CEREC Crown Feels Weird

I had a dental crown placed on an upper molar a few years ago that broke. I wanted if fixed quickly, so I went to a nearby dentist who did CEREC crowns. When the crown was done it felt very uncomfortable, almost like I had an oversized marble in that spot. My dentist said I should just give it time, but I didn’t remember the original crown feeling like this bulky. I started biting my tongue in my sleep and decided I have to go back. She did see that it was a bit bulky at that point and started to grind it down a bit. It still feels big after that and my tongue is still being bitten in my sleep. I don’t know what to do at this point. I thought that CEREC crowns were supposed to be good, but maybe I need the regular kind?

Connie

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Dear Connie,

I am sorry you’ve ended up with two bad dentists in a row. First, your original crown should have lasted more than just a few years. Then, you end up with a dentist who does not understand either crowns or how to work the CEREC software. I don’t understand how she didn’t realize the crown was too bulky until you had to go back and point it out.

CEREC crows are generally more accurate because the dentist will scan the original tooth and and then the software can build up the crown based on the shape of the scan. In your case, she did not have the scan, but it is not hard to work the software to guide it in a way that it would build up the crown properly. She obviously did not know how to do that.

Her comment that you just need to “give it time” is very telling. When a crown is properly designed, you will not notice it at all. It will feel just like a healthy natural tooth. She should have known that too.

In your place, I would not trust her to get this right with the CEREC machine. It sounds like she is just now learning how to use the software. As much as you wanted to get this done fast, your best shot to get this fixed at this point is to either get a refund and go to a different dentist who does CEREC crowns or have this dentist do a traditional crown.

She absolutely should not leave it like this because not only can an improperly done crown can lead to TMJ disorder and biting your lip or tongue can lead to tumors. She needs to make this right one way or another.

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

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.

Will My Final Dental Crown Fall Off Like the Temporary One?

I am nervous about getting my permanent dental crown because the temporary one will not stay on. I got the crown in May, and it came off three times. Each time, my dentist bonded it back on. Should I ask my dentist to retake impressions of the tooth? – Thank you. Anvit from Silver Springs, MD

Anvit,

Thank you for your question. Your concerns are valid; we recommend waiting before you get a final crown.

Is It Normal for Temporary Crowns to Fall Off?

Although a temporary crown may fall off, it is unusual to fall off three times within two months. Your dentist may have taken wrong impressions of your tooth or over-prepared it so the crown will not stay on.

Over-preparing a tooth for a crown

If a dentist aggressively prepares your tooth, it will not leave enough tooth structure for securing your crown. Strong dental cement will not keep the crown on because it may be so much larger than the tooth beneath it that the crown is not secure.

Inaccurate tooth impressions

It is not unusual for a dentist to take incorrect tooth impressions. Sometimes fluid oozes around the impression and contaminates it. A dentist must examine the impression to look for mistakes and retake the impression as needed.

Can You Switch Dentists for a New Crown?

Your temporary crown is the model that the dental lab will use for your final crown. If your temporary crown does not fit well, neither will your final crown. At this point, you can ask your dentist for a refund and a copy of your dental records. Look for an experienced cosmetic dentist to examine your tooth and take accurate impressions for a crown that looks natural and fits precisely.

 

Dr. Thomas J. Goebel, a Moline, Illinois, cosmetic dentist, sponsors this post.

How Long Can I Delay Fixing a Crack in a Tooth Crown?

My second molar has a hairline crack. I got four crowns in 2002, so they are aging. Last month, I felt the crack as my tongue ran alongside the side of my tooth. But now I can see the crack, and I can feel it with my finger. How long can I delay getting it fixed? I am leaving for Pennsylvania in early July to give my sister a break from caregiving for our mom. Is this an emergency? I don’t want to be in another state and need a new dentist for a crown. It would take me away from the reason I am traveling. Thanks. Journee from Pittsburgh, PA

Journee,

Although the hairline crack in your crown is not a dental emergency, it probably will not be too long before the crown breaks.

How Long Can You Delay Fixing a Cracked Dental Crown?

It is usually not a concern if a tooth or dental crown has a craze line or hairline crack. But if you could feel the damage in the past but now see it, your tooth is getting worse.

We recommend asking your dentist to examine your cracked crown and the other crowns to determine the extent of the damage. Depending on the condition of your crowns, your dentist may recommend replacing all of them because they are old. Also, talk to your dentist about your travel plans. If you may be at risk of the crown breaking while in Pennsylvania, it is better to find out now so you can replace the crown before traveling. Dentists who use CAD/CAM technology can make a new crown for you in one visit.

