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Here’s what you should know about dental crowns:

What is a crown?

Dental crowns are an ideal restoration for teeth which have broken, cracked or been weakened by tooth decay or a very large filling. The crown fits right over the remaining part of the tooth, making it strong and giving it the shape and contour of a natural tooth. Crowns are sometimes called caps.

Why would I need a crown?

There are a number of reasons:

  • Your tooth was weakened by having a very large filling.
  • You have discolored fillings or a dark tooth and would like to improve the appearance.
  • You have had a root canal which will require a crown to protect it.
  • Your tooth was fractured or cracked.

What are crowns made of?

Crowns are made of a variety of materials. Each choice has advantages and disadvantages.

Here are some of the options:

  • Porcelain bonded to precious metal: This is the majority of crowns. A precious metal base is made and porcelain is then applied.
  • Porcelain: These crowns are not as strong as porcelain bonded to metal but they can look very natural and are most often used for front teeth.
  • Precious metal (gold): These crowns are very strong and hard-wearing, but are usually used at the back of the mouth where they are not visible.

How is a tooth prepared for a crown?

The dentist will prepare the tooth to the ideal shape for the crown. This will involve removing most of the outer surface and leaving a strong inner ‘core.’ The amount of tooth removed will be the same as the thickness of the crown to be fitted. Once the tooth is shaped, the dentist will take an impression with a digital scanner. With this new technology there is no need for sticky impression material that can cause gagging. The digital impressions are transmitted to our own laboratory technicians along with any other information needed to make the crown.

Who makes the crown?

The impression and shade information will be given to our in-house dental technicians. They are highly skilled and very experienced in making crowns. Using the digital information, models of your teeth will be milled using cad-cam technology. The crown will be constructed by hand to ensure that the crown fits perfectly. All of our crowns are handmade in-house. Computer aided crown fabrication available elsewhere does not meet our high standards.

Will the crown be noticeable?

No. A porcelain/metal crown, or an all porcelain crown, will be made to match your other teeth exactly. The shade of the neighboring teeth will be recorded to make sure that the color looks natural and matches the surrounding teeth. A temporary crown, usually made in plastic, will be fitted at the end of the first appointment to last until the permanent one is ready. Though temporary in nature, these plastic crowns are made to function very effectively.

How long does treatment take?

At least two visits are needed, the first for the preparation, impression, shade matching and fitting the temporary crown, and the second to fit the permanent crown.

Does it hurt to have a tooth prepared for a crown?

No. A local anesthetic is used and the preparation will feel no different than a filling. If the tooth does not have a nerve, then local anesthetic may not be needed.

How long will a crown last?

The life of a crown will depend on your oral hygiene. The crown itself cannot decay, but decay can start where the edge of the crown joins the tooth. It is very important to keep this area as clean as your other teeth, or decay may occur around the crown. Properly cared for crowns will last for many years — your dentist will advise you how long.

How are crowns fixed to teeth?

Once the fit and appearance of the crown has been checked — and approved by you — it will be cemented in place with special dental cement. The cement also forms a seal to hold it firmly in place.

Will the crown feel different?

No. It should feel fine and natural to you. The crown may need some adjustment if it feels like it crowds the surrounding teeth. If it is at all uncomfortable, you should ask your dentist to check and adjust it.

Technology

At Restorative and Aesthetic Dental Associates we know technology makes dentistry more comfortable, accurate and cost effective. We strive to keep abreast of new innovations to make your care better in these respects.

Digital Scanning

Our most recent advancement is the iTero digital scanner. We use this instead of conventional impression techniques for crown and bridge as well as implants and soon Invisalign orthodontics. This allows us to obtain precise models without the large mouthful of goop used in other offices. Your teeth are scanned with a LASER scanner similar to those used to scan UPC codes in check out lines at the supermarket. The information is processed in a computer and emailed off site and a model is fabricated in a CAD CAM facility. The model is returned to our office where our on premise laboratory custom fabricates your crown or bridgework. Our ability to evaluated each phase of the process on a computer monitor increases our accuracy and quality without time wasting reimpressions which require additional appointments that delay delivery and waste your time. Our patients have been happy with this innovation. We are the first office in Maine to have this type of scanner.

Digital X Rays

Here at Restorative and Aesthetic Dental we have made a significant effort to keep up with technological advances. Our x ray units are all digital which allows us to use minimal amounts of radiation get the information we need. This innovation allows us to make infinite exact copies. These copies can be emailed to specialists, if a specialty referral is needed, cutting down on unnecessary exposure and costs to you, the patient.

Laser Surgery

Another advancement is our use of a Diode Laser for some gum procedures. The Laser can be used instead of other surgical modalities which in the past have required a referral to a periodontist. LASER surgery can, in some cases, can decrease postoperative discomfort as well as speed healing. The LASER can also be used to speed healing of aphthus ulcers and other oral lesions.

Dental Implants: The Ideal Choice for Replacing Missing Teeth

When you are looking to replace missing teeth, whether a single tooth, several teeth, or all of your teeth, dental implants are an ideal option if you are in good health.

