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Welcome to the second blog post in my 8-week series about the different types of services a typical dentist offers! Last week’s topic was all about dental fillings.

This week’s topic is about DENTAL CROWNS!

Dental crowns are typically prescribed by dentists to act as a full-coverage protection of weak teeth that:

Dental crowns have evolved tremendously during the past few decades. Most dentists back in the day used GOLD as the primary material for crowns. Gold was a great choice of material due to its durability, strength, and conservative preparation requirements. However, its limitations were predominantly in its poor visual appeal.

As we became more aesthetic-conscious, porcelain-fused-to-metal (PFM) crowns quickly rose in popularity. PFM crowns achieve their strength and rigidity from their metal substructure, and their natural aesthetics from the porcelain coated on top of the metal. This enables dentists to seamlessly blend the dental crown with your natural teeth because porcelain is able to mimic the natural contour and color of teeth.

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Over the last decade, dentistry has moved even further away from metal due to the gray discoloration it can produce by the gum line. Nowadays, full-ceramic crowns like Feldspathic, Emax, and Zirconia are the most common materials used because of their superior aesthetic results. Though they lack metal substructure, they are extremely rigid and durable due to significant advances in ceramic dentistry. These advances have brought even more attraction to cosmetic dentistry.

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Though they are all ceramic, each material has different properties. Therefore, they differ in strength and aesthetics. Your dentist will determine which is the ideal ceramic material for you depending on your grinding habits, the nature of your bite, and the location of the tooth.

Below are a few key points that differentiate each ceramic material.  

Feldspathic: Feldspathic porcelain is ideal for front teeth and is typically used for veneers because it is the most visually appealing. It has great translucent qualities that mimic the natural tooth color most. However, it does not handle strong occlusal/bite forces. Thus, it is not ideal for posterior (back) teeth because it is not as strong as other porcelain.

Emax: Also known as lithium disilicate glass, Emax is the most commonly used ceramic for veneers and anterior restorations due to its excellent translucent qualities and strength. It is great for both front and back teeth. Emax crowns can also be bonded to your natural teeth. Thus, it is the ceramic of choice for short teeth that lack the height needed for adequate retention of the crown.

Zirconia: It is the strongest ceramic, but it is also the least aesthetic of the ceramic crowns. It is more opaque in color and lacks the translucency of a natural tooth because it is monochromatic in structure. It is made out of white, powdered metal oxide which gives it its incredible strength. Zirconia ceramic is the ideal material for dental bridges and for individuals who suffer from severe wear due to grinding and clenching. To compensate for its poor aesthetics, the dental lab can add a layer of porcelain on top of the zirconia layer, giving it a more natural appearance.

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This is a typical step-by-step instruction of how a tooth is prepared for a dental crown:

1. Your dentist will diagnose a crown if necessary, to protect your tooth.
2. When you achieve profound anesthesia, your dentist will use a high-speed drill to remove any decay and/or damaged enamel around the tooth. A “build-up” composite filling may be necessary to fill the areas if decay is extensive.
3. The dentist will continue to prepare the tooth so that at least 1 mm of tooth structure is removed from all around the tooth. This is necessary because this is where the porcelain crown will sit on top of the tooth to provide coverage.
4. Once the dentist is finished with the preparation, a mold or an impression, is made. This mold is used by the dental lab to fabricate your crown. Any disturbance in the mold will result in an imperfect crown, so it is crucial that the impression is perfect.
5. Your dentist or the dental assistant will fabricate a temporary crown chairside so that you can function normally as we wait for your crown to be made.

Seat Crown Appointment:

1. Two to three weeks later, you will come for another appointment to seat your permanent crown.
2. Your temporary crown is removed, and the permanent crown is seated. Your dentist will inspect the margins, making sure everything is properly sealed. A properly sealed tooth will have no space or voids between the tooth and the crown. Any voids or space will result in recurrent decay and/or sensitivity. Your dentist may use an x-ray to verify a proper seal.
3. Your bite will then be adjusted so that when you bite, the crown is not too high. A crown that is too high will cause pain and sensitivity, so it is crucial that it is adjusted properly.
4. After proper seating and bite is confirmed, your dentist will use a permanent cement to cement your crown.
5. Excess cement is cleaned. Your bite is re-checked for good measure.

Frequently Asked Questions:

Is it normal to feel sensitivity after a crown?

