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I can’t say I have ever had somebody tell me that they were excited to hear that they needed a crown.  At least not a dental crown.  Who knows why someone decided to call it a crown anyways.  They don’t look like any real crown I have ever seen.  They don’t make you a royal (although, wouldn’t that be cool).  I have seen some with jewels in them, but that probably isn’t what you are looking for.  You may have also heard them called “caps”.  The technical term is really “full coverage indirect fixed restoration”.  I suppose that was a bit a mouthful, so crown was just easier.

There are many reasons people need crowns, but the most common reason stems from weakness or cracks in the surface of your tooth.  That may be from biting something hard at the wrong angle.  It could also come from past large fillings in your teeth.  It also happen in teeth that have just been weakened by your chewing pattern and the way your teeth come together.  If you have had a root canal on a premolar or molar, a crown is needed because the tooth has been largely hollowed out in the middle and will fracture into the root without one.

The most common instance we see for needing a crown is on teeth that have large, and usually older, fillings in them.  I often use the analogy of a house when talking about what leads up to the need for a crown.  Our tooth starts out as a house with walls and a roof.  When large fillings have to be placed in the middle of teeth, we are essentially removing the roof of the house.  Those walls no longer have a structure that reaches from one side to the other to hold them together.  They are still bolted to each other at the corners, but just don’t have the support on top anymore.  The force of chewing on our back teeth in sideways directions puts stress on those connections between the walls of the house.  Often times the fillings that have been placed also disrupt one or more of the walls of the tooth as well.  So that leaves some of the walls only connected to another wall on one side.  Over time the stress of chewing eventually creates small cracks between the walls, and leaves them standing on there own.  At this point, they may not break off completely, but are now only bolted to the floor.  You can imagine that it takes a lot less force to push on a wall of a house and knock it over if it is only bolted to the floor.

When these cracks develop, most of the time we don’t know how bad they are.  We may see small cracks that are only superficial.  Sometimes a piece of the tooth just breaks away.   There is something we call “Cracked Tooth Syndrome” where patients will tell us they get a zing in their tooth when they bite on something hard.  It goes away quickly, but is an indication that the tooth is flexing at the crack.

When any of these things happen, we need to do something to protect what is left of the tooth and keep it from falling apart completely.  If a piece has already broken away, the crown will help to strengthen what is left and replace the missing tooth structure.  Fillings can replace missing tooth structure too, but don’t tend to fare as well long term when there is no wall to help support them.

Crowns are a little like the metal ring around a wood plank barrel.  Those planks don’t want to stay together, but the ring has equal and opposite forces pushing against each plank from around the outside.  This keeps the barrel together and strong.  That’s called the Ferrule Effect, probably named after some really smart Physics Professor somewhere.  Crowns fit so precisely and are so strong that they can keep the rest of the tooth from falling apart, and are cements are so good now that they help increase strength as well.

Crowns are most often made from tooth colored material now.  Used to be we mostly used porcelain that was baked onto an under surface of metal.  Those crowns look better than a gold one, but still often show some darkness from the metal around the edges.  The vast majority of the time now, we use materials in our crowns that are stronger than the old porcelain and metal crowns, and are made from single blocks of ceramic-like materials.  They are made from lithium disilicate or Zirconia.  I know, you are really happy you know that now.  Maybe someday you can get a trivial pursuit question right from things you learned by reading this.  Although I don’t seem to remember a lot dental technology questions in Trivial Pursuit.

When we make crowns, or any full coverage fixed restoration, we do have to remove some healthy tooth structure.  But our materials are so strong and precise now, that it is almost always less than 1.5 mm of tooth.   Here is a link to a simple animated video to help visualize what I am describing: https://www.youtube.com/watch?v=9Ia_wD5XfmM.

These newer materials we use are very strong, and when done properly, can last a long time.  We often take digital scans now instead of using gooey impression material, and our lab uses 3D Printing, CAD?CAM, and mills to create very precise crowns for us.  Here is link for a video showing one of the crown types we use on a regular basis for back teeth.  Scroll to about 30 seconds into the video to see a hammer test showing how strong these new crowns really are.  https://youtu.be/D4taHSdbP_w

So, you need a crown.  Just know that you are not alone, and that often times it was inevitable that at some point it was going to be necessary.  That day you had a big filling placed as a teenager started you down this road, and you probably couldn’t do much to prevent it.  Just know that the procedure it pretty simple, and the results will look and feel great.