While traditional bridgework used to be our first choice, dental implants have overtaken bridges as the first and most ideal option for replacing missing teeth in most circumstances. A big advantage of dental implants is that they do not require the preparation of neighboring teeth for support. With proper conditions and diligent patient home care, dental implants will last decades.

Uses for dental implants:

  1. Replacing one or more teeth.
  2. Supporting a bridge and eliminating the need for removable dental work.
  3. Helping in the retention of a loose denture, making it more secure and comfortable.
  4. Preserving bone in the area of the missing tooth.

What is an implant?

A dental implant is basically a titanium post that is embedded in the bone. The bone grows tightly around the implant, making it quite secure. Dental components are then added to the top of the implant, creating an artificial tooth that is lifelike in both appearance and function.

What are some of the advantages of dental implants?

Improved Appearance Dental implants look and feel like your own teeth! Since dental implants integrate into the structure of your bone, they prevent the bone loss and gum recession that often accompany bridgework and dentures. No one will ever know that you have a replacement tooth.

Improved oral health. Dental implants don’t require reducing other teeth, as a tooth-supported bridge does. Because nearby teeth are not altered to support the implant, more of your own teeth are left intact, improving your long-term oral health. Individual implants also allow easier access between teeth, improving oral hygiene

Tooth-saving Dental implants don’t sacrifice the quality of your adjacent teeth like a bridge because neighboring teeth are not altered to support the implant. Your existing teeth are untouched, a significant long-term benefit to your oral health!

Confidence Dental implants will allow you to once again speak and eat with comfort and confidence! They are secure and offer freedom from the irksome clicks and wobbles of dentures. They’ll allow you to say goodbye to misplaced dentures and messy pastes and glues.

Reliable The success rate of dental implants is highly predictable. They are considered an excellent option for tooth replacement.

In our office, placing dental implants is a team effort.

We work closely with some of the finest oral surgeons and periodontists in the area to provide you the optimum outcome. After a thorough diagnostic workup and consultation, your surgeon will place the dental implant fixture to our specifications. Following a short healing time, we will custom fabricate the components to create your beautiful new teeth.

We take the time to custom fabricate everything for you.

While most dental offices use stock components off-the-shelf, we custom fabricate each component specifically for your mouth and situation. Utilizing computer technology, the implant components are custom milled to fit the contours of your gums and teeth. The artificial teeth are then custom-fabricated in our own dental laboratory to ensure the highest quality treatment outcome.

Come talk to us to learn how we can help you.

If you need to have a missing tooth or teeth replaced, dental implants offer the highest quality, longest lasting, most life-like tooth replacement possible. Our office provides totally custom fabricated treatments using a team approach to provide to you the best treatment outcome possible. Call us for an appointment to see how we can help you.

Response to Dental Shielding

Response to Dr. Oz call for Mammographic and Dental Shielding

FROM: TERRY D. ZIPPER, M.S., DABR
DATE: March 28, 2011

We have had many inquiries about the recent recommendation from TV show host Dr. Oz that patients who undergo dental and mammographic x-rays wear thyroid shields.

These radiographic procedures focus a radiation pulse on either the breast or mouth, and a small amount of this radiation may be “scattered” to other areas of the body.

The organs sensitive to radiation from dental x-rays are the lens of the eye, and in children, the thyroid gland. The sensitive organs (other than the breast) from mammographic x-rays are also the lens of the eye and the thyroid gland.

Part of our duties as medical physicists is to promote radiation safety and lead shielding is one way to reduce radiation exposure to patients.

We agree with the concept that radiation can cause injury to the cells in our body, and that we should all keep our radiation exposure as low as reasonably achievable. However, the radiation exposure to the thyroid and lens of the eye from these procedures is very small. Damage to the eye (cataracts) would require about 50,000 dental x-rays to occur. The exposure to the thyroid from mammograms is also very small.

Some published studies have claimed that an overall increase in thyroid cancer may be partly due to dental x-rays. However, with the modern x-ray equipment currently used by dentists, this cause is unlikely, and we have not found any publication that actually proves the claim.

The American Dental Association (ADA) recommends that thyroid shields be worn by patients during x-ray exposure, especially children.

The American College of Radiology (ACR) recommends that thyroid shields not be worn by patients due to interference with or the masking of diagnostic information and because the dose is so low it is very unlikely to cause harmful effects.

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April 14, 2011: Response from the American Association of Physicists in Medicine (AAPM) regarding the use of lead aprons and thyroid shields in mammography: please click to view response (This link will take you away from the PCI site.)

Press Release

Restorative & Aesthetic Dental Associates

Portland, Maine

Restorative and Aesthetic Dental Associates is pleased to be the first dental office in Maine to feature the Itero imaging technology.  This new tool creates 3 dimensional digital images of a single tooth or the entire mouth.  The quality of the images is the first step in creating beautiful restoration work such as crowns, bridges, and implants.