Ensure your dentist has the cosmetic dentistry training to color match your crowns with your natural teeth and ensure your bite is well balanced.

Dr. Thomas J. Goebel, a Moline, Illinois, cosmetic dentist, sponsors this post.

Please give step-by-step instructions to safely pull my own tooth

Please help. In November, I started feeling a toothache on and off. Now the tooth is starting to hurt really bad, but it’s not an emergency yet. I take Advil, and I can get along without horrible pain. Two weeks ago, I saw my dentist, and she wanted to do a root canal and a crown, but I do not have money for that. I can’t even afford her tooth extraction fee. I am down to part-time work on 2 different jobs.

Before it gets even worse, I just need step-by-step instructions on how to safely pull my tooth at home without doing any damage to other teeth, cutting myself, or doing some damage. It is not my intention to be reckless about this. I do not need an emergency room bill either. I Googled it and found instructions online, but nothing looks like it’s really from a dentist. This is a top left second molar tooth with a filling that I think either fell out or is no good. Thank you for helping me without making me feel bad about this. Abel from Colorado

Abel –

Thank you for contacting our office. Unfortunately, we cannot provide you with step-by-step instructions to safely pull your tooth at home. We would feel horrible about you receiving instructions on pulling your tooth and finding out later that something went wrong. In addition to the factors you mentioned, it will be difficult to know if you have removed all parts of the tooth or if anything remains. Please understand that we want to help. We will advise you in the best way for your long-term oral health.

Instructions for Extracting Your Tooth—Know the Dangers

Even if you find instructions for extracting your tooth, it is not wise. Please consider that a toothache is a symptom of an infection. An examination is needed to determine if the infection has spread into the jawbone or other teeth. Even if you successfully remove the tooth, the infection may still be there. You will need root canal treatment to get rid of the infection. Your dentist knows the condition of your tooth and recommends a crown because a tooth is weak after root canal treatment.

Think about the consequences of removing your tooth:

• How will you ensure that the instruments you use are sterile for use in your mouth?
• What will you do if you have excessive bleeding, pain, or swelling during or after the extraction?
• What if the tooth roots are deeply embedded, and only part of the tooth comes out?
• How will you get rid of the tooth infection and prevent it from spreading to other teeth?

Save a Tooth Whenever Possible

The good news is that the tooth may not need to be extracted at all. We recommend that you call a few dentists in the area, explain your urgent need for dental care (it is an emergency), as well as your financial situation. You can find a dentist who offers payment plans and financing and will give you the correct treatment for your tooth.

We wish you the best, and we urge you not to treat the tooth yourself.

Dr. Thomas J. Goebel, a Moline Illinois dentist, sponsors this post.

Can I see an emergency dentist and get a new crown right away?

My old crown fell off my left front teeth, and I think I need a new one. I’m going out of town next Friday to visit my family in NY. I will be gone until January. If I can get in to see an emergency dentist, will I be able to get a new crown within the next three days? I don’t want to take the risk of being out of town with a loose crown and having my vacation ruined. Thanks. Ezra from Colorado

Ezra– An emergency dentist will examine your crown and bond it back to your natural tooth if possible. Unless the emergency dentist provides same-day crowns—and you are a candidate for one—it is unlikely that you will be able to get a new crown right away. And still, the dentist may not have time in their schedule to make the crown during your visit.

Is a Same-Day Crown the Best Option for a Front Tooth?

Additionally, the location of the crowned tooth affects the type of crown that is best to use as a replacement. If a front tooth is involved, a porcelain crown made by a laboratory will produce more natural-looking results than a crown that a dentist completes the same day. A ceramist at a lab can add a layer of porcelain over a crown to ensure it looks like a natural tooth.

If you have a dentist that you regularly see, schedule an appointment with your current dentist instead of visiting an emergency dentist. Dentists arrange time in their daily schedules for emergency appointments. They will see you promptly and be able to make a recommendation for you.

You can likely receive a temporary crown to protect your tooth. A durable temporary crown can last for months. It can help you avoid making a rushed decision that you may later regret.

Thomas J. Goebel, DDS, of Moline, Illinois, sponsors this post.

What Can I Do About Tooth and Gum Pain from Acid Reflux?

