All posts by writeradmin

CEREC crowns

Can You Get a Cavity Under a CEREC Crown?

I have a CEREC crown, and at my last check up I was told that I have some decay under the crown. I thought crowns couldn’t get cavities. How can I decay underneath it when it’s covered? I feel like he must have done something wrong. Or maybe there isn’t even a cavity there and he’s just making it up to get money. I didn’t feel anything to indicate a problem. When I needed this crown to begin with it was because I had a toothache. Now, I don’t feel any problem

Bill

Dear Bill,

CEREC Machine

CEREC crowns are made from dental ceramic, so they don’t decay the way natural tooth enamel does. However, there is still a natural tooth underneath your crown, and that tooth can develop decay. This is sometimes called recurrent or secondary decay. Usually, the problem starts around the edge (margin) where the crown meets your natural tooth.

How can a cavity get underneath a crown?

Even though a crown covers the visible portion of your tooth, it doesn’t make the tooth immune to bacteria. There is always a point near the gumline where the crown ends and your natural tooth begins.

Plaque can accumulate around this margin just as it does around your other uncrowned teeth. If plaque isn’t removed regularly, bacteria can produce acids that damage the exposed tooth structure and eventually cause a cavity.

Decay can also become a problem if a crown no longer fits properly. A damaged crown or compromised margin may create an area where bacteria and debris can collect and slip through.

One advantage of CEREC crowns is that your dentist can digitally scan your tooth and design your restoration with a precise fit. Your crown can then be milled and placed during the same appointment. These crowns are better fitting than many traditionally created crowns.

A well-fitting crown is important because the margin between the crown and your tooth should be as smooth and closely adapted as possible. However, even an excellent CEREC crown cannot prevent every future cavity. Your oral hygiene, gum health, regular dental care, and even your diet have an impact on how your tooth does.

Decay beneath a crown doesn’t always cause symptoms right away. That is one of the great things about check ups. You can catch things much earlier than if you wait until you’re in pain. The last thing you want is a dental emergency.

For those who might be wondering, here are some symptoms of a problem:

  • Sensitivity to hot or cold
  • Pain or tenderness when biting
  • A dark area near the edge of the crown
  • A pimple or gum irritation around the crown
  • A crown that feels loose or different than it used to

How to prevent cavities around a CEREC crown?

Treat your crowned tooth like you would a natural tooth. Brush twice a day with fluoride toothpaste, floss carefully around the crown once a day, and keep up with your dental visits. A CEREC crown can protect and strengthen a damaged tooth for many years, but the natural tooth underneath still needs your care.

This blog is brought to you by a friendly Gilbert dentist, Dr. Matt Roper.

Porcelain Veneers

Porcelain Veneers Staining After Just One-Year

I had my porcelain veneers done about a year ago. At the time, I was told that they are very stain resistant. I did mention I smoked but my dentist didn’t seem concerned. Now here I am one year out and I’m getting stains between the teeth. I’m still paying for these and don’t want to keep paying if I was mislead. Help!

Michelle

Dear Michelle,

An image of a porcelain veneer being held up to a tooth.

You were not misled, porcelain veneers are very stain resistant. In fact, they are more stain resistant than your natural teeth. I wish I had a picture of your veneers because that would help me narrow the problem down. What I can give you is some general advice.

For the benefit of others reading this post, if her staining were over the complete surface of her teeth (which hers aren’t), then that would mean something damaged the glaze on her veneers. The glaze is not only what gives veneers their natural shine, but also is what protects the veneers from picking up stains. Never let a dental hygienist use something like a Power Prophy Jet or acidulated fluoride on your porcelain veneers. That will destroy the protective glaze quicker than quick.

Your staining, however is between your veneers. Those are what is known as margins, where the porcelain wafer meets the tooth. There are a couple of reasons why these could be picking up stains.

1. There is a gap between the veneers and the tooth. This would be tricky to fix and would likely mean replacing them. A gap will allow for bacteria to get in there, which not only discolors the tooth, but will also expose them to problems with decay.

2. A second issue is there is some composite bonding there that is picking up the stains instead of the veneers themselves. That is a simple fix. It just requires some polishing. I would go back to the dentist who did the veneers to polish them. While this is simple, not many family dentists will know the procedures.

