CEREC: The One-Visit Solution for Same Day Crowns

Are you too busy for two dental appointments?

Technology today is changing our everyday lives. Technology also is impacting dentistry in new and exciting ways. Cutting-edge innovations in dental instruments mean less time in the dental chair, less discomfort and satisfying results. Recently, our office has incorporated a breakthrough instrument into our practice called CEREC®. This is a medical 3D printer. This “tooth printer” allows us to quickly restore damaged teeth with natural-colored ceramic fillings. This saves you time and makes your experience much more convenient and easy.

What Is CEREC?

CEREC is an acronym for Chairside Economical Restoration of Esthetic Ceramics, or CERamic REConstruction. Translated, it means that we can economically restore damaged teeth in a single appointment using a high-quality ceramic material that matches the natural color of other teeth.

How Does the CEREC Instrument Work?

CEREC uses CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) technology, incorporating a camera, computer and milling machine in one instrument. We use a special camera to take an accurate picture of the damaged tooth. This optical impression is transferred and displayed on a color computer screen, where we use CAD technology to design the restoration. Then CAM takes over and automatically creates the restoration while you wait. Finally, we bond the new restoration to the surface of the old tooth. The whole process takes about one hour.

What Does This Innovation Mean for Our Patients?

A tooth-colored restoration means no more silver fillings discoloring our patients’ smiles. The filling is natural-looking, compatible with tissue in the mouth, anti-abrasive and plaque-resistant. We no longer need to create temporaries, or take impressions and send them to a lab. Because of this, a second visit traditionally required for this process has been eliminated. With two decades of clinical research and documentation to support the technology, these restorations have been proven precise, safe and effective.

No conventional impression is needed for chairside fitting of implants. No more unpleasant impression trays or gagging. Customized abutments with crowns or directly screw-retained crowns can be made chairside, in one session.  Customized solutions meet the highest standards for clinical safety and natural-looking results.

The benefits of chairside restoration of implants:

• Fast: Digital impressions enable you to fit implants in one session
• High quality: Customized abutments provide greater clinical safety than standard abutments. In addition, the tooth-colored abutment ensures a natural look.

Is This an Option for You?

Just ask us when you’re in the office next, send us an email at julie@chadds.net or give us a call at (707) 579-1201. We will be happy to answer your questions about this new technology. Or look out for the 1-800-Dentist commercials offering same day crowns. They are talking about using CEREC technology and we have it here already!

Dental Exam

A comprehensive dental exam will be performed by your dentist at your initial dental visit.  At regular check-up exams, your dentist and hygienist will perform the following:

• Examination of diagnostic X-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.  X-rays also help determine tooth and root positions.
• Oral cancer screening: Check the face, neck, lips, tongue, throat, tissues, and gums for any signs of oral cancer.
• Gum disease evaluation: Check the gums and bone around the teeth for any signs of periodontal disease.
• Examination of tooth decay: All tooth surfaces will be checked for decay with special dental instruments.
• Examination of existing restorations: Check current fillings, crowns, etc.

Professional Dental Cleaning

Professional dental cleanings (dental prophylaxis) are usually performed by Registered Dental Hygienists.  Your cleaning appointment will include a dental exam and the following:

• Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface.  Calculus forms above and below the gum line and can only be removed with special dental instruments.
• Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth.  It is a growing colony of living bacteria, food debris, and saliva.  The bacteria produce toxins (poisons) that inflame the gums.  This inflammation is the start of periodontal disease!
• Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Dental X-Rays

Dental radiographs (X-rays) are essential, preventative, diagnostic tools that provide valuable information not visible during a regular dental exam.  Dentists and dental hygienists use this information to safely and accurately detect hidden dental abnormalities and complete an accurate treatment plan.  Without X-rays, problem areas may go undetected.

Dental X-rays may reveal:

• Abscesses or cysts.
• Bone loss.
• Cancerous and non-cancerous tumors.
• Decay between the teeth.
• Developmental abnormalities.
• Poor tooth and root positions.
• Problems inside a tooth or below the gum line.

Detecting and treating dental problems at an early stage can save you time, money, unnecessary discomfort, and your teeth!

Are dental X-rays safe?

We are all exposed to natural radiation in our environment.  The amount of radiation exposure from a full mouth series of X-rays is equal to the amount a person receives in a single day from natural sources.