I was diagnosed with GERD earlier this year. I’ve been on and off medication, but now I am changing my diet and doing other things to minimize the problem. My gums burn, and my teeth are so sensitive that it hurts to chew food. Two weeks ago, I saw my dentist, and she said that if the problem continues, she will recommend crowns to protect them from reflux. Are crowns necessary, or is there some coating that can protect my teeth? Thanks for your help. –  Anatoly from NY

Anatoly,

Thank you for choosing our office for your question.

GERD (gastroesophageal reflux) is a disorder that causes fluid from the stomach to back up into the esophagus. When the acid backs up into your mouth, it can burn your gums and erode your teeth. Also, medications used to help control the issue can cause dry mouth—limiting saliva production and saliva’s bacteria-fighting effects.

How Can You Prevent Acid Reflux from Eroding Your Teeth?

The based way to prevent acid reflux from damaging your teeth is to get the disorder under control. As you mentioned, dietary changes can help. Avoiding spicy and acidic foods and drinks can help calm your stomach. In the article, Erosion – Stomach Upset and Your Teeth, the American Dental Association also recommends these precautions:

• Avoid eating food at least three hours before bedtime
• Avoid smoking and drinking alcohol
• Chew sugar-free gum to increase saliva production
• See your dentist regularly to help protect your teeth

Dental Care for Acid Reflux

• Fluoride treatment – Your dentist can recommend fluoride treatment to strengthen your teeth and minimize sensitivity.
• Toothpaste for sensitive teeth – Toothpaste, such as Sensodyne, can minimize sensitivity.
• Rinsing your mouth – Thoroughly rinse your mouth with water after every meal to neutralize the stomach acid and protect your teeth.
• Dental crowns – Covering your back teeth with crowns will protect them from stomach acid. But over time, acid can seep in, attack your teeth, and weaken the crowns.

Thomas Goebel, DDS, a cosmetic dentist in Moline, Illinois, sponsors this post.

 

My dental crowns and bonding don’t match

I needed two old crowns replaced and some repairs for chips on three front teeth. My dentist placed CEREC crowns are on my left first and second molars. I’ve had this dentist for four years, but he never did any major work on my teeth. The crowns look great. But he placed the dental bonding three weeks ago, and it is the wrong color. And I am not sure how it happened, but my left front tooth is longer than the right one now, and the color on my incisors and canine teeth do not match the crowns.

I complained to my dentist about the color and the long tooth. At first, he told me to give it a week. When I went back to the office, he said that he would see what he can do. I scheduled an appointment for last week, but I canceled it because I am afraid that he will make my teeth look worse.

I chose this dentist because he is calm, and I have dental anxiety. But I can tell you that I am getting anxious about my teeth. My dentist does not sound confident that he can correct the bonding. If he can’t get the bonding right on the next try, will it hurt my teeth for another dentist to remove and replace the bonding? Thank you. Tiera from KS

Tiera,

Thank you for your question.

Dentists complete dental bonding by hand. Bonding is an artistic procedure with each tooth as the canvas. As an artist, a dentist must select and manipulate dental composite for the right color, texture, and translucence to match your surrounding teeth. A small number of dentists have artistic talent and advanced training to produces results that look like a natural tooth. Unfortunately, your description sounds like your dentist lacks the experience, creative talent, and training to achieve your desired results.

Cosmetic Dentists Are Persistent

Artistic cosmetic dentists take their art personally. They will not settle on a smile that looks okay. They listen to you and will not complete your case until you are happy with the results. Your dentist’s comments reflect that you can adjust to the way your teeth look or he will try again. But what if you do not like the results?

Can a Dentist Remove and Replace Dental Bonding?

An advanced cosmetic dentist can remove and replace dental bonding on your teeth. And a cosmetic dentist has the required tools to remove the bonding only without damaging your teeth. But if you think you might need to have another dentist redo the bonding, why not schedule a consultation with a cosmetic dentist? The dentist will examine your teeth and bonding and explain what they will do to ensure a perfect match with your CEREC crowns and surrounding teeth.

Thomas J. Goebel, DDS, a cosmetic dentist in Moline, IL sponsors this post.

My tooth is turning dark, but my dentist is not concerned

My right incisor is turning dark, but my dentist is not concerned about doing anything to it. She says that it is not that bad. I have a small smiling in the corner of the tooth to replace a chipped-off piece. But I was 17 years old when it happened. Now, I am 47, and the tooth is getting darker. My dentist said the tooth is dead, and the canal is calcified, so it is too risky to do a crown. And she said that I would not be happy with a veneer, and it costs too much anyway. She suggests that I do nothing unless it becomes very noticeable. But it is noticeable and getting darker. What are my options? Thank you. Trevor

Trevor,

Your description sounds like your dentist is uncomfortable with cosmetic dentistry procedures. We recommend that you not ask your dentist to provide treatment that she is not comfortable completing. Many patients who insist on treatment are unhappy with the results.