I would consider the polishing of the bonding a regular maintenance issue. A hygienist or dentist will use fine polishing strips along with an ultra-fine aluminum oxide polishing paste. This will do a few things. It will keep the area smooth. It will help keep them resistant to stains. It will help prevent plaque accumulation. Smoking makes this even more important.

This blog is brought to you by a friendly family dentist in Gilbert, Dr. Matt Roper.
Click here to learn about solutions to dental anxiety.

Teeth Whitening

Whitening My Non-Veneered Teeth

I went to an expert cosmetic dentist in another state to get porcelain veneers. My dentist does porcelain veneers but was new to them at the time and suggested Lumineers which I’d heard bad things about. The expert dentist wanted to do ten veneers on my teeth, but my dentist said he’d do six. I’d saved up for six and this other dentist was more expensive so I told him I only wanted six. He said I’d need to get my teeth whitened first or the new teeth would look fake. I didn’t like that but agreed because it was the only way he’d do them. Fast forward and now my non-veneered teeth have yellowed over the past several years but my veneered teeth look great. It wouldn’t matter except I have a wide smile so those yellow teeth show, making the veneers look obviously fake. I’m too embarrassed to go back to the expert dentist to get this fixed. Is there a way I can use something like Crest Whitestrips to whiten the teeth back? Will it hurt the veneers?

Stacy

Dear Stacy,

Image of teeth whitening trays
Professional teeth whitening trays

While using Crest Whitestrips will not hurt your porcelain veneers, it’s not likely to make a difference either. First, they’ll only cover the front six teeth. In your case those have veneers already so that would be pointless. You could cut them in half and try to place them on the teeth adjacent to your veneers. What you need to bear in mind, though, is that Crest Whitestrips are not very strong. Because of this, it will take you a very long time and many kits to achieve the same amount of whiteness that you would get in a short time with a professional whitening from your dentist.

The good news is that you will not have to go back to the original dentist to have this done. While you were wise to have an expert cosmetic dentist do your porcelain veneers, that is not necessary for teeth whitening. Any general dentist who offers it should be able to do teeth whitening just fine.

While the whitening will not harm your porcelain veneers, it is possible for your dentist to custom fit the trays around your veneers so that the only teeth getting whitening gel on them are the ones you actually want whitened. My suggestion is you go to your dentist and ask for just that. You shouldn’t have any problem.

This blog is brought to you by a gentle Gilbert dentist, Dr. Matt Roper.

CEREC crowns

Open Margins on CEREC Crowns

I had three CEREC crowns made. I don’t feel like they are fitting well and I’m think there are open margins. There are radiolucent images that seem to support this but my dentist is telling me that those are radiographic burnout. Can you verify that?

James

Dear James,

block of porcelain for a cerec crown.

I can verify it with any definitive answer without examining you. CEREC crowns are usually more accurately fit than traditional ones because they are milled by a machine that designs the crown based on sophisticated software. Even so, it is still possible for a dentist to place them with open margins.

I can tell you that radiographic burnout is possible. A cleaner x-ray and running an explorer around the margins should tell you with certainty.

It doesn’t sound like you have much faith in your dentist to tell you the truth. This is a problem. You really do need a dentist that you can trust and feel is ethical. I would get a second opinion from another dentist. Make it a blind second opinion. By that I mean do not tell them who your dentist is or tell them anything about the radiolucent image.

The dental field is a small universe and it is very likely your dentists know each other. He or she may feel torn about saying your dentist messed up if they know who they are. If they ask, just tell them you want an unbiased opinion so just to look at the crowns and ask if there are open margins.

If it turns out that you do have open margins, then I would start looking for an ethical dentist who does quality work. Check out their reviews online. That can often be a way to weed out those whose patients have had bad experiences with them.

This blog is brought to you by a friendly dentist at Libertyville, IL Dr. Matt Roper.
Open Saturdays by appointment.

Sedation Dentistry

Should I Bother About this Rotted Wisdom Tooth?

I am not thrilled with dentists as a whole. It’s nothing personal but I’ve have never had a pleasant dental appointment. I’ve had a wisdom tooth with a cavity and let it go. It has pretty much rotted out. The top part is completely gone. All the way to the gumline. There doesn’t appear to be anything inside the gum. Can I let it go or do I need to do anything about it?

Ellory

Dear Ellory,

Man in pain, grabbing his cheek in need of emergency dental care.

