One of the reasons I love dentistry is the constant increase in technology to provide dental care to my patients. Same-day restorations are one of those technologies. CAD/CAM dentistry, or computer-aided design and computer-aided manufacturing, is where I can prepare your tooth for a crown, scan the prepared tooth with a special device, and computer generate and mill the restoration in minutes.
Some of the benefits of CAD/CAM restorations are: more precise fit than laboratory generated crown, seals out microbes better than traditional lab generated crowns, milled restorations are completed at chair-side, the milled materials are strong as natural teeth and natural looking, and the procedure is done the same day. Those are just a few of the benefits of these hi-tech restorations.
CAD/CAM restorations are definitely not figured into insurance fees, and will be an upgraded restoration. However, most patients choose these restorations due to the convenience of having the crown or inlay/onlay restoration cemented on the same day. Receiving a CAD/CAM Restoration usually only requires an additional 45 minutes added to the crown appointment.
CAD/CAM technology is just another way we choose to serve our patients with the best dentistry has to offer.
More to come on why we chose the E4D CAD/CAM system over the competition…
CAD/CAM Restorations
Crowns: Why they differ in substance and price
Many years ago when a patient was in need of a crown restoration to preserve a tooth, gold was it! Although gold is still used to restore teeth, we now have many types of restorations available to preserve our dentition.
Cosmetic restorations have become the norm in today’s dental offices. The two most common crown restorations done today are Porcelain Fused to Metal and All Porcelain Crowns. Within these two types of crowns are several choices, and everyone should be given the choice regardless of insurance coverage or economic situation.
Whenever one of my patients has an indication for porcelain fused to metal crown, I generally use a metal called Tilite. It is the only metal guaranteed not to react to tissue. On top of the metal coping is where the porcelain is stacked. Not all porcelain is created equal either. In my practice I have the lab use Noratake Porcelain, and they additionally do a multiple clear porcelain stack to enhance the natural look of the crown.
However, the crown of choice with today’s technology is an all porcelain crown. More specifically, zirconium or lithium disilicate. Procera and Cercon are the two brand names of zirconium I use, and the coping or foundation under the porcelain is very strong. However, they are limited to strength by the porcelain fused to the coping. Which means the porcelain is still subject to fracture depending on its strength. Although not as strong as zirconium, IPS e.max is the lithium disilicate I choose when I need strength and esthetics. The overall strength and beauty of IPS e.max is winning the battle from premature fracture. It’s a full thickness lithium disilicate crown when created in our office with our CAD/CAM equipment from D4D. We are seeing great success with this technology, and the crowns are generally made the same day as the tooth preparation. It generally adds an additional 60 minutes to the procedure. However, you do not have to return for a cementation appointment, which is convenient and time saving for our patients. I will be posting more on this technology this month.
All of these crown restorations are way beyond the average types of crowns insurance plans base their fees upon. And each of them differs in lab costs due to material costs. However, I always give my patients the choice of crown materials they want to have placed in their mouths, and the additional fees associated with those crowns.
Often times new patients, with existing crowns in their mouths, will come to my practice, need a crown, and experience for the first time, a choice in the type of restorations offered. What bothers them the most is the fact their previous dentist never gave them a choice. This is why I believe it should be the patient’s choice what goes in their mouths when a choice exists, regardless of insurance coverage or financial position. And patients appreciate being given the choice.
Tooth Sensitivity after Dental Work
Dental technology has made modern day dental care more comfortable than when I was growing up. However, most procedures still fall under the category of same-day surgery. That’s right! When we drill on your tooth, or do some form of tissue surgery, it is surgery. Which means you should normally experience some discomfort after most dental procedures.
It’s not unusual for a patient to experience bite, hot, and cold sensitivity after tooth colored fillings for up to eight weeks, and sometimes longer. Every tooth will vary with sensitivity. Meaning, you can have five fillings done on the same day and each tooth will respond differently. You may have sensitivity in one, two, or all five teeth, or none at all.
The same applies with all dental procedures. Every tooth is its own organ, and will behave differently. Some teeth will heal faster than others. Some decay goes deeper in the tooth, and requires more time to heal.
If you experience tooth discomfort that gets progressively worse, then the tooth will probably be in need of additional treatment such as root canal therapy or possibly extraction if the tooth has an unseen fracture. Bottom line, it’s the human body, and sometimes things that need to be fixed can go in reverse. However, the large majority of all dental procedures fixes unwanted problems and does so with little or no discomfort.
Sensitivity to bite usually means a minor bite adjustment. Sensitivity to cold generally goes away with time, but is helped with products such as desensitizing toothpastes. But remember, if sensitivity becomes worse over time, or is consistent for over two months, you should probably be seen in our office.
TOOTH WHITENING
We’ve seen another jump in whitening technology this past year. Tooth whitening gels for custom trays are now in concentrations of 10%, 15%, 20%, and 35%. Although higher concentrations can sometimes increase tooth sensitivity short term, manufacturers have now added fluoride to help reduce any discomfort. The important thing for patients to know is higher concentration strengths does not mean better tooth whitening outcomes.
If you need quick results for a party or function, meaning you need your smile to “shine” in a hurry, the higher concentrations are the way to go. You may even want to consider in-office whitening which shows immediate results. With this modality of tooth whitening, you will get the best results in the shortest amount of time. However, your overall whitening will tend to fade sooner than if you maintain the whitening with lower concentrations.
Recent research has shown if you use 10% to 15% solutions, and wear them in your trays overnight, your teeth will maintain their brilliance for 3 to 4 months longer. Does this mean the higher concentrations are of no value? Of course not.
Lets say you want to achieve three to four complete shades brighter in value immediately. In-office whitening would be the better decision as it will obtain the best result in most patients. Or, you dislike wearing the tray overnight. Then you could purchase the higher concentrations and wear the trays for one hour or less with great results. Technology has brought forth choice in the way patients choose to brighten their smiles.
One important thing to know is “laser” whitening dehydrates the teeth. The increase in value will quickly return to your natural color, and that is why we do not use that technology in our office. We use a product from Ultradent called “Boost” for our in-office procedures, and the results are much better than tooth dehydration with a laser type system. Not to mention healthier.
At your next appointment, ask our dental team which whitening treatment best fits your schedule and needs. Nothing says more about you than your smile.
Welcome to Our Blog!
Welcome to our new Thorup Dental Blog!
I’m so excited to share news, product information, upcoming practice events and much much more with you! At Thorup Dental, we provide
Complete Dental Care With A Gentle Touch
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