Dental X-rays produce a low level of radiation and are considered safe.  Dentists take necessary precautions to limit the patient’s exposure to radiation when taking dental X-rays.  These precautions include using lead apron shields to protect the body and using modern, fast film that cuts down the exposure time of each X-ray.

How often should dental X-rays be taken?

The need for dental X-rays depends on each patient’s individual dental health needs.  Your dentist and dental hygienist will recommend necessary x-rays based on the review of your medical and dental history, dental exam, signs and symptoms, age consideration, and risk for disease.

A full mouth series of dental X-rays is recommended for new patients.  A full series is usually good for three to five years.  Bite-wing X-rays (X-rays of top and bottom teeth biting together) are taken at recall (check-up) visits and are recommended once or twice a year to detect new dental problems.

Root canal therapy is needed when the nerve of a tooth is affected by decay or infection.  In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is filled with special, medicated, dental materials, which restore the tooth to its full function.

Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed.  Many patients believe that removing a tooth that has problems is the solution, but what is not realized is that extracting (pulling) a tooth will ultimately be more costly and cause significant problems for adjacent teeth.

Root canal treatment is highly successful and usually lasts a lifetime, although on occasion, a tooth will have to be retreated due to new infections.

Signs and symptoms for possible root canal therapy:

• An abscess (or pimple) on the gums.
• Sensitivity to hot and cold.
• Severe toothache pain.
• Sometimes no symptoms are present.
• Swelling and/or tenderness.

Reasons for root canal therapy:

• Decay has reached the tooth pulp (the living tissue inside the tooth).
• Infection or abscess have developed inside the tooth or at the root tip.
• Injury or trauma to the tooth.

What does root canal therapy involve?

A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).

While the tooth is numb, a rubber dam (a sheet of rubber) will be placed around the tooth to keep it dry and free of saliva.  An access opening is made on top of the tooth and a series of root canal files are placed into the opening, one at a time, removing the pulp, nerve tissue, and bacteria.  If tooth decay is present, it will also be removed with special dental instruments.

Once the tooth is thoroughly cleaned, it will be sealed with either a permanent filling or, if additional appointments are needed, a temporary filling will be placed.

At the next appointment, usually a week later, the roots and the inside cavity of the tooth will be filled and sealed with special dental materials.  A filling will be placed to cover the opening on top of the tooth.  In addition, all teeth that have root canal treatment should have a crown (cap) placed.  This will protect the tooth and prevent it from breaking, and restore it to its full function.

After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.

You will be given care instructions after each appointment.  Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.

The term “periodontal” means “around the tooth.”  Periodontal disease (also known as periodontitis and gum disease) is a common inflammatory condition that affects the supporting and surrounding soft tissues of the tooth, eventually affecting the jawbone itself in the disease’s most advanced stages.

Periodontal disease is most often preceded by gingivitis which is a bacterial infection of the gum tissue.  A bacterial infection affects the gums when the toxins contained in plaque begin to irritate and inflame the gum tissues.  Once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat.  Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone.  If left untreated, it can cause shifting teeth, loose teeth, and eventually tooth loss.

Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

Types of Periodontal Disease

When left untreated, gingivitis (mild gum inflammation) can spread to below the gum line.  When the gums become irritated by the toxins contained in plaque, a chronic inflammatory response causes the body to break down and destroy its own bone and soft tissue.  There may be little or no symptoms as periodontal disease causes the teeth to separate from the infected gum tissue.  Deepening pockets between the gums and teeth are generally indicative that soft tissue and bone is being destroyed by periodontal disease.

Here are some of the most common types of periodontal disease:

• Chronic periodontitis – Inflammation within supporting tissues cause deep pockets and gum recession.  It may appear the teeth are lengthening, but in actuality, the gums (gingiva) are receding.  This is the most common form of periodontal disease and is characterized by progressive loss of attachment, interspersed with periods of rapid progression.
• Aggressive periodontitis – This form of gum disease occurs in an otherwise clinically healthy individual.  It is characterized by rapid loss of gum attachment, chronic bone destruction and familial aggregation.
• Necrotizing periodontitis – This form of periodontal disease most often occurs in individuals suffering from systemic conditions such as HIV, immunosuppression and malnutrition.  Necrosis (tissue death) occurs in the periodontal ligament, alveolar bone and gingival tissues.
• Periodontitis caused by systemic disease – This form of gum disease often begins at an early age.  Medical condition such as respiratory disease, diabetes and heart disease are common cofactors.