First, I am sorry that all of your experiences with the dentist have been discouraging. I have a solution to that which we will get to in a moment. First let’s get to your question. If the crown of the tooth is gone, the remainder of the tooth will decay and you should be fine. Because the tooth is open, there is very little chance that an infection will get into the bone. You won’t have any enamel left so the decay will dissipate.

I will say if the decay on that tooth got so bad that the crown either decayed or fell off, then you likely have decay on other teeth. You lucked out with your wisdom tooth not developing an infection during all that decay. You might not be so lucky with the other teeth. Even though I think you are probably fine with your wisdom tooth, I think it would be wise (see what I did there?) if you had the other teeth checked. This way you can prevent an infection before it starts. These can turn into dental emergencies quickly. Believe it or not between 6-10 people die every year from a tooth infection.

How to Have Anxiety Free and Pain Free Dental Care

I am going to recommend that you see a sedation dentist, specifically one who offers oral conscious sedation. This is a medication that he or she can give you to take shortly before your appointment. This is very strong and you will need to have someone drive you to and from your appointment. Some patients call this sleep dentistry because it is strong enough that you can sleep through your appointment if you want to.

People who’ve avoided the dentist for much of their lives find that by using dental sedation it completely changes their lives. They are finally able to catch up with years of missed dental work becuase of their anxiety.

This blog is brought to you by a compassionate dentist in Gilbert, Dr. Matt Roper.

Dental Emergency

Antibiotic for a Tooth Infection?

I had a root canal treatment a few years ago. My dentist put in a temporary filling. I think I was supposed to go back in for a dental crown or something, but I don’t like dentists (no offense). When they didn’t call me back, I didn’t remind them. After a while the tooth started hurting. It’s got another infection. Because I already had the root canal treatment, I think I would just need an antibiotic to clear this up, right? Which one?

Cameron

Dear Cameron,

A woman holding her jaw in pain

If your root canal was done successfully, then there wouldn’t be any pain to your tooth. Either you are dealing with a failed root canal treatment or there is referred pain from another tooth infection. What you don’t want to do is just take antibiotics. These do not cure a tooth infection. All they can do is hold it at bay for a short time. Once the antibiotics run out, the infection will flare back up.

If it is the same tooth, you have two choices. Your first choice is to get a root canal re-treatmnet. There is still a chance that the second root canal will fail. If there is a part of the canal that can’t be reached, then it won’t matter how many times it is done.

A second option is to have the tooth extracted. This will definitely take care of the infection, but it also means replacing the tooth. My recommendation in that case would be a dental implant.

What you don’t want to do is leave it alone and allow it to blow up into another tooth infection. This can quickly turn into a dental emergency.

This blog is brought to you by a skilled Gilbert Dentist Dr. Matt Roper.

Porcelain Veneers

Mouthwash and Porcelain Veneers

I have porcelain veneers and I want to take good care of them. I have this homemade mouthwash that I read about and wondered if it is okay to use it. Here is my recipe:

8 oz. of filtered water
8 oz. of hydrogen peroxide
2 tbs. sea salt

Will this damage my veneers?

Graham

Dear Graham,

A porcelain veneer on a tooth

It is great that you want to take care of your porcelain veneers. While your mouthwash won’t harm your porcelain veneers, I am concerned about long-term use of your mouthwash because of the peroxide. This will end up killing some of the microbes in your mouth, which will lead to the growth of candida albicans, a yeast. Regular use of this will cause you to get an oral yeast infection.

Using a mouthwash is okay, but you will want to make certain that there is no alcohol in the ingredients. Otherwise it will damage the bonding that keeps your veneers secure to your teeth.

One thing I will recommend is that you use Supersmile Toothpaste. This is specifically designed to work with cosmetic dental work without causing any damage to your veneers.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
Click here to learn about sedation dentistry options.

CEREC crowns

The Only Holistic Dentist Damaged My Teeth

I live in a small city and we only have one holistic dentist. I wanted to replace a metal based crown and two silver fillings to be all metal free. We started with the crown. She used one of those CEREC crown things. I thought that would be good because everything would go faster.

But, when my CEREC crown came in, it didn’t feel right. She said I just wasn’t used to having a proper crown because my old one was too big. Every time I tried to eat it hurt. I went back and she ground down the other side of my bite, but that made things worse.

