Zirconia Crowns

I am trying to keep you all abreast to the latest in the dental field. With the cost of "Gold" going sky high the dental field was looking for a material as hard and serviceable as gold, but without the cost. They think they have found it with Zirconium crowns. Zirconium is all white and has shown great strength. You would eliminate the gold coping substructure and now have a coping out of Zirconium. You would still put your porcelain over the top , but you save all the cost of not needing the gold. It is suppose to be as strong, as good looking , and good to the tissue as well.
I am going to wait to have any of these put in my mouth to see how they stand up to masticatory forces. I personally think they will be OK up to the premolars, but do not know how they will hold up in the molar area. If they do not break this will be quite a break through. One brand name out on Market is called "Lava" crown.

Be True to Your Teeth or They Will Be False to You

Just like taking care of other body parts you need to take care of your teeth also. You need to give your teeth the care and preventive maintenance they require or they will be false to you. Ask yourself a question. Do you want to have false teeth? Do you want to take teeth out unnecessarily? Do you want to walk around with a hunk of plastic in your mouth that doesn't allow you to taste your food? If you answered No to all these,then you better start coming in to your dentist and get the necessary cleanings , whitening, veneers, and crowns you deserve to maintain that dentition. If you say nothing hurts,that is good; but we want to keep it that way so you do not end up with dentures or partials. The way dentistry is today with all the advances , you can keep your teeth your whole lifetime. No question. Don't put off the flossing and brushing with the electric tooth brush either. Your teeth deserve it, and so do you.

Quality of Care

As an Orlando dentist I get many calls each day asking questions of Dentistry in the Quality of Care department. I will explain what I mean. Today a potential patient called about getting a crown done, and how much does it cost? This is what I mean about quality of Care. At this office we only give our patients the top of the line in regards to quality of care. We do not give them a choice of using a lesser product. Patients don't understand that a crown is not just a crown. You have many different types of crowns, and most dentists do not use the highest nobel alloy when making your crown. You need to know this so you understand what you are buying. The higher nobel alloy you use in the metal of the crown; the better the crown fits, the longer it lasts, and the margin where the tooth meets the crown is sealed better. High nobel alloy is when you have more gold in the crown. Gold fires more precise, which means to the patient better fit. This is the only crown I offer for my prices. If you ask your dentist to make you a crown with this high nobel alloy he will probably charge you more. Remember, your crown is still white in color on top , but has the best gold underneath where you cant see. This is my standard high quality. We do not offer the lower ones and this is where you have to be careful when getting a quote on what you are getting. My office policy with all our products is that we only offer top of the line. When you go to a clinic you are not getting high nobel alloy in there crowns unless you ask for it , and pay extra for it. With my office we make top of the line our standard. It is like buying a car and getting all the extra options included in the car, and only paying for a standard package.
At our office these top of the line quality issues are all included in the price. When going to a clinic and not a single practitioner you are going to see differences in quality. Be careful. We will be happy to go over any estimate you get and give you our quote with all the top of the line products that do not cost extra. We will even explain to you what your getting for your money if you show us your estimate. If we can help let us know. I will give you more examples in the future of Quality of Care examples in other areas.

Dental Insurance

As an Orlando Dentist we get phone calls each day about dental insurance . We get asked if they can buy dental insurance and which one to get. Unfortunately, buying private dental insurance is almost impossible and if you can find it without long waiting periods for major work it is expensive and then the maximum for year is only a thousand dollars. It is better than paying for this insurance premium, to just pay at the dentist for what you need done. This insurance is not really helping you. The insurance also does not cover veneers or teeth whitening or crowns.

The best insurance you can get is from your employer, and when they put on the seminar you want to select the PPO not the HMO. With the PPO you can choose your dentist and usually they have higher maximums and cover more things. You might pay out of your check a couple penny's more, but it is worth it. You definitely want to get all your work done when you have this type of insurance, and use the whole maximum each year giving you updated dental work. In your life time you will need your dentistry replaced about 3 times. Everything wheres out including dentistry.

We will be happy to tell you what your insurance covers and all your benefits. We do what we call a blue sheet that gives my staff all your insurance information. They tell us everything that is covered and at what percentage. We would be happy to help you also. Our office takes most insurance and all PPO's.

Root Canals fact or fiction

Today I wanted to briefly touch on root canals. To many people root canals are a dreaded experience. They do not have to be. The most likely reason for this is that the patient needing the root canal waited so long to have the dental work done the tooth became infected. Once the tooth reaches the infected point, doing a root canal can be painful because now it is hard to get the patient numb. When giving a anesthetic injection of a basic solution that will now mix with an acidic environment causing, so to speak, neutralization of the anesthetic. Another words if you need to have a root canal done get it done before you acquire an infection.
Root canals or Endodontics is usually needed when a tooth has a cavity that reaches the nerve. There are other reasons like trauma that will also necessitate the need, but most often it is a cavity that reaches the nerve that is the culprit. A root canal is when the doctor makes a small hole in the top of the tooth and basically cleans and sterilizes the inside of the tooth. After he sterilizes the inside he then places a filling in the tooth to seal the tooth. After the root canal is done you need to have a crown placed to protect the tooth. After root canals teeth become more brittle due to loss of blood supply and thus the need for coverage with a crown.
Root canals are a good way to save your teeth and keep your mouth stable. With this treatment you are keeping yourself from getting teeth extracted and more crowns. This treatment allows you not to have spaces which are not esthetically pleasing ,but also allows your other teeth not to move or shift. Root canals have a good success rate. If the tooth can be restored selecting root canal over extraction is the best way to go.