Treatment for Periodontal Disease

There are many surgical and nonsurgical treatments the periodontist may choose to perform, depending upon the exact condition of the teeth, gums and jawbone.  A complete periodontal exam of the mouth will be done before any treatment is performed or recommended.

Here are some of the more common treatments for periodontal disease:

• Scaling and root planing – In order to preserve the health of the gum tissue, the bacteria and calculus (tartar) which initially caused the infection, must be removed.  The gum pockets will be cleaned and treated with antibiotics as necessary to help alleviate the infection.  A prescription mouthwash may be incorporated into daily cleaning routines.
• Tissue regeneration – When the bone and gum tissues have been destroyed, regrowth can be actively encouraged using grafting procedures.  A membrane may be inserted into the affected areas to assist in the regeneration process.
• Pocket elimination surgery – Pocket elimination surgery (also known as flap surgery) is a surgical treatment which can be performed to reduce the pocket size between the teeth and gums.  Surgery on the jawbone is another option which serves to eliminate indentations in the bone which foster the colonization of bacteria.
• Dental implants – When teeth have been lost due to periodontal disease, the aesthetics and functionality of the mouth can be restored by implanting prosthetic teeth into the jawbone.  Tissue regeneration procedures may be required prior to the placement of a dental implant in order to strengthen the bone.

Please contact our office if you have questions or concerns about periodontal disease, periodontal treatment, or dental implants.

A denture is a removable dental appliance and a replacement for missing teeth and surrounding tissue.  They are made to closely resemble your natural teeth and may even enhance your smile.

There are two types of dentures – complete and partial dentures.  Complete dentures are used when all of the teeth are missing, while partial dentures are used when some natural teeth remain.  A partial denture not only fills in the spaces created by missing teeth, it prevents other teeth from shifting.

A complete denture can be either “conventional” or “immediate.”  A conventional type is made after the teeth have been removed and the gum tissue has healed (usually takes 4 to 6 weeks).  During this time, the patient will go without teeth.  Immediate dentures are made in advance and immediately placed after the teeth are removed, thus preventing the patient from having to be without teeth during the healing process.  Once the tissues shrink and heal, adjustments will have to be made.

Dentures are very durable appliances and will last many years but may have to be remade, repaired, or readjusted due to normal wear.

Reasons for dentures:

• Complete Denture – Loss of all teeth in an arch.
• Partial Denture – Loss of several teeth in an arch.
• Enhancing smile and facial tissues.
• Improving chewing, speech, and digestion.

What does getting dentures involve?

The process of getting dentures requires several appointments, usually over a period of several weeks.  Highly accurate impressions (molds) and measurements are taken and used to create your custom denture.  Several “try-in” appointments may be necessary to ensure proper shape, color, and fit.  At the final appointment, your dentist will precisely adjust and place the completed denture, ensuring a natural and comfortable fit.

It is normal to experience increased saliva flow, some soreness, and possible speech and chewing difficulty, however this will subside as your muscles and tissues get used to the new dentures.

You will be given care instructions for your new dentures.  Proper cleaning of your new dental appliance, good oral hygiene, and regular dental visits will aid in the life of your new dentures.

Teeth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile.

Because having whiter teeth has now become the number one aesthetic concern of most patients, there are a number of ways to whiten teeth.  The most popular method is using a home teeth whitening system that will whiten teeth dramatically.  Since teeth whitening only works on natural tooth enamel, it is important to evaluate replacement of any old fillings, crowns, etc.  Replacement of any restorations will be done after bleaching so they will match the newly bleached teeth.

Teeth whitening is not permanent.  A touch-up may be needed every several years, and more often if you smoke, drink coffee, tea, or wine.

Reasons for teeth whitening:

• Fluorosis (excessive fluoridation during tooth development).
• Normal wear of outer tooth layer.
• Stained teeth due to medications (tetracycline, etc.).
• Yellow, brown stained teeth.

What does teeth whitening involve?

This type of teeth whitening usually requires two visits.  At the first appointment, impressions (molds) will be made of your teeth to fabricate custom, clear, plastic, trays.

