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A Conversation About Crowns - The Quality and Convenience of Same Day Restoration

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Finding ways to relieve stress for patients with better techniques is always a top priority at Bellano. In this blog, Dr. Mefford shares his wealth of knowledge about same day crowns and the technology that is redefining the patient experience.

  • What are crowns?

A crown is a way to restore a tooth that has been damaged, either by decay or cavity, or by trauma. For example, if someone chipped a tooth accidentally, crowns are a way to restore the tooth to form and function. Crowns are made outside the mouth, and then seated in the mouth with a type of cement. A crown covers the damaged tooth and makes it whole again.

  • How do crowns differ from other cosmetic dental procedures?

Cosmetic cases are typically elective, and patients can make their choices based on preference. Crowns are typically a necessity. If the patient wants to save the damaged tooth and maintain a healthy smile and bite, they need the crown.

  • What is the process for getting Same Day Crowns?

For all crowns, we start by getting a record of the damaged tooth and creating a model of it. This used to be done with the goopy impression material, but advances in technology have drastically improved the process.

For same day crowns, we use a digital scanner to take a 3D picture of all your teeth, including the damaged tooth. We then design the crown on a computer using this 3D model. This is all done right in the office, chair-side, within a minute of taking the impression.

Next, we use CAD Cam technology to fabricate the crown. We start with a block of porcelain and use a milling machine that essentially carves out the crown, like carving a statue out of marble. This process is extremely precise, creating accurate crowns that fit without needing adjustments. It really is a high quality restoration.

Because the crown is milled in our Bellano office and not sent off to a lab, we’re able to finish the entire process within the span of a few hours. The patient can go home that same day with a new, permanent crown.

  • How do same day crowns differ from traditional crown procedures?

Traditional crowns are created in a lab, and not in-office. The dentist takes a physical impression of the tooth, using the goop we mentioned previously, and mails that model to the lab. The lab then creates the crown and mails it back to the dental office. This process can take 2-3 weeks, during which time the patient wears a temporary, plastic crown which has a higher risk of fracturing than the permanent crown. When the permanent crown arrives, the patient would need to come back into the office to have their new crown applied.

The difference between same day crowns and traditional crowns can be broken down into two things, quality and convenience.

QUALITY: The new approach for same day crowns is more comfortable for patients and is much more accurate. There is little to no distortion in a digital impression, especially in contrast with the older goopy impressions, and we get a 1:1 digital model of what the tooth measures in shape and size. The accuracy of the digital scan helps us create a higher quality crown that fits better, and therefore lasts longer.

As the dentist taking care of the patient and knowing their teeth, I am the most qualified person to be designing the crown. I know exactly what I want it to look like, and with this Same Day Crowns technology I no longer need to rely on someone at the lab to read my mind.

CONVENIENCE: The key that every patient can appreciate is the convenience of same day crowns. Typically with same day crowns, I can take care of a single crown in 2 hours or less! We do a little work at the beginning of the appointment, then they wait comfortably in the office while we make the crown. We try to fill their time waiting with any other routine or cosmetic dental procedures they may want. We value our patients’ time, and like to help simplify their lives as much as we can. They no longer have to wear a temporary crown, wait weeks for the lab to make and ship the crown to us and then come back to the office for it to be applied.

  • Are there circumstances when same day crowns might not be an option, and the patient needs a traditional one? Can you give an example?

While we can do multiple crowns in a single visit, the benefits of same day restoration start to decrease once you get past 3 crowns. That 4th crown would add a substantial amount of time to the appointment because we have one mill in the office, and can only mill one crown at a time. Each crown takes about 15 minutes to mill, so if you’re doing many more than three it lengthens the time in-office, and we would most likely tell the patient that it’s best to make temporary crowns and have the patient come back.

That said, we can still make 4 or more crowns at our office so patients can come back within a few days to have their permanent crowns applied. This is still a much faster turnaround time than two weeks, and offers peace of mind for patients.

There are special cosmetic cases where we seek the hand of a master ceramist. In these circumstances, we send the lab our digital impressions in order to maintain the maximum level of quality and fit.

  • Which doctors at Bellano perform same day crown procedures?

Currently, I (Dr. Mefford) am the only Bellano dentist that performs same day restorations. We do these at our Appling office.

  • Who would make a good candidate for crowns? Is there anything that makes someone a poor candidate?

There are rare occasions where the material I use to make my same day crowns wouldn’t be a good fit for someone with a very hard bite/clench or who grinds their teeth. Couple that with it being on the very back teeth where they can create more force. We may need to send out for a particular crown that would hold up well for these patients. It’s pretty rare that I have to make this call, but I will sometimes. Our in-office CAD Cam technology is especially beneficial for patients who use Invisalign trays as it makes an exact clone of the pre-existing tooth so there is no discomfort or issues when wearing the tray after a crown is applied. Same day crowns really do work for a lot of people.

  • How do I care for dental crowns?

It’s just like caring for your natural teeth. We recommend brushing and flossing twice a day. There’s still a natural tooth under the crown so while porcelain doesn’t decay (like a tooth), the tooth underneath can re-decay if not cared for.

Also just like natural teeth, we recommend being careful with hard foods, like chewing ice or biting hard candy. Patients can confidently chew, if I’ve done my job right.

  • How much do crowns cost and does insurance cover it? Does the Bellano Dental Savings Plan apply to crowns?

Crowns are a worthwhile investment. If we’re in-network with your dental insurance, what we charge is dictated by the insurance company. We would have this conversation ahead of time so patients are aware of what’s coming. If you participate in the Bellano Dental Savings Plan, you would receive the standard discount.

  • What should I expect the day of my procedure?

There are no special pre-appointment requirements. Get ready just like you would on any other day. If you’re coming for a couple of hours, you may enjoy being in comfortable clothes but our patients wear everything from suits to uniforms.

While we’ve done a thousand of these procedures, we always remind ourselves this may be the patient’s first experience of this type. To help ease our patients, we have awesome assistants who answer all questions before we start and we establish communication practices (such as raising hand if you need a break) to ensure that patients are comfortable and feel like they can speak up at any point.

Also before we begin, we make sure the patient is fully numb and we do offer nitrous oxide for those patients who would like a little more help relaxing.

  • How should I care for my teeth to avoid needing crowns?

Prevention starts with a good diet (avoiding sugary foods and drinks), good at home care and a good partnership with your dental office. We have a great team here to build hygiene plans for our patients, that include ADA approved toothpaste with fluoride, regular x-rays, and routine appointments to catch problems early so it’s a cavity and not a crown.

  • I think I need a crown, what should I do?

Call our office or go online to schedule a consultation appointment!

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