CEREC Crown Archives - Susan M. Dennis, D.D.S

Are CEREC Crowns Strong?

Posted on April 3, 2023 by Dr. Dennis.

I have to have two crowns. I went to a dentist my insurance lists, but he really wants me to get a CEREC crown. I went to an insurance dentist so the treatment would be covered, but they only cover traditional crowns. I do like the idea of getting both crowns in one appointment, but if I’m going to pay extra I want to know they’re as strong.

Larry B.

Dear Larry,

How strong are CEREC crowns?

When you’re talking about the strength and longevity of a dental crown, it depends more on the skill of the dentist than the crown. Though, there are some advantages to CEREC crowns.

They can be done in just one appointment, as your dentist mentioned. This saves you from having to take additional time off work. If you’re an hourly employee, that usually makes up for the additional cost.

They’re milled by computer. There’s something about the precision of computers which helps with crowns. They’re much more likely to fit properly the first time than their man-made counterparts.

No matter what type of crown you get, there are some things neither can stand up against. If you’re a tooth grinder, just like your natural teeth, they will crack, chip, or break. A simple precaution, such as a nightguard, will protect both your natural teeth and any dental work you have.

No dental work, whether it’s a crown or porcelain veneers, will whiten once they’re made. So, if you’re considering taking some years off your appearance, by giving those chompers a boost, do it before your crowns are designed. That way they can be made to match the bright new color of the rest of your teeth.

Dental Crowns Versus Porcelain Veneers

We often get asked what is the difference between crowns and porcelain veneers and can you get a smile makeover with either one of them. I can answer both of those now.

Porcelain crowns are generally used after a root canal treatment or when the decay on a tooth takes up too much surface or goes too deep. Unfortunately, they require a significant amount of grinding down of tooth structure in order to fit the crown.

Porcelain veneers are strictly cosmetic. Some mild shaving on the front of the tooth is generally done, but it’s only about the depth of a fingernail. They’re used to change the cosmetic appearance of your teeth.

While both can be used for smile makeovers, you generally only use a crown for one when the tooth you’re making over already has one. That’s because a veneers saves much more of your natural tooth structure.

Either way, make sure whoever does your smile makeover has a beautiful smile guarantee.

This blog is brought to you by Dr. Susan Dennis.

Who Can Do CEREC Crowns and Veneers?

Posted on March 22, 2023 by Dr. Dennis.

I am going to a new dentist after a transfer to another city. I had to go to the first one who could fit me in because I had a crown break on a front tooth. Dr. —– from Maine is recommending I get a CEREC crown. He also said if I was interested in a smile makeover he could make CEREC veneers too. I don’t know anything about this dentist. How do I know if this is a good idea?

Lorraine

Dear Lorraine,

A block of porcelain used by a CEREC machine for crowns

CEREC Crowns are milled from a single block of porcelain

I’m very glad you wrote. I’m going to save you from a potential disaster here. The first warning bell which sounded out to me was his suggesting a CEREC crown for your front tooth. While CEREC crowns are quite convenient, they’re more useful on back teeth because they’re milled from a single block of porcelain. That means the color will be completely uniform.

If you looked at your teeth in a mirror closely, you’d notice there are subtle varieties in the translucency, and therefore the shading, of the tooth. To get that with a dental crown requires your dentist does this the traditional way with an all-porcelain crown, where they can pull from several blocks of porcelain with varieties of color.

Because Dr. —- doesn’t seem to understand that, it makes me think he’s not a skilled cosmetic dentist.

Who Should Create Your CEREC Restorations?

I decided to do some research on the dentist you mentioned just to see if my hunch was correct. Here’s what I found. This dentist has a website, but it’s not that great. There’s no smile gallery where you can see results of the work he’s done. Next, I checked his Yelp! and Google Reviews. No reviews, which means no one feels passionate enough about his work (good or bad) to bother writing a review.

So, I took the additional step of researching some of the more well-respected schools which teach cosmetic dentistry, specifically in creating beautiful smile makeovers. He doesn’t seem to have attended any of them, which backs up my gut feeling.

