Crowns & Fillings

The bread and butter, heart and soul of any general dentist is restorative dentistry, most commonly crowns and fillings. It's the art and science of making things whole again.

We offer the newest composite and ceramic technology, but with a healthy respect for proven approaches that still work today. A lot of the "new" options in dentistry are product driven solutions that sacrifice durability for slight improvements in esthetics. Every treatment decision must find a balance between appearance, cost, durability, strength and bio-compatibility. Since there is NO perfect dental material, we still recommend prevention above all.

Here are some blog posts on restorative dentistry.

Bruxzir vs PFM: New Zirconia vs Old Tried and True

Full contour zirconia crowns vs the traditional PFM crown

This is the first comparison case I am doing to test a new crown technology. Glidewell Labs has a new type of crown for back teeth made out of zirconia, a high strength ceramic. Like gold crowns, they are virtually unbreakable, don't require a lot of tooth height. Unlike gold crowns, they are tooth colored.

Many people know about 3M's Lava crowns. They are porcelain fused to zirconia. They are beautiful in the front, but they are expensive to produce, and the porcelain is relatively fracture prone. Few problems on front teeth, but using them on high-load molars is risky; I've actually had a couple of them break myself. In every documented case of failure, (I'm talking the published clinical studies) the outer porcelain breaks off, leaving the inner zirconia intact. So the folks at Glidewell decided to make the entire crown out of zirconia.

The benefit is a lower cost, more conservative tooth reduction (dental colleagues, they're claiming 1mm occlusal reduction), and better appearance than a gold crown. The tradeoffs: harder for the dentist to adjust, harder for the dentist to repolish, and poor translucency. (which is why they are meant for back teeth) I decided to ask my friends at Glidewell to make me two crowns: a PFM, the tried and true porcelain fused to metal crown, and a new Bruxzir, the all-zirconia crown.

Here's the photos:

As you can see, the zirconia crowns hold up very well to the PFM crowns that go on 90% of my patients. And compared to a gold crown, they are hugely better. As a matter of fact, this patient chose the zirconia crown. She said it fit like a glove, and she loved the appearance much better. We agree. We're doing another case to confirm our very positive initial findings.

Second Opinion: Do I Really Need All These Porcelain Inlays, Onlays and Crowns?

Replacing old fillings is like replacing old shoes...everyone's got a different opinion. new-shoes-replacing-inlays-onlays-crowns-fillings-dental

Did your dentist recommend a lot of porcelain inlays, onlays or crowns? It's like replacing shoes...everyone's got a different opinion on when is a good time to make a change.

Name Your Own Price: Should Dental Fees be Compared?

As a practicing dentist for 9 years, I empathize with patients wanting to get the best deal on care. Small practices like mine provide dental care at reduced, but not rock bottom prices. On a pure price basis, we cannot price compete with larger volume practices.

When you go for your $29 cleaning and get pressured into $5,000 of unnecessary treatment, it's no bargain at all. I can't tell you how many times I hear about fear mongering dentists, followed by high pressure "closers." Don't even get me started on the quality of the work I sometimes see...sloppy fit, no attention to detail, refusal to grant re-dos or even refunds. Even with our higher fees, our patients almost always come out with a lower total cost of treatment, because we don't upsell them on work of questionable necessity. Goodwill and trust are hard to factor into an algorithm.

Sites like Brighter and Pricedoc may help people find dentists, but they may have the unintended consequence of commoditizing dentistry. If it helps consumers do more homework and make smarter decisions, that's a positive. If it drives the growth of discount dental chop shop chains at the expense of small family practices, that's a loss for everyone. If I want to price shop for a laptop, it's the same laptop at the BigBox as it is at the MegaMart, and customer experience is a very small part of the equation. But in service businesses like auto-repair, hair salons, or dentistry, trust, integrity, the quality of worksmanship and friendly customer service should count for much more than the price. --VL

FDA confirms amalgam is safe

The FDA just released an updated statement declaring that amalgam is safe and effective as a filling material. While we routinely place white, composite resin fillings, Dr. Le keeps amalgam around for the specific (and very rare) situations where it's still the filling material of choice. It is Dr. Le's position that amalgam is a safe, viable, long lasting material when used properly in the right situations. Amalgam is also a necessary material to maintain the low cost and higher availability of dentistry to underserved populations, such as inner city or rural free clinics. We invite all our patients to discuss the pros and cons of the different fillings with us at their next visit. There is NO such thing as a perfect filling material. Read on for a comparison of amalgam and silver filling materials.

Lead found in Chinese-made Crowns

An Ohio local news station has found lead in a dental crown that was outsourced to China. We take a brief look at this sensational story, and examine your personal risk. Let's separate the facts from the fears.