– 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..