Let’s say you go through with this and go ahead with the smile makeover, but end up hating it. Will he reimburse you? There’s no recourse if he doesn’t Most excellent cosmetic dentists have a beautiful smile guarantee but they’re not required to.

Your best bet is to go to a different dentist for both the crown and a smile makeover if that’s really something you’re interested in.

This blog is brought to you by Dr. Susan Dennis.

Do CEREC Crowns Break Easily?

Posted on February 26, 2023 by Dr. Dennis.

I’ve had four crowns in my lifetime, but they’ve all held. I got my first CEREC crown and it’s only lasted a few months. In between that time, it kept causing a lot of trouble with pain when I bite down. Is this a CEREC issue or a dentist issue? I was going to a new dentist when I received the CEREC crown.

Deborah

Dear Deborah,

A CEREC machine

When you have pain when biting down on your crown, it’s usually for one of two reasons.

There is still an infection.
The crown is sitting too high

Because your crown broke, I think the problem is it was sitting too high. That causes all the force of your bite to concentrate on that spot. Usually, a crown can take that kind of force for a while. And CEREC crowns are just as strong as traditional crowns. The pain generally, tips off the dentist something is wrong and he adjusts the crown into proper position. Did your dentist try adjusting it?

It’s a moot point now that the crown is broken, it would just help me determine if the dentist paid attention to the fact you told him you’re in pain.

Options When a CEREC Crown Breaks

Because this crown didn’t last even the minimum lifespan of a crown, you have the right to ask for a refund and have it done by someone else. Or, if you prefer, you can give him another chance and ask him to redo the crown.

If he’s unwilling to do either, you may have to put up a small fight for the refund. Let him know you’re willing to contact the dental board and contact an attorney. Also, let him know you’ll be leaving reviews about the type of results and treatment you received from their office.

That might spur them onto more reasonable treatment. I know this isn’t your fault, but you don’t want to leave a broken crown too long. The tooth underneath could break and then you’ll be looking for a tooth replacement option instead.

This blog is brought to you by Kalamazoo implant dentist Dr. Susan Dennis.

Front Crown Doesn’t Match Other Teeth

Posted on January 31, 2023 by Dr. Dennis.

I had a crown placed on my front tooth. It doesn’t match the other teeth. It’s a CEREC crown. Is that the problem. Can it be fixed?

Ben

Dear Ben,

CEREC Crowns are milled from a single block of porcelain

The fact that it’s a CEREC crown isn’t the whole problem. Truthfully, only the best of the best cosmetic dentists can do a CEREC crown for a front tooth. CEREC crowns are milled from a single block of porcelain.
Now the cream of the crop cosmetic dentists can do some color changes on the crown, but you’re talking about 1% of dentists. Most, even great cosmetic dentists, will tell you to have a traditional crown done on a front tooth.

While they can be made to match the color of the other front tooth, they won’t have the subtleties of your natural tooth because it has varying depths of opacity as you go from top to bottom of the tooth. However, based on what you said above, it doesn’t sound like your dentist even matched the color. This has nothing to do with the fact it is a CEREC crown and more to do with the skill of your dentist.

Where Do You Go From Here?

You could ask your dentist to do it again, this time using a traditional crown. However, if he couldn’t match the color the first time, I don’t feel too confident that he’ll get it right this time. Though, you may feel it is worth giving him a second try.

Another option is to ask for a refund and go to a different dentist to have the crown done. Unfortunately, it is up to him whether or not he refunds your money. The standard for dental work, such as a crown, is whether it is functional or not. Your crown is functional so there’s no way to require him to give you a refund. It’s a matter of whether or not he cares about how his patients feel about his quality of work.

I’m sorry you’re having to deal with this hassle. This blog is brought to you by Dr. Susan Dennis of Kalamazoo.

Dentist Can’t Get CEREC Crown to Match

Posted on January 17, 2023 by Dr. Dennis.