Having a dry mouth may seem like a small issue. Most people don’t realize how important saliva is to your health. I am not talking about a little “cotton mouth” every once in a while when you wake up, or while doing exercise. I am talking about a consistent low level of saliva throughout the day and night. The medical term for this condition is called Xerostomia, and the damage it causes can be long lasting and permanent.

For most people, our teeth and gum tissues are bathed in Saliva throughout the day and night.  That constant flow of saliva has many benefits.  It can act as a buffer against acid attack from our food and drinks.  It helps to wash away debris from on and around our teeth, and also fight against the bacteria that want to try to colonize on our teeth.  When someone has persistent dry mouth, we don’t get those benefits, and often we find that the rate of decay on their teeth goes up very quickly.  Many people also find that it can affect there speech, or that they get a burning sensation in the mouth because everything is so dry.

Dry mouth can be caused by many things, but the most often we see it as a side effect to other medications.  The list of medications that have this side effect are too long to put here, but suffice it to say that are large portion of the most commonly prescribed are on that list.  So why not just change medicines?  The answer is that most of the time, the benefits of those medications outweighs this side effect.  If a drug is helping someone stay healthy, or saving their life, I am not going to ask their M.D. to take them off of it.  There are a couple of diseases that also cause dry mouth, including Sjorgren’s Syndrome, diabetes, and Lupus.  People who have had extensive head or neck radiation are also often victims of dry mouth because there salivary glands have been affected.

Unfortunately, there is no magic way to fix this problem.  People who have xerostomia battle it everyday.  Most of the time, we hear patients tell us that they learn to deal with it over time.  The most important thing we tell people is that is becomes extremely important that they are diligent in cleaning their mouths to keep that bacteria off the areas the saliva would normally help with.  There are a few things that we recommend on a regular basis to try to fight against this process.  Since we know that the lack of saliva allows the bacteria to break down tooth structure more quickly, we often recommend increases in fluoride for our patients.  That can be either through higher concentration toothpaste, or fluoride mouth rinses.  There are also lots of dry mouth products on the market.  Most are mints, gums, pastes, or rinses that the manufacturers claim help to increase salivary flow, or coat the tissues so that it is not as noticeable.  The two brands that I have found most effective in limiting the effect of the dry mouth are Biotene and Colgate Dry Mouth.  Both have a line of products, and most recently I have had more people tell me they prefer the Colgate.  Many people also find that gum with Xylitol in it is an effective way to increase saliva output, and the Xylitol actually helps to fight the decay.  Sometimes though, there is just no supplement for lots of water.

If have dry mouth, or have questions about any of this, please let us know.  It is important to do all we can to help manage this annoying and possibly detrimental problem.

I listen to Sirius XM radio in my car, and recently have heard the same commercial over and over. The commercial is about teeth whitening. In the ad, they claim that they have a tooth whitening product that works in five minutes a day, and all you have to do is swab your teeth. On top of that, their product can even whiten crowns, veneers, and fillings. Now that sounds like a miracle product. Who wouldn’t want to buy that?  Maybe your teeth could look like this.

Maybe that is why everyone in Hollywood wears sunglasses inside; their teeth are so bright they can’t look at each other if they didn’t.   (These are veneers by the way)

Now, I have not tried this particular product, and will not even honor it by saying the name, but you will have to forgive me for being skeptical.

Anytime I hear a claim in an ad, or see a Groupon for a new tooth whitener, I find myself having to take a deep breath. I get a little upset by these things, and it is not because I am worried about them affecting my teeth whitening business. I get upset because these ads are fooling people. They make statements about what their product can do, and it just can’t be reality in 99.9% of the cases. There are no real restrictions on what “supplement” companies can state about their products, so they don’t have to back it up. The particular ad I am talking about above makes a couple of claims I take issue with, but the biggest thing is the whitening of crowns or veneers. I can tell you this really isn’t possible. Porcelain on crowns is the color it is going to be when it comes from the lab, and we can’t really change that, no matter how powerful a bleaching agent someone uses. You could rinse with bleach (please don’t), and it wouldn’t matter. Five minutes is also a pretty short amount of time for whitening. Must be strong stuff. Can’t imagine what it is doing to the rest of the mouth. But they really have a convincing pitch. Same thing with the Groupon kit that comes with a light. Sounds like a great idea. Dentists use a light when they do whitening, right? So it must work the same, right? I doubt it.

