When a patient comes to my office complaining of a specific tooth that is hot, cold or biting sensitive, often times there is a tooth suffering from reversible or irreversible pulpitis.  The treatment under these circumstances can often be root canal therapy.  But that isn’t the most common scenario.  Usually the patient is suffering from exposed dentin or sensitized cementum.

Often times exposed dentin or cementum (root surface ) isn’t sensitive but at times it is.   Sensitive teeth can be exacerbated by sweets and acidic foods and drinks, soda pop being one of the worst. Improper bleaching technique is another.   But there are patients who stay away from common contributing factors and still suffer from sensitive teeth. 

It is not uncommon for me to see excessive tooth wear on patients.  It can happen with all ages but is more common in older patients.  Tooth wear can be a serious dental problem but the good news is that for the most part it is preventable.

The most common cause of tooth wear is abrasion.  This is typically caused by using too much force while brushing your teeth.  It can be complicated by using abrasive toothpaste especially those that promote teeth whitening.  These toothpastes work by an abrasive action to remove extrinsic stains.  While they can help to remove tea and coffee stains, they can also remove your tooth enamel.  So someone that has a history of abrasion should not use whitening toothpaste, and consider brushing with a fluoride or xylitol mouth rinse INSTEAD of toothpaste.

This article is meant to educate you, the consumer, on how to “shop” for a crown.  Let’s say you break a tooth, it isn’t hurting but both friends and family have assured you that you will need a crown.  What should you do?  Well, most of you would start by calling your dentist and make an appointment.     

After some discussion with your dentist you decide on getting a porcelain crown.  What you may not know is that there are dozens of different kinds of porcelain crowns.  Most commonly for a back tooth porcelain crowns are fused to metal alloys.  These are called porcelain fused to metal crowns or PFMs.  The metal alloys used can differ greatly. There are predominately base metal, noble metal and high noble alloys used with crowns.   The PFMs made with predominately base metal are significantly inferior. The alloy doesn’t bond to the porcelain as well and there are elements that commonly cause allergic reactions such as nickel.  The PFMs that use noble metal are also inferior to high noble because of the potentially allergic content of the alloy. 

    Back in the old days dentists did a lot of their own lab work.  My Dad was no different.  He would sit at the kitchen table with all his dental tools and gadgets and happily work away.  I couldn’t have been older than four when I first remember watching him.  “That’s what I want to do someday” I would tell myself.  And that’s what I did.

    He built his dental office with my grandfather in 1956 not more than 6 blocks from our home.  And after more than 55 years that is where I practice today!  But boy have there been changes.