I had a root canal and the tooth needed a dental crown. My dentist has had a very hard time getting it to look natural. The first one looked way too white. Then he redid it. The next one was a more realistic shade, but still doesn’t match my adjacent teeth. He bonded that one on. At first, I thought I could live with it but I’m really uncomfortable having mismatched front teeth. He’s willing to try again. Do you think I’m being too picky? I can tell he’s getting frustrated, even though he hasn’t said anything. Is this because it was a CEREC crown?

Louisa

Dear Louisa,

CEREC crowns can look natural

The tendency for most patients in your situation is to finally just settle for a crown that doesn’t look quite right. If this is a front tooth, however, even a slight variation in the color between the crown and adjacent teeth will be noticeable to others and will make the crown look fake.

Your dentist may have the best of intentions, but it is a highly developed skill to get a single crown on a front tooth to match perfectly, that is especially true with CEREC crowns where the crown is often milled from a single block of porcelain. With a traditional crown, it also requires a good relationship between the dentist and the laboratory technician, where they can communicate about color and understand one another.

Even with expert cosmetic dentists, there will often be several try-ins before the crown is matched perfectly. In your case, since your dentist bonded on a crown that didn’t really match, it doesn’t appear that you are in the hands of an expert cosmetic dentist.

Another way that is being used very effectively to match crowns on front teeth is photography. Using sophisticated camera equipment designed for taking dental photographs, the dentist will start by taking a photograph of a standard shade tab of a shade that is close to the shade of your natural teeth. The shade tab will be put up against your natural teeth and photographed, and this photograph will be sent to the ceramist as a guide in re-creating the natural color of the tooth. Then, if the crown provided by the ceramist doesn’t match perfectly, that crown is tried in on the tooth and a new photograph is taken. The ceramist then will be able to see, in the lab, exactly what color modifications need to be made to get it to match perfectly.

A typical family dentist will not likely have photography equipment like this. Furthermore, if he or she has only the training provided by dental school, they are going to be lacking in a lot of color training. Dental schools teach very little about color, and will ordinarily not get into the complex and subtle variations of color and translucency that make up a tooth.

So what do you do? If you are willing to settle for a crown that is just close to the color of your existing teeth, stick with this dentist and keep having him send it back to the lab (or in your case, re-do it on his CEREC machine) until it is right.

If you want to get a perfect match, then have a frank discussion with your dentist and transfer to another dentist who has more expertise in cosmetic dentistry. But know that only a small percentage of dentists have that level of expertise that you need to get a perfect match. For most of them, the way they get a perfect match between two front teeth is to do two crowns on them.

This blog is brought to you by Portage, MI Cosmetic Dentist Dr. Susan Dennis.

3 CEREC Crown Secrets

Posted on December 14, 2022 by Dr. Dennis.

I’m thinking of getting a CEREC crown. Mostly, I’m thinking about it because my dentist is pushing it. It feels like he’s pushing it too hard. Are there any downsides to this I should be worried about?

Clarke

Dear Clarke,

Great question. It’s hard to trust someone when it feels like they’re sales pitching you, isn’t it? While I’m not sure what your dentist has told you, I can give you three things he may have not told you.

You Shouldn’t Pay Extra for the Convenience of CEREC Crowns

Yes, the dentist invested a lot of money to get the CEREC machine. They cost a dentist approximately $100,000. That’s quite a chunk of change. However, the dentist is saving on lab fees that he would otherwise have to pay using the traditional crowns, so it evens out… eventually.

CEREC Crowns are Not Ideal for Front Teeth

While traditional porcelain crowns are crafted from several blocks of porcelain, allowing the tooth to having varying hues of opacity, CEREC crowns are milled from a single block of porcelain.

While they can match your adjacent teeth and look quite natural in almost all cases, front teeth are different. They’re more up front and exposed to the natural light. Without those subtle changes in opacity, they won’t look quite as natural as other crowns.

