CEREC crown appt scheduled - Have a couple questions

[sharon]

I've had consultations with 3 different dentists for the 2 CEREC crowns I have to have and finally scheduled an appt with the third. I felt very comfortable with him and actually left the appt almost looking forward to the crown appt, which is very strange for me. I will take valium the night before and the morning of and hope that will get me through with little anxiety.

Here are my questions -

All the advertising hype on the web talks about a one hour appt for a CEREC crown. In reality how long does it take? I am scheduled for 3 hours, yes THREE!!! He said it takes 20 minutes to mill, 20 (or 30 or 40, can't remember exactly how much) in the kiln, so I'll be spending a lot of time just sitting there. I haven't read anything on the web about the kiln, just the milliing, so what is with this denist, why 3 hours? Can anyone help me understand or tell me how long your appts were?

What's with the impression? Again all the hype says no impression which is why I wanted this. I went into full panic and depression mode thinking about having an impression. But he tells me I have to have a small one to get the bite right? Is this true? Have you had to have this? How small is small?

And how big is the thingie that takes the digital picture? I know I've asked before but I need to ask again. Is it gag inducing big? Bigger than the gigantic digital xray?

What happens if I lose my tooth? Big fear of mine, he takes the old crown off, sees the tooth can't be saved and has to pull it. (This has happened to me before.) One of the crowns is on #10. I can't leave with a big gap there. Nor can i sit there while he puts crowns on the two adjacent teeth so that I can have a bridge (nor can I afford that). He told me not to worry about it. I am worried about it. What happens?

Thanks, Sharon

 

[blackhound]

I have had CEREC inlays done so I can only speak to that. I believe "Steve in Cleveland" has had CEREC work as well. Not sure if he had crowns but hopefully he can enlighten you on that process if he has.

I can tell you in general terms about the process. Again, I had inlays so there may be variations in how it is done for a full crown. After the tooth is prepared, the dentist will spray a powder in the area of the tooth needing restoration. The wand that goes in your mouth to take the measurements is small. It is nothing more invasive than any of the other dental instruments. You will hear it 'click' as it takes the measurements. Then the 3D image of your tooth/teeth will show up on a screen in front of the dentist and he will do some work with the digital pen to make sure the tooth is milled to his needs.

I had 3 inlays done in one appointment (my choice). Each inlay took about 20/25 minutes to mill. In the case of the inlay there was no kiln process that I am aware of.

I know that someone telling you the process is no big deal is cold comfort when you are dealing with anxiety, but the CEREC process is not a horrible procedure. I was actually thrilled with the whole business and the result. Yes, it was a long time in the chair but I came out with 3 shiny 'new' teeth. You'll do great.

BH

 

[Sparkles]

Hi Sharon

Just thought i'd jump in here as I had a CEREC crown done a couple of weeks ago, and i've also had CEREC inlay done.

Blackhound described the process very well its pretty much the same for an inlay and a crown.

After the dentist has got you nice and numb he will remove the old filling and give the tooth a clean and check it is ok to take the crown. He might polish some of the surfaces of the tooth to make them a good surface for the crown to sit on. The preparation of my tooth took about half an hour, but that's cause I can only work in 10 second bursts so may be faster for others!!

There is a powder that gets dusted over the tooth, a wand like metal thing that takes the 3D scan of the tooth (it's not big) and is only in your mouth for a few seconds it doesn't hurt and just sits over the tooth and clicks when its taken the scan.

Then I had a piece of wax only big enough to cover that single tooth to bite down on and then the scan thing again so they could see how the crown would fit with my bite. The wax part is NOTHING like getting impressions done. I promise as I hate impressions. This was barely noticeable. Like biting down on a bit of chewing gum.

The the dentist can show you the 3D image on the computer and it takes him some time to design the crown around the image and make sure it will be the right size, shape and contour for your tooth. That maybe took about 10-15mins.

The the crown gets milled (cut) to shape that takes about another 10mins and then after getting the colour right (he literally paints some stuff onto it) mine went into the oven for 30mins. After that it needs a little minute to cool and they put the glue inside the crown and stick it on your tooth then it is simply a case of some minor polishing to get it to feel like a normal tooth and sit comfortably in your mouth. The adjustments take as long as is required till it feels ok for you, took me about 15-20 mins but again that is due to working in small bursts.

Don't worry that the dentist has allowed 3 hours, you will not be sitting in the chair getting work done for that length of time and will probably be finished much faster than that. You will be fine, it is honestly the nicest procedure i've had done and actually was really interesting seeing the 3D image and watching as he designed it.

I know it's easier said that done but honestly its very straight forward and painless. Hope this helps.

 

[sharon]

Sparkles and Blackhound, thank you for your good descriptions. Maybe when they say 1 hour they mean 1 hour plus mil time plus kiln time. I can't imagine all of that taking only one hour. I have to have build up done so that will also add time. To me it seems that since I've already had a crown on both of these teeth there can't be that much to drill away.

A little wax impression I can handle, especially since you say you hate impressions, Sparkle, but you could handle this. I hate impressions so much and that is what has really been putting me over the edge.

So afraid I will lose the tooth and have to leave the office with a big hole.

10 second bursts of work time - I would like that but I also want him to do everything as fast as he can I can get out of there sooner!

 

[Steve In Cleveland]

Sparkles' description pretty much match my experience with CEREC. I didn't know there was a kiln involved but it's taken around a half an hour to get the crown created, and I usually sit in the lobby and read. My dentist's system doesn't seem to require an impression that I can remember, but bear in mind when you read about CEREC online that there are various versions of both the machine and the software, and it's fairly pricy. So whatever CEREC is hyping at the latest medical shows may not be entirely what your dentist has.

The picture taking gizmo is about the size and shape of a toothbrush, not gag-inducing (and I have a terrible gag reflex!). They do have to get your mouth really dry and spray a powdery substance around the tooth, so you have to hold open and still for a minute or two while the pictures are taken, but it's nothing gaggy at all.

Regarding your question, what happens if the tooth fails after removing the old crown? I don't think that there would be an immediate need to extract the tooth; most likely your dentist would add a temporary crown much like they do for an incomplete root canal, to cover and protect the remaining tooth. Before CEREC, I had six crowns fit at the same time for #6-#11, and so the dentist had to make temporaries to wear for the week or two it took to have permanent crowns made at the lab. The temporaries looked and felt and functioned just like normal teeth (the color was a bit off). So I think if the tooth isn't eligible for a crown your dentist could make a passable temporary until you decide what to do long term (implant, "flipper", or bridge). But I don't think you'll be sent home with a giant hold in such a visible place as #10.