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What is Cracked Tooth Syndrome?

March 11, 2016

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Cracked tooth syndrome is a common reason for expensive dentistry.  The pain from an affected tooth can be almost unbearable, and if treated early can avoid root canal therapy.  What exactly IS it?

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Despite tooth structure being the hardest substance in the human body, teeth flex microscopically.  The flex is so small that we cannot feel it.  However, if a part of the tooth is removed, it can flex MORE.  Even if the missing tooth structure is replaced with a filling, the flex still increases.

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Over time, the flex can lead to cracks.  Like Nancy Reagan said, say no to crack.  Small cracks become big cracks, and big cracks lead to fractures.  In some cases cracks and fractures involve the nerve of the tooth, which can kill it.  Normally the pain in earlier stages will lead to treatment before the nerve is involved, but sometimes the first sign of a problem is the fractured and dead tooth.

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To treat a tooth with Cracked Tooth Syndrome, the cracked part must be removed.  If small, an onlay can be placed that covers a single cusp, but the most comon treatment is a full crown.  More than just removing the cracked part, the crown directs the chewing forces inward, so any micro-cracks left behind are less likely to propagate.

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A more advanced issue is an indication for root canal therapy, but in a small percentage of cases the crack/fracture is so significant that the tooth is hopeless and must be removed.  A dental implant is normally the best solution, and a dental bridge a close second..

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We all want to be sure we don’t “cry wolf” when a tooth hurts.  Many people try to ignore pain and assume it will just go away or get better.  This usually doesn’t work and ends up costing more to fix the longer one waits.

Custom Diagnostic Waxup

February 29, 2016

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A well done diagnostic waxup is what separates the excellent dentists from the average ones when it comes to delivering a new smile.  While ANY dentist can give “A” new smile, without proper steps the final result is a gamble, or an expensive game of chance.  Also, without proper planning, the dentist may irreversibly remove more tooth structure than needed which results in a weaker tooth or teeth.

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Step number one is taking impressions. Traditionally this is done with trays and “goopy” material that sets after a few minutes. This leads to stone models of the teeth that can be evaluated and a smile design can be created. NOW, Dr Timmerman uses a digital scanner to electronically record the teeth and can virtually plan or 3D print models for the evaluation. This means NO gagging and saves DAYS of lab time, so treatment can begin QUICKLY.

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There are several STYLES of teeth to consider, and after one is chosen, the lab can transfer the design to the models. YOU can now evaluate the design to YOUR teeth before you even start!  If you desire any changes, Dr Timmerman can do them right then.

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The BEST part of a diagnostic waxup is the transfer.  Impressions of the WAXUP can be taken, and your smile design PROTOTYPE (your temporary smile) can be worn after your teeth are shaped for the veneers (if needed).  Now you can SEE the new shape of your smile BEFORE it is done!  Sometimes the waxup looks great on a model but not what you expected in your mouth.  Whatever changes you desire can be worked out with Dr Timmerman and then communicated to the lab.

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An alternative to the lab fabricated diagnostic waxup is to have Dr Timmerman design your smile right in your mouth.  This MAY be all you need to see, but has SOME draw backs.  Impressions of the intra oral mock up may dislodge it, so the prototype may be a challenge to create and may not look as nice as using a lab.  So, YES, you can save a couple days (and we really are saying 2 days and not a week or two since the digital scanner is used) but having the lab participate from the start may be a more comfortable experience.

Smile Design Choices

May 29, 2015

Filed under: Blog,Smile Makeovers — drtimmerman @ 11:22 am
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The “smile design” is an overlooked part of doing a smile makeover.  Dr Timmerman has a unique way to deliver the smile YOU want that REQUIRES input from YOU!  Choose from these various smiles or even mix features of one style vs another.  Some people prefer longer central teeth, others like them all the same length.  These photos are all the same person, so you can see how small changes can have dramatic impact!

Which do YOU prefer?

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Once Dr Timmerman knows your goals and preference, he can send this info to the lab, where they can create a diagnostic wax up.  This is a blue print, a sort of “measure twice, cut once” approach.  This information can be transferred to YOU, and you can wear a “trial smile” in an effort to be SURE that you like your new smile.

The final result of your smile makeover will be a smile that you can you can be proud of.

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It is not unusual for patients to be overwhelmed with information and unable to choose for themselves which design is best.  Don’t worry!  Dr Timmerman has done hundreds of smiles and can assist you in your choice.  Often, people will bring photos from their youth or magazine photos to assist in guiding the direction to take.  All information helps.

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If the provisional restorations are similar to the final outcome, wearing them allows you to really know if you like the shape and design.  If you change your mind, simply come back to see Dr Timmerman within 72 hours of placement and he can contour or polish your temporaries.  If small changes are done, a photo can be sent to the lab.  If major DRAMATIC alterations, then an impression can be taken to inform the lab of the improvements, ensuring total satisfaction.

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