You’ll Want to Consider Teeth Whitening

This only applies in two conditions: First, if the crown will be visible when you smile. Second, if you’ve ever considered whitening your teeth anyway

If you’re perfectly content with the color of your teeth, you can ignore this last bit. However, if you’ve toyed with the idea of whitening your teeth, it will be more cost effective for you to do it before you get your crown (CEREC or otherwise).

The color of a dental crown is permanent. Once it’s made, it won’t change. If you whiten your teeth beforehand, it can be made the color of your whiter teeth. If you wait until a later time, the crown will have to be re-made to match the rest of your teeth again.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Investigating CEREC Crowns

Posted on November 24, 2022 by Dr. Dennis.

I’m in need of a crown. My dentist said I can get a CEREC crown in one appointment or a traditional crown in two. I can’t decide. The idea of one appointment is appealing, but can it really be as good if it’s made so much more quickly? This will be my first dental crown so I don’t have a lot of experience either way.

Betty

Dear Betty,

CEREC crowns can look natural

I hate it when dentists give patients choices without thoroughly explaining the options. This causes the patient to have doubts. Let me walk you through the differences.

Manufacturing a CEREC versus Traditional Crown

The biggest advantage to a CEREC crown is it utilizes CAD/CAM technology. This stands for “Computer Aided Design/Computer Aided Manufacturing”. A computer essentially makes a 3-Dimensional map of your mouth and designs then mills a crown. This generally can be done in around an hour.

With traditional porcelain crowns, your dentist sends instructions to a lab. It takes them around two weeks to complete the crown. You will wear a temporary in the meantime. This won’t be as aesthetic as the final crown, but it is a way to protect your tooth in the meantime. It isn’t recommended that you eat anything very sticky because they’re not securely bonded. Instead, they’re designed to be easily removable.

The Cost of CEREC Crowns

Traditional and CEREC crowns cost about the same. While the dentist doesn’t have lab fees, the CEREC machines cost a pretty penny. The cost works out about the same for the dentist with both types of crowns.

One tip when it comes to any restoration which is visible when you smile. Make certain your dentist tries it in with a temporary try in paste. Make sure you like how it looks before your dentist permanently bonds it on. If you don’t like it, he or she should be willing to send it back to the lab (or CEREC machine) to try again.

This blog is brought to you by Kalamazoo Dentist Dr. Susan Dennis.

Would a CEREC Crown Have Saved My Tooth?

Posted on October 23, 2022 by Dr. Dennis.

I had a root canal some time back. I wanted to have a CEREC crown placed on it, but my dentist didn’t have the machine. I was disappointed, but he’s been my dentist for years so I felt guilty considering going to someone else. I agreed to get the regular kind of crown. Though, he wanted to see how my tooth would do without a root canal first. We waited a couple of weeks and then I decided I’d rather not wait any longer. I had the temporary made and then went out of town on business. On the first day out, the temporary crown broke. I was going to be gone for over a week so I called my dental office. They told me it was no big deal and don’t stress over it, the tooth would be fine. But, by the time I returned to town and went to see them they told me the tooth couldn’t be saved. I was furious. If I’d gotten the crown sooner maybe this wouldn’t have happened. He said it wouldn’t have mattered, it was brittle from the root canal. Should I get a second opinion? Would I have saved the tooth if I’d gotten a CEREC?

Felicity J.

Dear Felicity,

CEREC Restorations

Yes, you should definitely get a second opinion. It’s always better to save a tooth whenever possible. Plus, there are some things your dentist is saying that doesn’t quite fit. Your tooth wouldn’t have been unsavable that quickly. It’s possible he’s covering for the fact that he didn’t take the care with you he should have. In addition to providing a crown sooner, he should have sent you to a dentist who sees non-established patients in the case of dental emergencies after your temporary crown broke, especially given how long you were going to be away. Even if your tooth can still be saved, it’s very likely your teeth have shifted and the permanent crown will no longer fit.