At your second appointment, you will try on the trays for proper fit, and adjustments will be made if necessary.  The trays are worn with special whitening solution either twice a day for 30 minutes or overnight for a couple of weeks depending on the degree of staining and desired level of whitening.  It is normal to experience tooth sensitivity during the time you are whitening your teeth, but it will subside shortly after you have stopped bleaching.

You will receive care instructions for your teeth and trays, and be encouraged to visit your dentist regularly to help maintain a beautiful, healthy, white smile.

A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures, etc.  The decayed or affected portion of the tooth will be removed and then filled with a composite filling.

There are many types of filling materials available, each with their own advantages and disadvantages.  You and your dentist can discuss the best options for restoring your teeth.  Composite fillings, along with silver amalgam fillings, are the most widely used today.  Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or more visible areas of the mouth.

As with most dental restorations, composite fillings are not permanent and may someday have to be replaced.  They are very durable and will last many years, giving you a long lasting, beautiful smile.

Reasons for composite fillings:

• Chipped teeth.
• Closing space between two teeth.
• Cracked or broken teeth.
• Decayed teeth.
• Worn teeth.

How are composite fillings placed?

Composite fillings are usually placed in one appointment.  While the tooth is numb, your dentist will remove decay as needed.  The space will then be thoroughly cleaned and carefully prepared before the new filling is placed.  If the decay was near the nerve of the tooth, a special medication will be applied for added protection.  The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.

It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.

You will be given care instructions at the conclusion of your treatment.  Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.

A crown (or cap) is a covering that encases the entire tooth surface, restoring it to its original shape and size.  A crown protects and strengthens tooth structure that cannot be restored with fillings or other types of restorations.

Although there are several types of crowns, porcelain (tooth colored crown) are the most popular.  They are highly durable and will last many years, but like most dental restorations, they may eventually need to be replaced.  Porcelain crowns are made to match the shape, size, and color of your teeth, giving you a long-lasting, beautiful smile.

Reasons for crowns:

• Broken or fractured teeth.
• Cosmetic enhancement.
• Decayed teeth.
• Fractured fillings.
• Large fillings.
• Tooth has a root canal.

What does getting a crown involve?

A crown procedure usually requires two appointments.  Your first appointment will include taking several highly accurate molds (or impressions) that will be used to create your custom crown.  A mold will also be used to create a temporary crown which will stay on your tooth for approximately two weeks until your new crown is fabricated by a dental laboratory.

While the tooth is numb, the dentist will prepare the tooth by removing any decay and shaping the surface to properly fit the crown.  Once these details are accomplished, your temporary crown will be placed with temporary cement and your bite will be checked to ensure you are biting properly.

At your second appointment, your temporary crown will be removed, the tooth will be cleaned, and your new crown will be carefully placed to ensure the spacing and bite are accurate.

You will be given care instructions and encouraged to have regular dental visits to check your new crown.

Veneers are very thin pieces of durable, tooth shaped porcelain that are custom made (for shape and color) by a professional dental laboratory.  They are bonded onto the front of teeth to create a beautiful and attractive smile.

Veneers can completely reshape your teeth and smile.  They can often be alternatives to crowns and the ideal solution in treating many dental conditions.

As with most dental restorations, veneers are not permanent and may someday need replacement.  They are very durable and will last many years, giving you a beautiful long lasting smile.

Reasons for porcelain veneers:

• Cosmetically, to create a uniform, white, beautiful smile.
• Crooked teeth.
• Misshapen teeth.
• Severely discolored or stained teeth.
• Teeth that are too small or large.
• Unwanted or uneven spaces.
• Worn or chipped teeth.

What does getting porcelain veneers involve?

Getting veneers usually requires two visits to complete the process, with little or no anesthesia required during the procedure.  The teeth are prepared by lightly buffing and shaping the surface to allow for the thickness of the veneer.  A mold or impression of the teeth is taken and a shade (color) will then be chosen by you and the dentist.

On the second visit the teeth will be cleansed with special liquids to achieve a durable bond.  Bonding cement is then placed between the tooth and veneer and a special light beam is used to harden and set the bond.

You will receive care instructions for veneers.  Proper brushing, flossing and regular dental visits will aid in the life of your new v

What is a dental implant?

A dental implant is a small titanium screw that serves as the replacement for the root portion of a missing natural tooth. Dental implants can be placed in either the upper or lower jaws. Due to the biocompatible properties of titanium, a dental implant fuses with the bone and becomes a good anchor for the replacement tooth. Dental implants can be used in solutions for replacing single or multiple missing teeth.