Cosmetic Dentistry Options for a Dark Tooth

A porcelain veneer or direct dental bonding are treatment options for a dark tooth. But a dental crown requires aggressive preparation—grinding your tooth to a stub. And usually, a crown is not necessary for correcting tooth color.

• Porcelain veneer – A dentist with advanced cosmetic dentistry training works with a skilled ceramist at a lab to custom craft a veneer. The veneer will match the shape and size of your dark tooth, but the color will match your other teeth. If you want your teeth whitened, do it before you get a veneer.
• Direct dental bonding – While you sit in a dental chair, a cosmetic dentist can mix shades of dental composite to match your surrounding teeth. The dentist will apply, shape, and harden the bonding, then polish it to a natural gloss.

Schedule a Consultation with a Cosmetic Dentist

Although only one tooth is dark, a dentist who does not understand cosmetic dentistry can make your tooth look worse. So look for cosmetic dentists in your area. And examine patient cases in their website smile gallery. If a dentist does not have a website or smile gallery, perhaps they do not have any beautiful work to show. But read online reviews, too, before you schedule a consultation.

You can do something about your dark incisor tooth. And a cosmetic dentist can correct it with a porcelain veneer or dental bonding. Best wishes for a beautiful restoration.

 

Timothy J. Goebel, DDS, a  Moline, IL dentist, sponsors this post.

My new crown has been hurting for months

In January, my dentist put a crown over a top left molar that was cracked, sensitive, and had an old silver filling in it. During the procedure, my dentist had trouble getting the tooth numb, so drilling it was quite painful. When the dentist checked my bite, I told her that it hurt to chew on that side. Later during the week, I told the dentist that it was also painful to brush the tooth and floss around it. She never mentioned that I might need root canal treatment.

The dental office told me that the tooth was irritated and would settle down. I return to the office, and my dentist adjusted the crown. She said that if it did not feel better, she would readjust. I delayed the appointment due to the pandemic, but my tooth became quite painful in a few weeks. My dentist adjusted the crown again, and although it was somewhat better, it was still uncomfortable.

Last week when I saw the dentist, she said the tooth has a periapical abscess, and I need an extraction. My dentist has no explanation of why she didn’t see that the tooth was declining during my follow-up visits. How can I request a refund for the same-day crown? And is the same-day crown process the reason I had so many problems? – Thank you. Quinn from Indiana

Quinn,

Thank you for your inquiry.

Based on your description, it sounds like your dentist was somewhat negligent for several reasons:

• Cracked tooth – Your molar tooth was already cracked and at risk of needing root canal treatment. Your dentist should have mentioned the possibility of needing root canal treatment.
• Sensitivity – Some sensitivity after crown placement is common, but the pain you experienced was abnormal.
• Your bite – When your dentist checked your bite, she should have worked to get it right. A crown should blend with your bite so well that you cannot tell the difference between it and your natural teeth.

Requesting a Refund for a Dental Crown

You can request a refund for your crown for several reasons:

• Your dentist did not explain that you might need root canal treatment
• Your dentist placed the crown on a sensitive tooth without addressing the sensitivity
• The same-day crown does not function well and did not function properly when your dentist first checked your bite
• Your dentist did not attempt to treat the tooth despite your complaints further

Several ways to motivate your dentist to refund you include:

• Report the issue to your dental insurance company, if applicable
• File a complaint with the state dental board
• Leave negative online reviews

Consider Root Canal Treatment from a Specialist

Root canal treatment on a tooth with a periapical abscess is worth a try. It may save your tooth—especially if you allow an endodontist, a root canal specialist, to treat it. If there is a chance of saving your tooth, why not consider it? Otherwise, after an extraction, you will need a dental implant or bridge to replace the missing tooth.

Without an implant or a bridge to replace your extracted tooth, you can experience some or all these issues:

• Your adjacent teeth and the tooth opposing the missing one will drift into the space
• You will begin to experience TMJ issues
• Tooth movement can create a need for orthodontic treatment

Get a Second Opinion

We recommend that you get a second opinion from an experienced dentist. A conscientious dentist wants to preserve your teeth and your oral health. Request an examination, discuss your treatment options, and weigh the pros and cons of tooth extraction.

Timothy J. Goebel, DDS, a Moline, IL dentist, sponsors this post.