Dr. Hall,
I broke my two front teeth in an accident, and they both need crowns. I really want the same day crowns, and my dentist doesn’t do them. Should I ask him for a referral?
– Nolan from Florida

Nolan,
You THINK you want same day crowns, but I’m not sure you really do.
Your answer to this question will tell me whether or not you want CEREC (same day) crowns for these two teeth. Which is more important to you–that they look natural, or that you take care of this in one appointment without having to wear temporary crowns?
Your front two teeth are the most important teeth in your smile, and most people would be willing spend a little more or go through a little more inconvenience to get them looking just right. CEREC crowns simply aren’t that esthetic.

Let me illustrate with a close-up photo of a front tooth.

Look closely at the coloration in this tooth. Notice that there is a tannish color present at the base of the tooth that fades out as you get to the halfway point. Notice also some subtle white splotches in various places. There are a couple near the base of the tooth and some more subtle ones near the center. There is also some gray that you see near the biting edge and wrapping around the sides of the tooth a little. And the very biting edge has a whiteish halo.

A porcelain crown for a front tooth is stacked in layers, and a good ceramist operating from good instructions from a skilled cosmetic dentist and maybe from a photograph will build all of these different colors into your crown, so that it looks lifelike. A CEREC crown, on the other hand, is milled out of a single block of ceramic and so will be missing all of this characterization.

Now there are some highly skilled cosmetic dentists who can paint on these characterizations and make a CEREC crown look more lifelike, but you’re talking about fewer than 1 in 100 dentists who can do this and have the equipment to be able to bake these colors on. And even with them, it is still not as good, in my opinion, as having the color embedded in the crown the way it is in a natural tooth.

I should mention also that this is really a job for a skilled cosmetic dentist. The vast majority of general dentists would not be this attuned to the appearance of these front teeth.

Now if you don’t mind having two front teeth that have a flat color and are fake-looking, then go with the convenience. The temporary crown that you have to wear for a couple of weeks is annoying. But I think most people would put up with that for the result of attractive front teeth.

If you opt for the CEREC crowns, you don’t need a referral from your dentist. It’s easy to find a dentist who does CEREC crowns–just search for CEREC crowns with the name of your locality also in the search box.

By the way, there are other brands of same-day crowns. CEREC is the most popular. There is also PlanScan and E4D, which use the same on-site milling technology.