Yes!

Some people may feel sensitive for a few days after a crown preparation. This is because your tooth has just been worked on and may take some time to heal. If it gets worse, this may mean that the temporary or permanent crown may be too high and will need a bite adjustment.

Can I eat normally on that side?

Yes and no…

To be on the cautious side, I always caution my patients to eat softer foods where the temporary crown is. Sticky foods like gum and taffy should be avoided because they can stick on the temporary crown and remove it. Same with hard foods, they can crack it. However, once the permanent crown is cemented, you can eat and function as normal.

Are dental crowns expensive?

Dental crowns are NOT cheap!

Luckily, your dental insurance will almost always cover a portion of it (usually 50%). If your dentist has prescribed you a dental crown, don’t delay treatment! Delaying treatment can result in a much more complex restoration that is more expensive down the line (you may end up needing an extraction and implant, which will cost about $4,000). Ask your dental office if they offer any payment plans. It’s better to get started sooner rather than later!

How many appointments does it take to complete a dental crown?

Two!

One appointment for the preparation. The second appointment is to seat the permanent crown. The first appointment typically takes 45 minutes to an hour. The seat appointment usually takes 30 minutes.

Questions about dental crowns? Visit BMEDental.com or book your appointment online!

Today, I will be starting an 8-week series of blog posts talking about the different types of services a typical dentist offers. Each week’s post will be dedicated to a specific procedure in dentistry where I will explain what you really need to know, including what it is and how it is performed.  

This week’s topic is the most common procedure done in dentistry – FILLINGS!

Back in the day, most dentists used METAL amalgam fillings. Over time, we started moving away from metal fillings due to its mercury component, which is a known neurotoxin. Research has shown that mercury can have harmful effects on many of our vital organs throughout the nervous, digestive, and respiratory systems.

As a result, most dentist nowadays use composite filling, aka tooth-colored fillings, as the gold standard for restorative dentistry. Composite fillings are made from resin material and is the preferred material by many dentists due to its superior aesthetic results and good durability.

Though fillings are fairly straightforward conceptually, the procedure is quite technique-sensitive. For instance, a filling will come off if it is not bonded well to the tooth or if it is exposed to saliva during the packing process. It is important that proper technique is used during the procedure, which is why it is invaluable to choose an experienced dentist when getting a tooth filled.  

This is a typical step-by-step instruction of how a cavity is filled:

1. Your dentist will diagnose decay through an x-ray or from detecting it directly on the tooth surface during a clinical exam.
2. Using a high-speed drill, your dentist will remove the damaged enamel. The inside of the tooth is further cleaned so that only solid tooth structure remains.
3. Next, the remaining healthy tooth structure is etched. Etching is done so that we remove any residual debris on top of the tooth to ensure a good bond with the filling.
4. After the tooth is thoroughly etched and rinsed, a dental bond is applied and light-cured with a UV light. This bond allows the filling to chemically bond to the tubules inside the superficial layer the remaining healthy tooth structure.
5. The dentist will pack the filling material incrementally inside the prep.
6. Once they shape the filling and make sure there are no voids or gaps, the UV light is again used to cure the filling. This will harden the filling in place.
7. The filling is adjusted so that when you bite your teeth together, you are not hitting the filling first. Once the ideal bite is achieved, the filling is polished so that it is smooth to the tongue.

Frequently Asked Questions:

1. Once I get a filling, can I get a cavity on the tooth again?

It all depends on your oral hygiene!

If properly done, meaning no voids and no decay remaining under or around the tooth, the filling should last you a long time. If you are someone who continues to maintain a high-sugar diet and does not properly brush or floss, there is a good chance you will get a cavity around the area in a few years.

2. Is it Normal to feel sensitive after a filling procedure?

Yes!

Some people are more sensitive than others. It is very normal to feel sore for a couple days after a filling. Some may even feel sensitive for a week or two after a filling procedure. However, if it becomes worse, you should call your dentist ASAP because bite adjustments may be necessary. If your bite is off and the filling is too high, it can cause tenderness, cold sensitivity, and pain upon touch.

3. Will I Be Able to Tell if I Need a Filling?

Cavities are almost always asymptomatic, meaning they do not hurt or cause sensitivity until it is too late.

