Do CEREC Crowns Work as Well As the Traditional Ones?

I saw a dentist a few months ago for a checkup. I had one of those same days CEREC crowns placed a few years ago. During that checkup, the dentist told me that the crown wasn’t fitting well and needed to be replaced. She also told me that the posts, which were previously removed, should have been vibrated out and not been removed by drilling. I need a crown on a different tooth and have a couple of questions before moving forward. First, are the computer same day crowns as good as the old-fashioned ones? Second, did the drilling instead of vibration to remove posts damage the bone?

Kevin

Dear Kevin,

I’m actually going to start with your second question. While it is ideal to have the post removed by vibrations using an ultrasonic, it is not always possible. Removing them by drilling won’t damage your bone. In fact, drilling is done all the time in dental offices with no repercussions to bones. The real risk when you are drilling out posts lies in the drill slipping and perforating the side of the root as a result. This would mean the tooth would have to be extracted. It sounds like that was not a problem for the dentist who had to drill your posts out so I wouldn’t worry about it.

Now, about this crown. Same-day crowns actually have a better chance of fitting well than traditional crowns. This is because they are milled by a computer. I’m a bit concerned about your dentist simply saying “It’s not fitting well”. What do they mean by that? Did you come in complaining about the crown? If not, then what we look for when we are checking crowns are any gaps in the margins. If there were, that is what the dentist should have said instead of the generic terminology he or she used.

Dentists will use a tool called an explorer to search for any gaps in the crown. No gaps mean the crown is fine, unless you are having something like pain when you are biting. Gaps would signify a problem regardless.

If you weren’t experiencing any pain, I would recommend a second opinion before having that replaced. If you’ve already replaced it, then it is too late. As for this new crown, getting a CEREC crown is fine.

This blog is brought to you by Moline Dentist Dr. Goebel.

Misdiagnosis by an Emergency Dentist Caused a Lot of Pain

I had a tooth that was giving me pain and sensitivity to cold. I am new to the area so I do not have a regular dentist yet. I went to a dentist who advertised as a dental emergency specialist. I went in and he said my wisdom teeth are impacted. I told him that tooth 19 seemed to be the problem, but he said it is definitely the wisdom tooth and that one of them either needs to be extracted or filled. I opted for the filling. This made my pain even worse. I went back and he adjusted the tooth and wrote me a prescription pain medication. All that did was make me loopy. Once the prescription wore off I was in even worse shape. I called back and he said to have the tooth extracted. I told him the pain didn’t feel close to the wisdom tooth at all but he insisted that was the problem. I had the tooth extracted and was again prescribed painkillers along with antibiotics this time. I was okay for a bit while the medicines lasted. Once they ran out, though, I was in complete misery. I finally went to the ER and they did an x-ray and told me that I had an abscessed tooth. I got fed up with this dentist and went to see an oral surgeon out of pocket. He told me it was tooth 19 (shocker) and that it is now too late to save it, so I had that extracted too. I’m so frustrated because I had to do several unnecessary appointments, including the ER, and ended up losing two teeth. Do I have any recourse for this or do I just have to suck it up?

Trent

Dear Trent,

What a nightmare! You certainly have some recourse here. In short, what this dentist did is malpractice. First, I’m going to tell you what to require of him, then I will tell you what mistakes he made.

The first thing I would do is tell this dentist he needs to cover the expenses not only for your extra visits to the oral surgeon and ER, but also for the cost of an implant and a crown to replace your missing first molar, as well as any bone grafting that may be necessary with a dentist of your choosing. If he refuses, tell him you will contact a lawyer and add pain and suffering to the amount. I feel fairly certain his insurance company will tell him to settle quickly.

This “Emergency Dentist’s” Mistakes

Let’s start with the fact that there is no emergency dentist specialty. Any general dentist can schedule emergency appointments and treat patients. He misled you with that. Second, at your initial appointment with cold bringing pain to the tooth, he should have advised you that you would likely need a root canal treatment. I have no idea why he was bringing up your wisdom teeth with these types of symptoms. Then, with your second appointment when you are still having problems, he adjusts your bite? Really? The prescription for antibiotics tells me he either suspected an infection or was just throwing around treatment options willy-nilly. Plus, antibiotics never completely cure a tooth infection. The job of antibiotics is to hold the infection at bay while you are awaiting an appointment for your treatment. By the final appointment, there should have been no doubt. I don’t know how he passed his courses in dental school.

You may be wondering why I’m having you include the tooth replacement in there with what your dentist should cover. It is because if he would have treated this in a timely manner, there is a good possibility you could have saved the tooth. Now that it is out, it must be replaced. Otherwise, the remaining teeth will drift or tip into the space. This will throw off your bite and can lead to painful TMJ Disorder. A dental implant is the best replacement available.

This blog is brought to you by Moline Dentist Dr. Thomas Goebel.