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Medical Forum / General / Dentistry / June 2006Cerec Porcelain inlay
A couple of questions for the group: I just started seeing a new dentist 3 months ago and on the initial visit , he and his assistant convinced me that I need to replace the old metal fillings on 3 teeth with porcelain inlays. I never usually question a doctor or dentist I just assume they are recommending necessary treatment. After talking to some people I'm starting to wonder, especially since he has the cerec (?) machine in his office, if he didn't push me to do the procedures because of this. Anyway... 1) If the insurance co. pre approves a procedure is it more likely to be necessary? 2) I had 2 of the 3 done last week and now I have a sesitivity to hot or cold liquids, is this normal? It seems like I am having more problems with the teeth now then before the procedure. 3) I'm wondering if it is really necessary to do the third. The previous dentist I went to never suggested that I needed the fillings replaced, and I saw him 6 months proir to seeing the new guy. I changed dentist due to a cross country move. 4) Are these inlays going to last the rest of my life(i'm 46)? Believe it or not I can't get straight answers from the dentist, when I am in the "chair" he only comes in the room to do the procedure or to tell you the news from an xray. This is the good part or just paranoia, the dental assistant is young and atractive and spends time chatting while the dentist is away. The conversation is like picking up a young lady in a bar, etc.. so naturally I get distracted. If I do try to steer the conversation toward the negatives of a procedure she suddenly is called away from the room. When she returns the blather starts over, like she is interested in you personally. I know it is all BS because when the visit is over she tells you to meet her at the front desk, but she never shows up, you do your papper work and leave. Hum.... the Cerec machine cost a lot, and this story is classic. If these inlays will stay all your life ?. May be . May be not. The little fillings stay often in mouth for all life. The big , no. I never force my patients to change their fillings if these are not broken or too used. Normally, your sensitivity to hot or cold liquids will go down month by month. If not... argl... good to crown ? ;-) If it is necessary to do the third ? Impossible to say with any look at them. If you have a doubt, see another dentist, or wait a while. a+ > A couple of questions for the group: > [quoted text clipped - 33 lines] > all BS because when the visit is over she tells you to meet her at the > front desk, but she never shows up, you do your papper work and leave. There is a dentist who used to frequent this group who has used Cerec for years with good results. It has some very convincing selling points, but I personally haven't gone for it in my office. There is nothing wrong with the Cerec concept. All of these treatment modalities have their place. No one can tell you if Cerec was the best choice in your particular situation. Cerec encourages more conservative (less tooth cutting) restorations. However, this can be done with conventional lab technology as well. It is not unusual to have some sensitivity after a bonding situation, but if it doesn't improve over a few weeks you should return to the dentist to evaluate the situation. Steve well i am a dental student would like to know why should there be sensitivity to hot or cold stuff after this cerec prosthesis?If i am not wrong this is suggestive of acute pulpitis.So my question is why should there be acute pulpitis? > well i am a dental student would like to know why should there be > sensitivity to hot or cold stuff after this cerec prosthesis?If i am > not wrong this is suggestive of acute pulpitis.So my question is why > should there be acute pulpitis? More likely what they used to call in my ancient dental school days "transient hyperemia" as a reversible condition, short in duration (to distinguish from acute pulpitis, which implies progression to pulpal death). The most common cause of this in your situation is improper bonding technique, esp. insufficient coating of the etched enamel/dentin with bonding agent. However, the truth is that for good technique or bad, pulpal response is all over the map. Back in my day you dare not etch a tooth without covering all exposed dentin with Dycal. Now etching dentin is OK. Obviously you don't want to remove the restoration unless you are forced to. As a dental student, you are better equipped than most to tell if things are going downhill. Good luck, Steve Thanks for the replies, but since most of you guys are dentists can you tell me, if the insurance co. preapproves it, then is it a necessary treatment? > Thanks for the replies, but since most of you guys are dentists can you > tell me, if the insurance co. preapproves it, then is it a necessary > treatment? No. It simply means that it is a covered service, and there is no basis on the x-ray to deny payment. Sorry if that sounds cynical. Choice of restorative material is a clinical judgement, and while Cerec may be perfectly fine in your case, you know what they say about the guy whose only tool is a hammer--everything looks like a nail. Steve Thanks Steve, I take this to mean that work was definetly needed on the tooth, but not necessarily an in-lay. > Thanks Steve, > > I take this to mean that work was definetly needed on the tooth, but > not necessarily an in-lay. Not only that, but there isn't usually one right answer. It's a judgement call. Steve I take this to mean that work was definetly needed on the tooth, but not necessarily an in-lay. ________________________________ There is no way to tell on the Internet if any of the three inlays were needed at all. Only an exam by a dentist can determine that. If you ever have doubts as to the actual necessity of any treatment, it might be wise to seek a second opinion. Once you have the work done, it's too late to change your mind. - dentaldoc True, but I guess I am naive. I always though that a physician or dentist should put the patients best interest ahead of making a profit. parently I am wrong. > True, but I guess I am naive. I always though that a physician or > dentist should put the patients best interest ahead of making a profit. > parently I am wrong. Well, of course they SHOULD, and most (but not all) of the time they do. Sometimes they misjudge, and occasionally they're just flat-out wrong. Dentistry has always been part hard science, part dark art. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 > Dentistry has always been part hard science, part dark art. > >Steve It's the dark art stuff that I like most. (lightning bolts emanate from index finger) Zap! >> Dentistry has always been part hard science, part dark art. >> [quoted text clipped - 3 lines] > > (lightning bolts emanate from index finger) Zap! I had a feelin'. ;-) Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >True, but I guess I am naive. I always though that a physician or >dentist should put the patients best interest ahead of making a profit. > parently I am wrong. Get used to it... different dentists will offer different opinions. It does not mean that they are wrong, only that they assess the situation differently It's your mouth, don't accept a procedure you don't want. > I never usually >question a doctor or dentist I just assume they are recommending >necessary treatment. This is an assumption you can no longer make with dentists, unfortunately. While many - like most of those in this group - are honest and good dentists, many of the dentists out there these days are somewhere closer to a used car salesman or snake oil salesman. I speak from much experience. > > I never usually > >question a doctor or dentist I just assume they are recommending [quoted text clipped - 6 lines] > > I speak from much experience. It pains me to say that you are correct about the "used car salesman or snake oil salesman" thing. I once had a lot more respect for my colleagues than I do today. That is not good for the public, nor is it good for those dentists who DO put their patients best interests #1. T |
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