Air abrasion Micro dentistry.

In 1995 I learned about Air Abasion Micro Dentistry. I went to a formal course in Texas and was amazed and excited about the technology. You are able to do small fillings without the need of anesthetic and without pain. I was amazed again after being trained of all of its advantages. As the dentist you do not need to have the patient get numb, which a lot of patients like; and you are able to keep the filling so small and conservative. You do not need to remove a lot of tooth structure.

Upon my return to Orlando channel 6 news learned that I was doing this for my patients and had the health reporter come out get a filling done live on the air so everyone could see this. The way this works is that the top surface of the tooth has groves, pits , and fissures. This is where 90% of the cavities start. We use to do sealants to help control getting cavities in these areas but then found out that there is an Organic plug of tissue in the groove that holds water and that is why the sealant fails. When using the air abrasion the organic plug is removed first. We also just don't lock in the filling like with sealants, we bond the filling in and the correct term now is preventive resins. If you look at the filling now from the side is looks like a parfait ice cream. I mean you have the organic plug removed , the fluoride composite place in the bottom then a flowable composite placed over the top that is bonded in place. These last very long. The air abrasion increases the surface tension which means to you it increases the strength of the restoration. We do not do sealants in my practice, we only do the Mercedes Benz of dentistry, the preventive resins with the use of air abrasion. This is revolutionary. Air abrasion also helps me the dentist each day with my cosmetic dentistry. I air abrade all my small fillings, which results in no line around the filling when it is finished. This is a problem for many dentist's with the line around the filling and how to get rid of it. If you air abrade the preparation prior to filling it there is no line. This means to the patient a more cosmetic filling.

I also use air abrasion each day with my crowns. I air abrade the inside of the crown and it increases the bond strength when the crown is placed. I have been doing air abrasion for over 13years and have a unit in each of my opperatories at my new office. I use it that much. My first office I had one unit to start and was pulling it in the room when needed and found I use it more and more I bought one for each room. It really is state of the art but many dentists do not use it. I don't know the reason exactly, but it could be they need to be trained better on the unit or are afraid of incorporating new things. I love to learn as much as I can and that is why I go to so much continuing education. This is good for my patients and gives them the latest in the field.

Thanks for reading,

Dr. Aschacher

Are all Crowns the same?

As a Orlando Dentist I receive many calls each week about crowns and the price of crowns. First, the reason you need a crown is usually due to a cavity you had when your dentist placed a filling in your tooth years ago. As a young adult, the filling material starts to wear out; you then need another filling or if the size of the area that requires a filling is to big you then need a crown. Crowns are needed when the loss of tooth structure is large that the tooth can not support a filling any longer. There is to much unsupported area that you need a crown to protect your tooth when you are chewing, to prevent the tooth from breaking. You also need a crown if you ever have had a root canal or endodontics on the tooth. Root canals take the nerve and blood supply out of the inside of the tooth and now you have to have a crown the tooth, to protect the tooth from fracturing.

Now that you know a little about why we need a crown, we have to mention the different types of crowns. Perspective patients will call my office price shopping but unaware that not all crowns are the same or of the same quality. So when you get a price on the phone you need to know what you are getting. For example in my office I offer the best quality. I do not give my patients a choice of the cheaper ones. They will not last and there really is not much difference in price for the quality you are getting. The important factor is how much gold is in the crown. The higher the quality of gold the longer the crown will last you. The higher gold content the closer the gold is fired when making it, which means to you longer lasting. So remember you want a crown that is High Nobel metal. High Nobel metal means more gold. If you are getting semi precious or non precious this means no gold or half gold and your missing out on quality and last.

Another type of crown is the all porcelain crown. These crowns are for the more aesthetic areas. They have no metal in them because you do not want the metal showing. These are good for the front areas of your mouth. I do not recommend these for the posterior areas do to my experience they break and fracture. I can place a nice white crown in the posterior area but will always have high Nobel gold underneath where you can not see, giving the patient more strength. In the anterior area I do use the all porcelain restorations and these are getting stronger. Don't let anyone fool you, what you give up in strength you gain in aesthetics and vice verse. So you do have choices. Many people are hearing about the one day crown.

They are called Cerec and in my opinion I do not do them. I have replaced many of these from other dentists that have failed. I only have the best laboratories make my crowns. It might take a week to get the crown, but your having a technician make your crown that has been doing crowns for 30 years is much superior. Do you really want a machine you program the characteristics of how the crown should look. This excellence is based on the doctors assistant dictating how it should look. They have minimal training not a ceramist who has been stacking Porcelain for 30 years. I use these cerec crowns as temporaries and then have the real one made by my laboratory. Sales associates are always trying to give me these Cerec crowns and I do not want them. The technology is improving but it is not there yet. Some doctors, to tell you the truth, do like this because they do not have to pay a lab bill and they cut chair time down to only one visit. I believe in quality and this is not my cup of tea.

Thanks Again,
Dr. Aschacher