I couldn’t take it anymore and went to another dentist who said that my CEREC crown wasn’t done properly. Was that because it was CEREC crowns? He redid it and said that in order to get my bite back he’ll need to add structure to the teeth that were ground down. He’s not a holistic dentist and I still need to get my silver fillings replaced. What do I do?

Angie

Dear Angie,

block of porcelain for a cerec crown.

The problem wasn’t the CEREC crowns. CEREC is run by a computer program, which put the onus on the skill of your dentist Remember the old saying Garbage in – Garbage out? That’s what happened in your case. The dentist didn’t know how to use the software and input the wrong information. Usually, because of the software, CEREC milled crowns are more accurate than those made in a lab.

Your dentist’s excuse that it didn’t feel right because you weren’t used to a proper crown doesn’t wash. When a crown is properly fit, you don’t even notice it. That was an excuse to shift the blame toward you.

I know you were excited about a holistic dentist, but it doesn’t help you if that particular dentist is not competent. There are plenty of dentists who do not label themselves as holistic dentists who would be willing to work with you on the materials used. Look for someone like a mercury-free dentist.

This blog is brought to you by a friendly Gilbert Dentist, Dr. Matt Roepr

Dental Emergency

I Think My Dentist Is Wrong

I see a dentist every three months. Even though it has only been two months, I asked for an extra appointment because I have a tooth that has been hurting for a few days. When I got there he looked at my imaging from my last appointment and said there were no signs of infections. He doesn’t see a crack or erosion in my filling near that tooth either so he thinks it’s probably fine. He gave me a z-pack and said as long as the pain goes away I don’t need to worry about anything. I feel like I’m being blown off. Of course it will feel better with antibiotics, right?

Drew

Dear Drew,

Woman holding her jaw from a toothache

I’m floored. I’ve heard stories about some questionable dental decisions before but this one is straight incompetence. First, let’s start with him looking at the previous x-rays. Of course there would be no signs of infection. Those were your x-rays from before your tooth started hurting. He should have done a new set of x-rays.

Next, let’s talk about him saying that if your antibiotic helps, you don’t need to worry about it or do anything. Your instinct is right. An antibiotic will make it feel better. That’s what it’s supposed to do. The infection will be held at bay until the antibiotics are completed and then the infection will start to flare back up again.

The only way to deal with a tooth infection is for a dentist to get in there and physically remove the infected pulp. Once you are done with this antibiotic, it will return, possibly stronger. At that point I would consider it a dental emergency.

Most people don’t realize that you can die from a tooth infection. In fact between six to ten people in the United States die from them every year. Don’t let this dentist’s incompetence make you one of them.

Find a different dentist and tell them what is going on to get the treatment you need.

This blog is brought to you by a top rated Gilbert Dentist Dr. Matt Roper.
Click here to learn about sleep dentistry.

Invisalign

Can I Get Invisalign After 60?

I just retired and inherited some money. I’ve always been embarrassed by my smile and would like to finally get straight teeth. I know my nephew got Invisalign and he had to tell me he had them. I couldn’t even tell. Am I too old to get that if I’m over 60?

Eleanor

Dear Eleanor,

An image of Invisalign aligners

First, congratulations on the retirement. That is very exciting. It’s even more exciting that you’re getting to live out a dream in improving your smile. The good news is that you are not too old to use Invisalign to straighten your teeth. In fact, you would not even be the oldest.

Dentists have these study clubs where they get together and discuss treatments along with how their patients are responding to them. While they respect their patient’s privacy and do not reveal information like their name or any other personally identifiable information. They only discuss things relevant to the treatment, such as age, etc.

In one of those groups, they were talking about the age ranges of their Invisalign patients. One of them had a 92 year old woman who was getting her teeth straightened and she was doing very well. So you see, compared to that, you are a mere babe.

You are right that no one will even know that you are straightening your teeth, just like your nephew’s treatment. Some people even call them invisible braces. There is another hidden benefit to Invisalign. They can double as teeth whitening trays. You would simply get some professional strength teeth whitening gel from your dentist and wear it in your aligners at a time that is convenient for you.

Doing this will not only straighten your teeth, but whiten them at the same time. Whitening alone can make your smile looks years, sometimes decades, younger, giving you a mini smile makeover. Because you can do them simultaneously, you will also be able to get that makeover at a fraction of the cost it would be if you did them separately.

This blog is brought to you by an affordable dentist in Gilbert Dr. Matt Roper.