Dr. Scott Burke, D.M.D, one of the dentists at Restorative and Aesthetic, praised the new patient experience.  “Many patients really dislike the old process of making impressions – carefully drying their teeth, inserting the impression material, and keeping it in their mouth for 3 minutes.    The Itero replaces that entire process and patients are very pleased with the results.”

The Itero machine is made by Cadent, Inc.  and has been on the market for 3 years.   But Restorative and Aesthetic is the first Maine dental office to acquire the Itero technology.  Another partner in the practice, Dr. Leigh Philbrick, D.M.D., commented “We are committed to the use of technology to improve patient results and overall experiences.”

Most dental offices in the state use gummy impression materials to develop molds for the creation of crowns, implants, bridges, and other restorative products.  They then send the impressions or models to an offsite dental lab, (often out of state), to create the actual crown.  Or in some cases they use milling machines which lack precision and accuracy to manufacture  crowns.  Restorative and Aesthetic will still hand make all crowns and restorative products in their high quality, on-site lab.  Dr. Tom Corwin, D.D.S., reaffirmed the practice’s commitment to quality “The Itero imaging solution has been a fantastic tool for improving the imaging process but there isn’t a machine yet that can match the quality of our lab’s restoration work.  Patients can be assured that our lab technicians and dentist will continue to provide the quality they are accustomed to.”

About Restorative and Aesthetic Dental  Associates

Restorative and Aesthetic Dental Associates was founded in 1954.  The practice is home to Drs. Burke, Philbrick, and Corwin who have been practicing together since 1993.  They provide general dentistry, regular care, and aesthetic services to patients who value a high quality of care.  The practice prides itself on the longstanding relationships they form with patients.    For more information about the practice, call 207-773-6331.

What Is An In-house Dental Lab

So what’s the big deal about having an in-house dental lab?  Let’s say it is like wanting to get a beautiful ring made but instead of driving to the mall jewelry store, you go to the talented craftsman who works in your neighborhood and makes all kinds of exquisite jewelry.  You don’t have to go to the chain store and get something made for you even if it is made according to your design.  Better is the person locally who can not only make your personal design but you can watch him to make sure every detail is what you want.  And remember that this jeweler is someone you know personally as a talented, ethical and dedicated craftsman.

Now let’s think about what this means in a dental office.  You might not know that very few dental offices have their own dental labs.  Most dentists send their lab work to mass production labs either in our area or out of the state.  You probably do know that the most precise and long lasting dentistry is that involving placing crowns on teeth to strengthen them.  Crowns are best made out of precious metals such as gold, platinum or palladium.  They can also be made out of porcelain.  These materials are nothing in themselves without someone with talent and skill working them into shapes which perfectly mimic the form and function of natural teeth.  Our two lab technicians, Karen and Robin have years of experience handling these materials, capable of producing any restorations with great skill and integrity.

Some further advantages are that because these talented technicians work within our office they are there to help choose the right colors (shades) for crowns no matter how intricate and individual teeth colors may be.  Also, they can respond immediately to the needs of dentists (and patients) by modifying restorations while the patient waits eliminating the need to return for additional appointments.  There is no temptation to accept “good enough” when these ladies can repair or modify restorations to make them the “best”.

As a dentist I cannot tell you how important Robin and Karen are to me as co-laborers in the very gratifying profession of creating mouths that function with health, harmony and beauty.  They produce provisional crowns, final crowns, implant crowns, occlusal guards (night guards), bleaching trays, athletic mouth guards, and other appliances.  They also create diagnostic wax-ups, which are like blue prints for rehabilitating entire mouths.  Thanks to them, the doctors, and more importantly the patients, at Restorative and Aesthetic Dental Associates have the best dental laboratory skills possible.

What is the future for your mouth?

If only your dentist could predict the future of your mouth. When that

molar would start to decay. When that filling would disintegrate. If

they could see into the future, one would think they could also take

action now to prevent or lessen its impact, right?

Exactly right. Look no further, for all of us dentists at Restorative

and Aesthetic Dental Associates are not only skilled and well-trained

in the dental craft, we are also that rare breed of dentists known

as…. Nostradentists. It’s true! Because we listen to you, because we

ask you about not only your whole mouth, but how you are doing as a

person,  we also gain a ton of info about your dental health – without

even looking in your mouth. Taking the time to really observe each

patient helps us accomplish the best dentistry in the most efficient

way.

But when we do look into your mouth, we can see the future just by

studying the present condition of your teeth. Just like in the rest of

your life, the decisions you make today regarding your teeth have

consequences on your future health and well-being. With our decades

and decades of experience as dentists, we are able to predict with

some certainty how fractures, wear, missing teeth and heavily filled

teeth will act over time.

We feel it’s our responsibility as your dentist to show you the

present condition of your mouth, and advise you on the likely

consequences of treating or not treating these issues…today. It’s

also our responsibility to listen to your goals, fears and priorities.

Together, this helps us predict your best dental future.

We’re here to help you make the right decisions for your dental

health. Make an appointment with us today! No crystal ball necessary.

Address:
650 Brighton Ave. Portland, ME 04102
Phone:
207.773.6331
Fax:
207.773.3701
Email: