What affects the cost of dental fillings?

If you've ever looked at an invoice after dental treatment, you may have noticed that the cost of dental fillings varies from tooth to tooth. In general, the billing prices of fillings are affected by three factors: the material, the location of the tooth in the mouth and the number of surfaces to be filled. Read on to learn how and why the different rates are calculated!

All dental procedures are categorized using the Current Dental Terminology codes, which are maintained by the American Dental Association. These codes allow standardization of information between dental offices, patients and insurance agencies. In regards to dental fillings, these codes can specify the location, surfaces and material used for the restoration. Generally, the number of surfaces to be filled has the biggest impact on final cost. A filling that requires three surfaces is typically more challenging and time consuming than a single surface restoration. This does not account for the size or depth of the cavity to be filled, but merely the number of tooth walls that are to be repaired. The type of dental fillings also affects the price. Materials that are more difficult to place (such as tooth colored "composite" fillings) are typically charged at a somewhat higher rate than others. Finally, the location in the mouth has some affect on filling prices. Fillings towards the back of the mouth tend to be larger and more difficult to place, and thus are coded at a higher rate. 

At Thousand Oaks Family Dentistry, we maintain treatment rates that are on-average with the Thousand Oaks area. However, we must urge against the pitfalls of choosing a dentist based on prices alone. You should choose an office that fits best with you and your family's specific needs. If you would like to know more about dental fillings, crowns or other dental procedures, please give our office a call!

Dental Questions: Can all teeth be saved with crowns?

Its easy to think of crowns as a save-all for cavities, cracked teeth and other dental disasters. Unfortunately, this is not the case. There are many situations where a crown will simply not improve the condition or longevity of a damaged tooth. The main benefit of crowns is that they restore strength to broken down teeth by creating a full coverage "cap" around the remaining structure. However, this means the tooth needs to have good gum and bone support along with some (minimal) amount of remaining tooth to hold on to. 

Firstly, a crown will do nothing to benefit a tooth with severe bone loss or gum disease. Splinting a tooth with periodontal disease to a healthy tooth may seem like a great way to stabilize roots and create a more sturdy anchor. However, research shows this is not the case and splinting teeth can actually create plaque traps that accelerate bone loss. In most instances, placing a crown on a tooth with poor bone support is ill advised and can further hinder its longevity in your mouth. 

In terms of restoring severe tooth decay or fractured teeth, crowns still have certain limitations. There needs to be a minimal amount of dental enamel and dentin above the gum line for the crown to be cemented upon. Procedures like root canals/posts, crown lengthening and orthodontics allow dentists to create more structure for the crown. However, there is a limit to how much can be done for a specific tooth. Generally speaking, teeth that are broken off at or below the gum line are usually impossible to save with a crown. If saving them is an option, it is almost always more economical and predictable to remove the tooth and replace it with an implant. 

Overall, crowns are an excellent way to recreate the bulk or body of a damaged tooth. Still, it is important to acknowledge their limitations. In some circumstances, removing the tooth in question and replacing it with a bridge or implant is the more favorable option. If you would like to know more about crowns, implants, bridges or other tooth replacement procedures, please give our office a call!

Dental Questions: Can I be allergic to dental crowns or fillings?

While understanding all of your medical allergies is essential to providing safe care, reactions to common dental materials are rare. Over decades, the products we use were developed to avoid irritation and work well with the natural tissues in your body. Overall, any allergic response to a crown, filling or implant would be extremely unlikely. 

In the past, fillings and crown materials relied heavily on the use of metal. Mixtures of different metals called alloys allowed labs to create resilient structures that adapted well to the natural teeth. In the early years, many porcelain and metal crowns contained high amounts of nickel in their structure. Patients with nickel allergies sometimes developed irritation, itching and swelling around newly placed restorations. In modern dentistry, less irritating metals such as gold and palladium are now used in place of nickel. As a whole, metal plays a much smaller role in today's practice, and thus metal allergies are not a predominant concern. 

Tooth colored materials are even less likely to cause an allergic reaction. The crowns we place are typically either made of ceramic or glass and thus have almost no allergic potential. The fillings we place at our office are also non-irritating. Composite (tooth colored) materials are placed in an "uncured" state (so that they are soft/moldable) and "cured" with a light to become rigid and durable. Once the material is cured, the chemical structure is permanently altered and unable to leak or leech compounds into the body. 

Overall, the materials used at a modern dental office are extremely safe. Our patients' health and safety is of utmost importance, beyond the need to fix a single tooth. If you would like to know more about the products we use at our office or have a question about how one of your allergies or conditions might affect dental care, please give our office a call.

Dental Questions: Why does it take two weeks to make a crown?

In today's world of on demand service, it may seem strange that a dental crown takes two weeks to make. Your confusion is probably compounded by news of "same day" crowns available at some dental offices. The reality is that many crowns are created (at least partially) by hand and take time, expertise and effort. Read on to learn how dental labs recreate and help replace lost teeth. 