Hopefully, your second opinion dentist will tell you the tooth can be saved. Otherwise, you’re talking about also having to deal with a tooth extraction and researching tooth replacement options. If that does become necessary, I’d suggest you look into getting a dental implant. They’re much better than removable partial dentures. A dental bridge is okay, but it also means grinding down two other teeth. If they’re healthy, I don’t see the point. It’s much better to save whatever tooth structure can be saved.

It’s true, a CEREC crown would have prevented all of this to begin with. You would have had a crown the same day. But, there’s nothing that can be done about that now, unfortunately.

Hopefully, things will work out with a different dentist. Never stay with a dentist out of guilt. Either they can provide you with the care you need or they can’t. It’s your health, so don’t feel guilty.

This blog is brought to you by Emergency Dentist Dr. Susan Dennis of Michigan.

Will CEREC Crowns Handle Grinding?

Posted on October 17, 2022 by Dr. Dennis.

I have a tooth which has cracked and my dentist wants me to get a CEREC Crown. The only thing I’m worried about is I grind my teeth at night. How do crowns hold up with teeth grinding?

Cory S.

Dear Cory,

CEREC Restorations

CEREC crowns are a great solution when you need a dental crown, but they won’t hold up long under the stress of tooth grinding. It’s not because there’s anything defective in the crowns themselves. Your normal teeth aren’t going to hold up with grinding either. In fact, that is likely why your tooth cracked to begin with.

Your dentist should have warned you about this. I’m concerned this didn’t happen. In fact, it puts you at risk not just of needing a mouth full of crowns, but of losing your teeth too.

A grinding habit can loosen your teeth to the point they even come out. Then, you’re not just looking at crowns but possibly a dental implant as well.

This can be solved simply. All your dentist has to do is fit you with a mouth guard designed to protect your teeth from grinding. It won’t cost that much and certainly will cost you significantly less than replacing your teeth from cracks or extractions.

Two things to be aware of if your crown is in a visible place. The color the crown is made with is permanent and cannot be whitened. If you’ll eventually want whiter teeth, now is the time to whiten them so the crown can be made to match your new white color.

Secondly, if it’s a very front tooth, you may consider getting a traditional porcelain crown. CEREC crowns, while beautiful and convenient are milled out of a single block of porcelain which makes the color rather flat. An artistic cosmetic dentist will create the crown for a front tooth out of different porcelain to give the tooth the same subtle variations you find in a natural tooth.

This blog is brought to you by Kalamazoo Cosmetic Dentist Dr. Susan Dennis.

CEREC Crown is too Bulky

Posted on August 10, 2022 by Dr. Dennis.

I had a dental crown from a previous dentist that broke after a few years. I decided to get a CEREC crown this go-round because my dentist recently got the machine and explained how much faster it works. I’ve only had a couple of crowns before and they’ve never felt this way. It almost feels like a wad of something is stuck there. Is this normal? Could my dentist make it feel better in my mouth?

Annette

Dear Annette,

When a crown is fitted properly, you don’t notice it at all. It’s like having a healthy tooth there. My guess is the struggle your dentist is having is because in a normal situation the software would build the crown from images of an existing tooth that needed to be crowned. In your situation, the tooth had already been crowned so the new one had to be built from scratch.

You mentioned your dentist recently acquired the CEREC crown machine. He or she may not yet have enough experience with the software to do this well yet.

Fixing it is possible, but not in your mouth. The crown will need to be removed and re-done. You have two choices with that. Your first choice is to ask your dentist to replace the crown using the traditional means. That will require a temporary crown and short wait before your permanent crown is ready. This will pretty much guarantee you’ll get a crown that fits.

A second option is to give your dentist another chance. This will give him or her some practice. Because you are a learning tool, you could ask for a discount, which would be a partial refund in your case, as you shouldn’t have to pay for the same crown twice.

The good news is even though your dentist wasn’t able to pull this off on the first try, they are definitely increasing their knowledge and acquiring the new technology in their field. That is always a good quality in a dentist.

This blog is brought to you by Portage, MI cosmetic dentist Dr. Susan Dennis.