- What's up guys?
This is Dr. O from Innovative Dental,
and pleasure to have you here today.
Man, I hope you're smiling, keep smiling right?
Anybody like that cheesy line I give at the end?
No, stupid?
Okay, well, I'll have to rethink it
because I liked it.
Dang it.
Hope you're tuned in and gonna listen a little bit,
learn about dentistry,
because I'm super passionate about it.
Hopefully you get that from the video.
We're gonna talk about,
why you shouldn't crown your front teeth,
and I'm gonna give you a clinical example.
My first video I created was Do Not Crown Your Teeth.
And I explained why front teeth hardly ever need crowns.
There's a lot of questions from that.
Even some dentists have some questions
of why that's my thought,
and questioning my reasoning behind creating the video.
And I wanna help bring some clarity to that so,
I'm gonna use a clinical example,
and then after that I'm gonna give you
maybe three or four reasons
why a crown may be necessary on your front teeth,
so you can maybe go okay,
those are really the three or four
that I might need a crown.
First, let's look at this clinical example.
I want to use this one
because it's pretty impressive, right?
You look at this, and you look at that photo
and you go, man, that looks like extractions, right?
Can we even save those teeth?
Probably gonna need some root canals,
definitely gonna need some crowns,
maybe even extractions if they're even saveable.
And if you look what we did here,
we went ahead and, first let's remove all the decay.
So in this photo you'll see decay is removed.
We wanna just see what the tooth structure's left
after decay is gone.
And you'll notice, we didn't get into any of the nerves.
So, all of the nerves were healthy and vital.
No root canals were needed here.
So, pretty cool, right?
Saved the guy let's say, four root canals,
4,000 dollars roughly in our area.
Next you'll see that we restored the teeth with composite.
So we reshaped the tooth structures
so that a way of veneer could be created
and bonded to the tooth.
And so you'll see, we reshape it.
By the way, the blue dye that you see
is purely to show any amount of decay
that's left on the tooth.
And we use that to make certain we get everything.
We don't wanna leave any decay behind.
One of the cheesy sayings I love is,
no bugs left behind.
That's kinda dumb, no bugs left, ah, you get it?
Bacteria, bugs?
No bugs left, it's stupid, alright.
Well anyways, so,
we definitely didn't wanna leave any decay.
Then we build it back up,
and then we image with our machine and create,
and you can see some of the machines behind me here.
Those are CEREC machines,
those allow us to image in our office
and create veneers right in our practice, single visit.
So this smile was completed in under four hours,
without any root canals, all veneers.
And matter of fact, if you would have crowned these teeth,
there's no way you could have saved them.
And the reason you couldn't have saved them
is because you would have cut all the enamel off the back,
and you would have had hardly any tooth structure left
after crowning these teeth.
Many dentists would maybe want to
take and do root canals electively,
and put pins inside the tooth.
We chose not to do that because I feel like
teeth are healthier when they don't
have these pins inside of them.
I feel like they're stronger, gonna last longer.
By the way, this treatment,
I know there might be some that go,
well how long does that last?
Did you do that last week?
This guy has been, I fixed this smile five years ago.
So this is a smile five years ago, still smiling today.
Comes in, awesome guy.
Here's the before of his smile and kind of how he looked,
and his confidence, and then look at him now.
And yeah, that chubby guy next to him is me.
But that was five years ago, after we fixed his smile.
Pretty fun to share that story.
Hopefully that clinical example helps you go ah-ha,
I understand what you mean when you say,
teeth don't really need crowns, in the front at least.
There's a lot of benefit to a veneer,
we save all that enamel.
And if you want more on that,
definitely go to the video link here,
I'll pry put it right here.
Link to that, and watch the video
of how I explain why crowns are probably
not necessary for you on your front teeth.
Now let's get to the four reasons
why you may wanna crown your front teeth.
So these are the exceptions to that rule.
The first one would be, an existing crown.
I started realizing that man, hardly any teeth,
I don't crown hardly anything unless
it's an existing crown I'm repairing.
So, you know, existing crowns, you have to crown them.
The damage has already been done.
The amount of tooth structure has already been removed,
or the decay is already so much
that the crown was necessary to begin with.
And so a crown is necessary to replace it.
Can't go backwards, right?
You can't go to a crown, and then go back to a veneer.