After your first crown appointment, there is typically a two week wait until the new restoration is ready to be cemented to your tooth. In this time, a lab has to receive the impression, create a stone model and make a wax replica of your tooth. While many offices are using computer aided design and digital scanners to simplify this process, most of it is still done by hand to some degree. Converting the wax replica to metal, zirconia, porcelain, or other ceramics involves delicate processing and layering to maintain the initial structure. Finally, most crowns are colored and glazed (textured) by hand to expertly match them to the adjacent teeth. Currently, there is no computer or machine that can visually blend a tooth color to the rest of the mouth like a skilled lab technician. 

Some dental offices currently offer "same day" or "one visit" dental crowns. Here, a digital impression is taken after your tooth is prepared and the crown is milled out of a ceramic block while you wait. You will leave the office that same day with your permanent crown cemented. While this technology is fantastic in some applications and has a very promising future, our office feels that it needs a little more refining before we offer it to our patients. Studies show that the margins (where the tooth and crown meet) can be less precise with these digitally milled crowns. Additionally, many machines require additional tooth structure to be removed in order to create a shape that is compliant with the milling process. Overall, there is nothing wrong with this style of dental crown, but we feel the benefits of using a lab created restoration outweigh the drawbacks of a waiting period. 

Dental crown placement is one of the most common procedures carried out at dental offices nation wide. At our office, we specialize in creating crowns that are beautiful, functional and feel natural in your mouth. If you would like to know more about crowns, veneers, fillings or other dental procedures, please give our office a call!

Dental Questions: Should I try to reattach a lost crown?

If you've had a crown fall off unexpectedly, you're probably familiar with the feeling of shock, confusion and horror as you gaze down at part of your tooth in your hand! While your first instinct may be to try and re-cement the lost restoration, this can come with some serious consequences. The best bet is to let your dentist evaluate and repair your tooth with the proper materials and techniques.

Temporary dental cements are available at almost every drug store and pharmacy. While these products may seem like a good idea, they can lead to a number of problems. If you don't use enough cement (or don't apply it properly), you run the risk of dislodging the crown again and potentially chipping a tooth or swallowing it. If you put on too much cement, the crown can seat too high and cause a sore jaw or excess material can ooze below the tooth and irritate your gums. Either way, it's best to have a dentist examine and recement the crown in-office. Crown usually fall off for a reason, and it is important to discern that the tooth and restoration are healthy enough to be reattached before creating a new set of problems. Additionally, never try to recement a crown with super glue, epoxy or any other household adhesives!

More common than losing a permanent crown is dislodging a temporary crown. These provisional restorations are used to save space between the first preparation appointment and delivery of the final crown. Thus, they are made and cemented with easy removal in mind. If you lose a temporary crown, it is important to return to your dentist ASAP. Waiting until the permanent crown is finished  can leave the underlying tooth vulnerable to chipping, nerve irritation or movement from the adjacent teeth. 

At Thousand Oaks Family Dentistry, we always make time for our patients' urgent problems. Wether a lost crown, tooth ache or broken appliance, we are here to help. If you would like to know more about what do to during various dental emergencies, please give our office a call!

Case Presentation: Premolar Crown

Premolars can be very difficult teeth to repair. They are both functional (absorbing about half the chewing force of molars) and cosmetic (adding to the "corridors" of the smile). Often times, fillings cannot satisfy all these needs when restoring tooth decay or a fracture. A full coverage crown is usually recommended to provide a solution that will both look great and help protect the underlying tooth. For today's patient, an Emax lithium disilicate crown was used to restore their right first premolar. Notice how the shade and opacity blends in with the enamel of the adjacent teeth. The result is a virtually undetectable dental treatment- good as new!

If you would like to know more about fillings, crowns, implants or veneers please give our office a call. We specialize in providing cosmetic treatments that stand the test of time and would love to discuss your options!

Dental Questions: What can I do if I have a cracked tooth?

Cracked teeth are notoriously painful and difficult to diagnose. They typically present as an ache when releasing your jaw from biting on something hard. The pressure of opening and closing the crack puts stress on the cells deep within the teeth and creates this painful sensation. You may also experience increased sensitivity to cold or a strange pushing or pinching sensation in your gums. 

If you think you have a cracked tooth, your first step is to schedule an emergency dental appointment. Here, X-rays, special lights and probes are used to identify the fracture and determine where it goes. Most often it is impossible to see the actual depth of the crack and the teeth must be treated based on their symptoms. Lowering the height of the tooth (so that the opposing tooth no longer puts pressure on it) is a typical first step. From there, a dentist may use a crown to provide extra coverage to the tooth or refer to an endodontist to take a CT scan or perform a root canal. 

