The Crown versus Filling

(2 minute read)

Sometimes, not always an easy decision for me.

A Crown is a wonderful restoration yet a destructive procedure where I drill away 2mm of tooth height and 1.5 mm of tooth wall, 360 degrees around your tooth, to accommodate a beautiful ceramic replacement of the removed bad enamel.

A filling is a filling. What is there to say? We do only the white ones in the office  because I am a  “cosmetic dentist” , like really…  All dentists are at least and should be, cosmetic dentists. Right? Think about that..Marketing, marketing, marketing……….

A tooth has Five surfaces. They are as follows:
Mesial-  surface towards the midline
Distal- surface towards the back of throat
Buccal-surface towards cheek
Lingual-Guess it?
Occlusal- the chewing surface that smashes your food.

When one surface is decayed you get the small filling- A one surface filling.
When two surfaced are decayed, you get the mid-range “model” filling.
When three surfaces are decayed, you get the big boy filling. You are almost there……
And You guessed it. When there is no more tooth to fill, you get The Crown.

A Tooth can “hold a filling”. However, fillings are not made to “hold your tooth together”.

Of course I over simplified it. There are other factors that I take into consideration which all require their own conversation. Let’s just say such I consider:
Past dental history, bruxism habit, para-functional habits, esthetic demands of the patient, age of the patient, home care habits of the patient, am I putting the patient in a worser position if I don’t crown that tooth ; setting them up unintentionally for a bigger failure?
Crowns are good because I can salvage the weakened tooth with a solid restoration that will last for many years. They attract less plaque because of the low coefficient of attraction due to the ceramic, they don’t stain with time.
They can be replaced and don’t last forever. My intention is to compete. I will always create with the intention to last forever using the finest materials and most competent skills. I want it real good, no problems for you or me. Everybody happy.

What God gave you did not last.Thats why you are in my chair.  How can you expect me, a mere creature blogger to create something better than what was given to you by greatness?

Best to keep healthy with good prevention.
Save royalty for Mrs Markle:)

Robert Emilio,  with over his 24 years of experience continues to enjoy practicing on his friends and family Five days week ( and sometimes six days ). He enthusiastically seeks  additional training to advance his craft. He currently holds a Master in Implantology with the I.C.O.I. ( an internationally recognized professional establishment in Implant dentistry) and emphasizes Digital Dentistry. Services include pediatric dentistry, teeth whitening, dentures, porcelain veneers, tooth extractions, treating bruxism, and advanced full mouth dental implant reconstruction. He has on site state-of-art capabilities for same day crown delivery; prosthetic fabrication via CEREC. He also provides gentle care via routine general dentistry  including root canal therapy, and always in a cosmetic artistic approach. He employs both Guided and Non-Guided Implant  surgery techniques. In addition on site, he utilizes a CBCT to aid in diagnostic radiography.

Dr. Emilio Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  dremilio@robertemiliodds.com

Office (203)866-7164      www.robertemiliodds.com.

Instagram dremilio2018

 

 

 

 

“Doc, my tooth hurts when I bite this way”

I hear this every day…. Cracked Tooth Syndrome, better known as Instant crown.

Basically what happens is that your tooth acquires a hairline fracture, usually underneath a deep or very shallow restoration ( usually an amalgam, better known as a silver filling). Upon a strong chew the tooth actually flexes and slightly bends to allow a tiny bit of moisture or air into the micocrack resulting in the stimulation of the finest nerve fibers emanating from within the tooth’s pulp chamber. Essentially you feel a SHARP pain, not dull, upon biting a certain way; usually an off-set  chew on the tooth. The brain says to your major Four chewing muscles STOP NOW!!! by eliciting an “a-sharpey”( Sharpey Fiber )  fiber  nerve transmission pathway, you release on the bite, hence salvaging you primordial advantage of being able to chew another day to sustain your preservation as a human species….

You can’t see the fracture on a routine dental x-ray., altough one needs to be taken to rukle out other possible issues. The diagnosis is made on clinical exam. Also, usually some cold sensitivity, not to hot tempertures.

Treatment is a crown which confines the fracture line from propagating further. My experience is that 50% of patients experiencing this very specific pain inevitably require the dreaded root canal. OMG……………..no…………..not that………………….