So, once it's crowned it needs to be crowned again.
The other one would be a root canal,
if you had a root canal, and it's quite a bit of decay,
and it needs a crown or something to cover up the decay,
I might wrap around and cover the access.
On the backside of the tooth,
there might be a little hole
where the root canal was performed.
I would cover that with the crown.
I would not grind all the way down to the gum line though,
like a traditional crown
which is really just more tooth removal than necessary.
So, that's how I would treat a root canal tooth.
The other one would be severe decay,
but man, it's hard to have decay
that actually goes around the backside of the tooth.
It just doesn't happen very often.
Every once in a while you'll see it
if somebody has like an enamel defect
or a groove in the backside
of the tooth, and it's pretty significant decay.
At that point, definitely, a crown would be a good option
for that patient in that scenario.
The other one I had somebody ask me is,
I had some questions like a chipped tooth, right?
What do you do with a chipped tooth?
I can't see any reason why a chipped tooth
should ever need a crown.
It's a really common mistake
maybe I would say in diagnosing.
Chipped teeth, veneers, or just resin fillings.
If the fillings keep failing,
which in this gentleman's story,
that's what was happening with him.
I recommended, I said hey,
you oughta encourage the dentist
to maybe be able to do a veneer for you rather than a crown
if you just keep having a filling that's chipping.
That way you save more of your tooth structure.
The other example would be, severe wear.
Now, if you have severe wear on your teeth,
have kept wearing each other down, like this,
then what's happening is over time,
you're filing down the backside of your top teeth.
If you go and crown those teeth, you're gonna have to remove
the amount of porcelain thickness
from the backside of your top teeth.
So, crowning initially, would be a mistake
and not a good recommendation for tooth wear.
So you don't wanna crown initially,
what you wanna do is you wanna use some sort of technique,
whether it's Invisalign or braces to create separation.
So create space.
So we wanna take what's no space,
and what's ground away in your tooth,
create some space, now we can rebuild
the tooth structure there.
And I can make a video that maybe helps better
clarify that but,
don't go in with tons of tooth wear
and expect to get crowns unless they're gonna open the bite
and change the vertical dimension.
Otherwise you're getting too much grinding
into a tooth that's already worn.
What that is likely to do is actually lead to
a root canal or tooth pain
from the fact that you just drilled so far into the tooth
that was already worn away by your lower teeth.
So, tooth wear, definitely gonna need a crown maybe
down the road, but create the separation first
with maybe like Invisalign or braces,
then choose to crown the tooth.
Alright, so, hopefully that helps
with a clinical example
of why you should not crown your front teeth,
and showing you that hey look,
we can take a smile that almost looks like dentures,
and we can restore it with technology
that is readily available,
and techniques that don't require so much removal
of the tooth structure.
And then I gave you the four reasons
why you wanna maybe consider a crown if it's necessary.
One being that you have a existing crown,
the other one being that there might be a root canal,
the third being that there's severe decay
the covers the backside of the surface,
and then the fourth one would be severe wear
after you get some sort of alignment
or separation created from braces, maybe Invisalign,
before you would then have those teeth crowned
so they're fixed and not have to be ground into,
like they would if you didn't get that separation done.
So, I hope that helps make sense of a video that
seems to get a lot of attention.
And hopefully it's helping people understand stuff.
Obviously the whole point of the channel
is to take, what I fell has been
not a lot of innovation
in the way that we've done things in dentistry.
And helping to think through why we do what we do,
and provide the latest for our patients.
And so, one of those would be rethinking
and retooling our brain to go,
we should be conservative,
and let's save as much tooth structure as possible.
And let's make things last longer for our patients.
Rather than being so aggressive with the hand piece.
So, hopefully you'll like this video, it makes sense,
and you know what, if you stuck around till now
and you found this useful,
definitely I'll give you a second,
hit the subscribe button.
Like it, share it with your friends.
And it would be helpful to them.
Obviously, I would love, and our team would absolutely love
to see you at Innovative Dental,
if you would love to make the trip or have thought about it,
don't hesitate to check out our Smiles Within Reach Program.
You can give us a call at 889-4746.
Also, you can head over to idspringfield.com,
and you can learn more there.
I look forward to seeing you guys in the next video.
And you know what, you have an awesome day.
And keep smiling.