards are consistently found to be the most comfortable and best-fitting, and the ones that offer your teeth the greatest protection. What’s more, recent studies suggest that custom-fabricated mouthguards can provide an additional defense against concussion — in fact, they are twice as effective as the other types. That’s why you’ll see more and more professional athletes (and plenty of amateurs as well) sporting custom-made mouthguards at games and practices.
“I would have saved myself a lot of dental heartache if I had worn a mouthguard,” noted Dr. Stork. So take his advice: Wear a mouthguard whenever you play sports — unless you’d like to meet him (or one of his medical colleagues) in a professional capacity…
“Redesigning” a smile is a lot like remodeling a house: the technicalities of construction must blend seamlessly with what is perceived as elegant and beautiful. The first aspect — the proper materials and techniques to achieve a sound restoration — is absolutely crucial. But the aesthetic is just as important for assuring the final restoration evokes beauty and style.
Balancing these two aspects of a smile makeover requires thoughtful intent and planning. What may be pleasing aesthetically may not be technically feasible; but what may be technically sound may not have that sought-after “curb appeal.”
You and your dentist must work together to achieve the successful blending of these two aspects. That’s why it’s important for you to have full confidence in your dentist: that he or she is both technically skilled and experienced in cosmetic procedures and artistically aware of what will look best aesthetically.
The first step in your makeover is a thorough dental examination to determine the overall state of your oral health. With this “bigger picture,” your dentist will have a better understanding of what’s possible and practical for you and your situation. The exam may also reveal problems that should be treated first before any cosmetic work.
From there, you must communicate clearly to your dentist what you perceive as wrong with your smile and what you would like to have changed. While there are general principles of beauty best followed, your dental work could hypothetically take different paths depending on your desires and expectations. You might prefer a more “sexy” look or one that’s “sophisticated.” Or perhaps you only want subtle changes that still retain features expressing your individuality.
Ultimately, though, your expectations must line up with reality. Much like your house contractor, your dentist will advise you on what’s both practical and possible. And with their experience in smile enhancement, they can also help you determine what will look most attractive given your facial structure and features.
With this preliminary planning, you can be confident as the work proceeds that the end of the project will be both exciting and satisfying. And just as with your newly renovated home, you’ll be more than happy to share your smile with others.
If you would like more information on enhancing your smile through cosmetic dentistry, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Beautiful Smiles by Design.”
If you're in need of a crown to cover a damaged tooth, you have a lot of options. But before you choose, you need to know what you want. Would you be happy with an affordable, well-fitting crown that holds up well and allows you to chew comfortably? Or are you interested in a more expensive one that also provides the most attractive result?
Crowns have been a mainstay in dentistry for generations. The first were made of metals like gold or silver — durable and effective but not very attractive.
In time, a ceramic material known as dental porcelain began to make its appearance in crowns. Dental porcelain could be fashioned to resemble the color and texture of natural teeth, but it had a significant drawback: it could be brittle and subject to shattering under chewing pressure.
This problem was somewhat addressed with the innovation of a crown with a metal substructure fused with an outer layer of porcelain. These porcelain-fused-to-metal (PFM) crowns combined the best advantages of both materials: strength and life-likeness. Up until around the mid-2000s, PFM made up over 80% of crowns.
But later porcelains continued to improve in strength, beginning in 1993 with the introduction of a Lucite-reinforced material. Newer formulations like lithium disilicate or zirconium oxide (now considered the strongest porcelain) have made all-porcelain crowns a viable option. Today, an estimated 60% of new crowns are all-porcelain.
From an appearance standpoint, all-porcelain crowns achieve the best results. The most realistic crown can be costly — not because of the material but the level of artistry required. A skilled dental technician will spend several hours, including brushing on as many as fifteen coats of liquid porcelain to the crown, to achieve the most life-like outcome. Your insurance plan, if you have one, will most likely not pay as high a percentage for that type of crown.
In the end, it's your decision as to what type of crown you wish to have. We'll help you weigh your options and decide what's best for you and your budget.