If the crack goes down the length of the root and extends to one of the canals, the tooth is likely not savable. In these instances, we usually suggest an extraction to relieve pain and to prepare for an implant in the near future. For more information on emergency appointments, cracked teeth and dental pain, please give our office a call!

Gold Crowns and Fillings

Before the age of modern dental materials, metal played an important role in almost all types of restorations. Many dentists opted to use gold for fillings and crowns for it's durability and ease of use. If you have gold dental work, you may be concerned if it's utility has been surpassed by modern technology. On the contrary, gold still stands as one of the best materials available for dentistry today. Read on to learn how and why gold was (and continues to be) a popular dental material. 

Gold is a very malleable metal with a relatively low melting point and high polishability. These properties make it an ideal material for replacing lost tooth structure. Molten gold readily flows into complicated molds, allowing it to be cast into a variety of shapes- including tooth crowns. Once a crown is cast, it easily polishes to a high shine surface that deflects plaque and has great adaptation to tooth structure. Gold is also highly inert, meaning it will not rust or corrode over time. In dentistry, pure gold is mixed with a variety of other metals to better control the durability, color and resilience of the final product. 

Today, gold is used much less frequently than previous decades. However, it still has its place in restorative dental treatment. Gold can be an ideal material for creating a crown on a tooth when only a minimal amount of tooth structure needs to be removed. However, many modern tooth colored materials have met or surpassed the qualities of gold while providing better esthetics. 

In short, there is absolutely nothing wrong with gold as a dental material. Still, there are many newer materials available that mimic the benefits of gold, but with better cosmetic results. If you would like to know more about gold crowns, porcelain crowns or dental materials, please give our office a call!

Crown Lengthening

A quick overview of crown lengthening. Once the Decay is acessable, a permanent crown or filling can be placed. 

Crown lengthening is a dental procedure most often performed by a periodontist where an incremental amount of bone and tissue is removed from a tooth's gum line. This is most commonly used to reveal more tooth structure and facilitate the placement of a crown. If a tooth has deep decay or a fracture to the bone level, creating a good seal between tooth and crown is impossible. In order to save the tooth, the "crown" (portion of tooth above the gum line) has to be "lengthened," at the expense of the root. Crown lengthening is also performed on the anterior teeth for esthetic reasons. Uneven gum lines and "gummy" smiles can sometimes be fixed through this procedure. Many times, this must be followed up with crowns or veneers to create a cosmetic appearance. 

While crown lengthening allows us to save teeth that would otherwise need to be extracted, it is not without potential drawbacks. Lowering the gum and bone level on a tooth can compromise its long term stability in the jaw. By gaining length in the tooth crown, the roots become gradually shorter and less anchored in bone. This procedure can also negatively affect the adjacent teeth as well. The periodontist needs to create a natural bone contour, and will often need to adjust around the neighboring teeth to make a smooth transition. 

Often times, crown lengthening is only one of a few treatment options. Teeth can also be extruded using orthodontics to create more crown structure. Likewise, a tooth with a questionable longevity can be replaced with a implant in many scenarios. Only a comprehensive dental exam will reveal what can and needs to be done to save a tooth. To schedule an exam or find out about more dental treatment options, please give our office a call!

Posts and Cores for Dental Crowns

If you have had a dental crown recently placed (particularly on a root canal treated tooth) you may have been surprised to learn that you needed a post or core placed in addition to the crown. These procedures allow us to maximize the strength of the natural enamel and add structure back to broken down teeth. In every instance, they are an integral part of the long term success of a crown. 

When teeth have root canals placed or deep cavities removed, they are left with a large hole in the center of the tooth or a missing wall of enamel. For a crown to be successfully cemented, the tooth has to have a fairly regular "teepee" shape. Any large holes or divots in the tooth prevent the lab from making a successful restoration.  A core is a bulk of material added to the tooth to provide strength and structure prior to finishing the crown. They are made from a variety of material, depending on the specific needs of the tooth and the plan for the final crown. Many times the endodontist will place the buildup themselves once the root canal is finished. 

When a tooth is missing multiple walls of enamel or lacks enough structure above the gumline (as is common with fractured teeth), a post may need to be placed in addition to a core. Posts are solid metal or composite rods that are cemented in the roots of root canal treated teeth. They extend upward and act as an anchor for the core buildup. Without a post, large cores are prone to failure and fracture. This causes huge headaches, particularly after the root canal and crown are completed. An important point to note is that posts can only be placed on root canal treated teeth, as it needs to be placed within the root system. In rare instances, a root canal may be performed on a healthy tooth so that a post can be placed.

We always try our best to notify patients of the potential need for a post and/or core prior to starting crown treatment. These procedures are not optional steps, but rather necessary precautions for the long term stability of the tooth. If you would like to know more about posts, cores, dental crowns or root canals, please give our office a call!