Why dental implants?

There are a number of reasons why you should consider a dental implant: Without the root structure of a natural tooth present, the jawbone can shrink. This shrinkage will make your face look older than it is. There are no loose parts to worry about losing. The dental implant is stable and comfortable. No adjustment is needed after placement. Normally, it will serve its owner for life.

How much do dental implants cost?

The fee for tooth replacement with dental implants depends on several factors, including the number of teeth being replaced and the number of dental implants required to support your replacement teeth. Some additional procedures may be required prior to the placement of your dental implants to ensure the long-term health of your dental implants. To obtain a specific fee estimate, it is necessary to have a doctor examine your mouth. After a thorough diagnostic examination, your dentist will recommend the treatment that is best for you.

Who is a Candidate?

Anyone who is missing one or more teeth due to injury, disease or tooth decay may be a candidate for dental implants. The determining factor is the amount of available bone. Your dentist is the best person to evaluate whether dental implants are a viable solution for you.

Is old age a problem?

Occasionally, older patients express concern that their age may prevent them from enjoying the benefits of dental implants. Health is more of a determining factor than age, If you’re healthy enough to have a tooth extracted, you’re probably healthy enough to receive dental implants. Certain chronic diseases may contraindicate dental implant treatment. Your dentist will determine if your a candidate for dental implants after careful evaluation of your dental & health history.

What are the advantages of dental implants over dentures or a dental bridge?

Improved appearance: When you lose the entire tooth – crown and root – shrinkage of the jawbone may cause your face to look older. Dental implants can stop this process. A traditional denture or dental bridge doesn’t.

Preserve natural teeth: With traditional dental bridges, teeth adjacent to missing teeth are normally ground down to be used as anchors for a dental bridge. Dental implants often eliminate the need to modify healthy teeth.

Permanent solution: There are no loose parts to worry about losing. The dental implant is stable and comfortable. No adjustment is need after placement. Normally, it will serve its owner for life.

How will dental implants affect my life?

Dental implant-supported replacement teeth look, feel and function like natural teeth. This means that you can eat and drink whatever you choose. But most importantly, dental implants often improve quality of life in a very concrete way. People who have felt embarrassed and worried because of their tooth problems are often overwhelmed by what new permanent teeth can do for their self-esteem.

Will my new teeth look natural?

When dental implants are used in combination with modern restorative dentistry, their appearance, comfort and function are very likely to exceed your expectations. Often they are hard to tell apart from your natural teeth.

Will I be able to chew with the same force and pressure I use with my natural teeth?

Yes. Following a brief adaptation period, chewing capacity is comparable to that of natural teeth.

How much time is required for a dental implant placement?

Today, state-of-the-art guided surgical techniques are convenient alternatives to place dental implants and allow you to have the dental implant placed in a single session using keyhole surgery. This new method has significantly simplified the procedure, for both patients and dentists. The major advantage of the guided surgical technique is the minimal amount of manipulation of the soft tissue due to keyhole surgery. This significantly reduces the healing time and the discomfort normally associated with traditional dental implant surgical techniques.

The conventional process can take from three to six months. First, the dentist places the dental implant, which is left for three to six months to heal and integrate with the jawbone. During the healing period, your are given a temporary prosthesis until the permanent crown is put in place.

The procedure chosen depends on several factors, such as your dental health, the number of teeth involved and which teeth are replaced. These factors will also determine the total number of visits to the dentist throughout the treatment period.

Is the treatment painful?

With any surgery, there can be some discomfort. Placing one implant normally causes less discomfort then placing several. Anesthesia and patient sedation are commonly administered to help reduce any discomfort during the dental implant process. Most patients report that they were much more comfortable following the procedure than they had anticipated. Your doctor will prescribe medications to ease any discomfort that may occur. Ask your dentist to recommend another patient who has already had tooth replacement therapy to assess their personal experience.

How will I feel after the treatment?

It is normal to have some bruising and swelling in the gum and soft tissues. But usually the discomfort, if any, is treated with an ordinary painkiller. You should expect to be able to work the next day.

How will I care for my dental implants?

Your new teeth must be cared for and checked regularly, just like your natural teeth. Brush and floss as recommended by your dentist or dental hygienist. See your dentist in six months, or more frequently if so advised.