Whew…I think I am done venting. I guess I just don’t like that these ads make people believe things that aren’t true, just so they can sell more product.

So, how can I help you understand what you really need to know about whitening your teeth. Most whitening products start with a similar make up. They have some sort of bleaching agent, usually some percentage of peroxide mixed with other products to make it a gel. The strength of the whitening is usually related to the percentage of peroxide. Whether you are buying white strips, or doing in office whitening, the chemicals are pretty similar.

Whitestrips

I really think that for many people the Crest Whitestrips, http://www.3dwhite.com/crest-products/intensive-pro-effects-whitestrips.aspx, you can buy at the pharmacy are a great, cost effective solution. They have been proven, and improved on, over many years, and work really well. The strips can be a little messy though. Once you use them they are done, but they are pretty cheap to begin with.

Custom Fabricated Trays

These are custom trays made by us from molds of your teeth. They fit tight, and have small spaces on the front of the teeth where the gel sits. The solution is usually a little stronger and more effective than strips because of the tight trays. The best part about this kind of whitening is that your trays should always fit, so you can do touch up whitening whenever you need to just by buying a little more solution. More cost up front, but less in the long run if you ever decide to whiten again.

In-Office Whitening

This really became popular after the Total Makeover shows that were on TV all the time for a while. In this type of treatment, the patient sits in the chair for somewhere between 1-3 hours while a very strong solution is applied to there teeth. Sometimes a light is also used because the manufacturer says it makes the solution work better. This is an option that I only offer to patients who need quick results. Quick like, “I am getting married in three days”. Usually we see a lot more sensitivity with this, and personally I have seen very little good results with this kind of whitening. We always end up sending these patients home with trays, and that is what really works. We don’t do a lot of this in our practice. Most people are willing to take the couple of weeks it takes to get white with the trays.

Please let us know if you have any other whitening questions, info@vtfamilydentistry.com, and please don’t order any five minute whitening swabs.

Who Gave The Tooth Fairy A Raise?

If you are of a “certain age,” you may remember gently placing your lost baby tooth under the pillow and hoping the tooth fairy (or one of their agents) would come by in the middle of the night and replace it with a dollar. Well it seems those days are gone!

According to a survey by Visa, the national average is now $3.70 per tooth, up 42 percent in the last two years!

“Tooth Fairy inflation clearly is surging,” says Jason Alderman, Visa’s director of global education. Alderman goes on to say this rise in rates is due to several things and names an improving economy and parental guilt as the two main drivers. “It’s hard for us to say ‘no’ to our kids,” he adds.

Neale Godfrey, chair of The Children’s Financial Network, agrees on the guilt aspect. They have seen that about 6 percent of tooth fairies (or their parental representatives) are leaving more than twenty dollars and two percent are tipping the scales with a whopping fifty bucks per tooth!!

So while we can’t counsel you on how much to suggest that your local tooth fairy slips under the pillow, when it comes to all things concerning children and their teeth, at Van Timmeren Family Dentistry, we are here for you!

To discuss any problems or questions, or to schedule an appointment for you or your children, please call us today at 616-538-1050.  And remember – having regular dental examinations saves you money – so you can be prepared for whatever the tooth fairy requires!!

For 35 + years, this dental practice has operated out of the same building. As I am sure most of you have noticed, the building just isn’t what it once was. The upkeep of the building has fallen off. The elevator has gotten scary. The building is not very secure. Staff and patients have had run ins with interesting characters in the common bathrooms. Most of the other businesses have either left, closed, or are in the process of moving. It is time for us to do the same.

Don’t worry! We didn’t go far.  In fact we can walk to the new space in under a minute.  The new office is next to LMCU in the old KinderCare facility on the South side of 44th St.

We are really excited about this, and we hope you are too. The new space will is more accessible, more comfortable, and better for all of us. We know you will find it a great change for you and your family. We have always worked hard to stay on top of the changing technology in dentistry for our patients benefit, and now our office space can finally reflect that again.

You can also rest assured that this move will not affect who we are as an office or staff. Our goal of providing exceptional care for the whole family, at reasonable prices, will stay the same. If anything, this will help us do an even better job of meeting your oral health, and personal needs. We are moving because we need to, not because we plan to change who we are.

Please come see us.  Take a tour, have some coffee or water and look around, and tell your friends!