This means the decay inside the tooth has gotten so big that it has invaded your tooth nerve. In this case, a root canal may be required. It is best to address the cavity and get it filled as soon as possible to avoid a larger, more complex procedure!

Curious if you have any dental cavities? Get a thorough dental check up today!

Book online at BMEDental.com!

Why Did I Choose to Go Out of Network?

For the past 4-5 years as an associate dentist, I was in-network with all the dental insurance companies known to mankind. Not only were they frustrating to work with, they also had POOR reimbursement rates. The low reimbursement fees don’t even come close to covering the cost of providing QUALITY dental care my patients deserve.  

Out of Network Does NOT Mean Out of Benefits

Just because a provider is out-of-network with your insurance company, it does not mean you don’t have benefits!

Out-of-network just means your dentist does not have a contracted rate with your dental insurance company. We still accept your insurance, AND you most likely will have identical benefits as with an in-network provider.

In-network means your dentist has a contracted rate with your dental insurance company. In-network providers are reimbursed according to the dental insurances’ rates.

Insurance companies have done a great job misinforming the mass public about the difference between in-network and out-of-network providers. They have overexaggerated the out of pocket fees a patient has to pay by going to an out-of-network provider. They prefer you go to an in-network provider because it costs them LESS. Meanwhile, going to an out-of-network provider will barely make a difference to your out of pocket, AND your dentist will be able to allocate more time for you, the patient, instead of dealing with the insurance companies.

We Will Still File Your Insurance Claims!

We take care of insurance claims so you don’t have to deal with the headache of paperwork! Before and after your dental visit, we verify, submit, and process your claims, just like an in-network provider. We want to make it as easy as possible for you!  

Needless to say, dealing with insurance companies can be frustrating at times. I chose to be a non-contracted provider because I believe in providing the highest standard of care to my patients that is not quite possible while under contract with insurance companies.

If you continue to have questions or concerns regarding your insurance, don’t hesitate to call us at (972) 208-9998, or visit our Insurance Page!

Almost all Texas dental offices were temporarily closed for business for two and a half months when the stay-at-home order was in place from March to May. Some areas that were hit harder, like New York City and Seattle, were shut down for longer. For many, this has led to delayed check-ups and cleanings as well as delayed treatment of any existing cavities. To make matters even worse, quarantining and working from home has probably led to more snacking and sugary treats; and it may even have disrupted your oral care routine.

Here are a few Do’s and Don’ts to stay cavity-free during the pandemic. Keep in mind that though these tips will help prevent cavities from forming, it’s still very crucial to go to the dentist every 6 months. Regular dental visits ensure that those hard to reach areas can be properly cleaned, and gives your dentist the opportunity to address cavities that may have formed.

Do…

• Brush your teeth twice a day. It’s especially important to brush your teeth before sleeping to remove bacteria and plaque that collect on your teeth throughout the day. Cavities form when your mouth bacteria interact with sugar to form acid, which then starts the process of tooth decay.
• Floss every day. This removes food particles and bacteria that get stuck in between your teeth and under the gums. Flossing prevents cavities from forming between your teeth and prevents your gums from developing gingivitis or worse — gum disease.
• If you’re cavity prone, use ACT Mouthrinse as an added defense. This fluoridated mouth rinse oozes into those areas you can’t reach with a toothbrush or floss, giving you a better clean. It also provides a small dose of fluoride to help remineralize enamel that’s been damaged by the acid formed by your mouth bacteria and sugar. For more information about fluoride, read this research study showing the benefits of fluoride use to help recover demineralized enamel.
• Drink water frequently. Keeping hydrated has many health benefits, including oral health benefits. Not only does frequent water consumption flush out waste in your body, but it also removes external staining, bacteria, and sugar on your teeth. This means less cavities, less teeth staining, and reduced bad breath. If you drink coffee or tea regularly and want to avoid discoloration of your teeth, it’s a good idea to constantly drink water. This will help remove the superficial staining before it enters the dentin underneath your enamel, which is what causes yellow teeth.

Don’t…

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• …lose track of your oral hygiene routine. With the current pandemic crisis, many people are working from home and thus don’t have a set schedule like before. Maybe we sleep and wake up later. Or maybe dinner and lunch have merged into a single meal. Our schedule has become anything but routine. Though our “new normal” is vastly different from before, it’s important to maintain good oral hygiene care to prevent cavities and gum disease from invading your oral health.
• …consume sugary drinks and food often. Sugar leads to plaque, which leads to tooth decay. Frequency of consumption is just as important as the type of food you eat. Slowly sipping on a can of Coke throughout the day is more harmful for your teeth than chugging that same can of Coke. This is because the bacteria in your mouth creates acid when exposed to sugar, which sticks onto your teeth for approximately 30 minutes after you eat or drink. Thus, constant snacking or sipping on sugary food and drinks restarts the acid-plaque production, increasing your vulnerability to cavities.
• …go to sleep without brushing your teeth. Residual plaque erodes the superficial enamel of your tooth, which starts the process of tooth decay. Going to sleep without brushing your teeth allows that plaque to create damage on your enamel for 6-8 hours while you sleep.
• …delay your dental checkup. There may be small, lingering cavities forming that need to be treated as soon as possible to prevent it from getting bigger and leading to more aggressive dental treatment. Almost all cavities are asymptomatic, meaning you won’t feel it until it’s too late. If your tooth starts to hurt, it means that the tooth decay has gotten so big that it has invaded your tooth nerve. At this point, a root canal may be required. Be sure to schedule your appointment, and if you’re worried about the pandemic, ask your dentist what safety precautions their office is taking!

For more questions about oral hygiene care and preventing tooth decay, visit BMEDental.com, or book your appointment today at
972-208-9998!

It’s without a doubt that the Covid-19 Pandemic has affected everyone’s lives. Dentists and specialists alike have faced serious challenges during these past few months.

Fortunately, people have always been able to adapt to difficult situations. Many dentists today, only a few months after the surfacing of the virus, have been able to pivot their businesses to growth and success in light of these challenging times.

I began my search for my dream practice back in September 2019. At that time, I knew that business ownership had its risks, but I had the peace of mind that purchasing an existing practice would be more predictable than starting my own business.

Then, in the middle of my practice acquisition in March, the stay-at-home order was put in place. Just like everyone else, I was full of fear, anxiety, and uncertainty. This was my dream and I wanted it more than anything; but suddenly, the risks just got 10x bigger.

How long is this virus going to stay? Would it be safe? Would there be patients going to the dental office in the middle of a pandemic? Despite these thoughts of uncertainty, I decided to push through with the dental practice acquisition. I knew what I wanted to do, and that’s to become the best dentist that I could be and serve my community and their dental needs to the best of my abilities.

Now, I’m the new practice owner of an amazing dental practice in Plano, TX. After months of diligent research and hours of quarantine online continuing education, I feel confident that I can serve the people of Plano safely and effectively in the midst of Covid-19.

At BME Dental, we are exercising extreme caution in order to provide the highest standard of care to our patients and employees. For a full list of our Covid-19 Protocols, visit my dental practice website page at BMEDental.com.

Below are just some of the key changes we are implementing:

1. All patients and staff are required to wear masks during their entire visit and should only remove them right before we start their exam, cleaning or any dental treatment.
2. All patients are pre-screened prior to their appointment to make sure they haven’t had any symptoms or been in contact with any positive covid-19 patients. Temperature checks are performed right when they arrive for their appointment.
3. Only one patient is scheduled every 30-45 minutes. We switch operatory rooms for every patient, meaning each room will be unused for at least 30-45 minutes in between patients.
4. As we have always done prior to this crisis, we use CaviCide to thoroughly clean our dental operatory rooms after each patient.
5. We limit any aerosol-producing treatments and always have the high-speed power suctions on to minimize aerosols if we do any treatment involving the high-speed handpiece.
6. Myself and my dental assistant will be in full PPE including N95s, surgical masks, full body gowns, and face shields.

In light of everything, I feel very blessed to have such an amazing team of employees and loyal patients who remain 100% supportive and compliant of our new rules and regulations created by the pandemic. I would like to reassure those who are still feeling uncertain that going to your dentist is not high risk due to the high standards of precaution we take for ourselves and for our patients.

This pandemic may be here for a while and it’s important we adapt to it accordingly. When the AIDS/HIV crisis hit nearly three decades ago, similar levels of fear, anxiety and uncertainty invaded our society. But through that crisis, the CDC implemented stricter rules and regulations that made gloves and masks part of our gold standard for safety. I believe that with extreme caution and safety, BME Dental will be able to serve my patient’s oral health safely and effectively through this Covid-19 pandemic.