Stay away from almonds and definitely don’t chew ice unless you want to see me:)

More Stuff for You.

For your Reference:

 Cracked Tooth Syndrome

Robert Emilio,  with over his 24 years of experience continues to enjoy practicing on his friends and family Five days week ( and sometimes six days ). He enthusiastically seeks  additional training to advance his craft. He currently holds a Master in Implantology with the I.C.O.I. ( an internationally recognized professional establishment in Implant dentistry) and emphasizes Digital Dentistry. Services include pediatric dentistry, teeth whitening, dentures, porcelain veneers, tooth extractions, treating bruxism, and advanced full mouth dental implant reconstruction. He has on site state-of-art capabilities for same day crown delivery; prosthetic fabrication via CEREC. He also provides gentle care via routine general dentistry  including root canal therapy, and always in a cosmetic artistic approach. He employs both Guided and Non-Guided Implant  surgery techniques. In addition on site, he utilizes a CBCT to aid in diagnostic radiography.

Dr. Emilio Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  dremilio@robertemiliodds.com

Office (203)866-7164      www.robertemiliodds.com.

Instagram dremilio2018

 

Acid Reflux

(3 minute read)

Acid reflux can create a feeling of burning in your throat and also wreak havoc on teeth. Long term Acid reflux is a potential killer.  In Barrett’s esophagus, normal esophageal cells are replaced with abnormal cells. Barrett’s esophagus is thought to be caused by long-standing gastroesophageal reflux disease (GERD), which causes stomach contents to back up into the esophagus.  Barrett’s esophagus .   People with Barrett’s esophagus may develop a rare cancer called esophageal adenocarcinoma. With that being said, if the acid contents are affecting the lining of your throat, imagine what it’s doing to your teeth.

Today, I had female in her late 20’s, a new patient consultation regarding a particular troublesome tooth. I couldn’t help noticing she was squirming in the chair as I was gently striking all of her teeth, as routinely done thru all  initial exams. My immediate question to her  was whether  she was actually “feeling” pain or was it “the sound” of the instrument gliding on her teeth. She stated the former. My next question was whether she’s always experienced this “feeling of pain and sesation of the cold metal” , and she stated, “yes, forever”. Immediately, I gathered that she was super sensitive due to the poor quality of enamel and dentin present. Odd, I thought considering her age…. The next question was critical. I asked… “do you have acid reflux?’. In turn her response only when I’m pregnant. Next question. “Okay,  how many kids do you have?” Her response THREE.

I do remember my wife was pregnant twice>Let me do the math. That’s 9 times 2 =18 months of being  subjected to an everyday bombardment of biomechanical and (hormonal) stress. Fortunately not too much nausea for Liza, my wife.

This poor patient, on the other hand,  suffered atleast 27 months of having her teeth subjected to a Hydrochloric Acid  bath (Stomach Acid).

My immediate concern was to direct attention to the caustic esophageal reflux disease and obvious urgency to getting that under control with her MD. Secondarily, I wanted to  fortify the current poor enamel and tooth surfaces with Fluoride. The fluoride treatment will be directed via two modes; paste and rinse. ACT, the rinse and my preferred for night time and Prevident prescription based toothpaste used daily in substitute of ordinary toothpaste. The fluoride works at two levels. One, it reconstitutes the enamel in such a way to make the enamel “more dense” at a microscopic level. The denser, the more resistent and impregnable to the acid bath. Also, Fluoride acts at the bacterial metabolic level. It actually binds to the bacterial’  “poop”. Yes,, poop. I wrote that. That is what causes tooth decay….. The fluoride binds to the poop and essentially neutralizes its deleterious effect, ie, cavity formation. Also, the fluoride will seal exposed microscopic tubules in any exposed roots from the outside world, essentially sealing annoying extra sensitive nerve fibers . Visualize “spackling” the receded exposed tooth surfaces with this industrial strenght “Sensodyne like” toothpaste. I do anticipate that her sensitivity will diminish over the next several weeks. I do admire what a mom endures and how much she will sacrifice for birth of a child.

So, if you have generalized cold sensitivity and you don’t excessively grind your teeth at night (this too can cause tooth sensitivity) and you were diagnosed “cavity free” by me or my staff,  you may want to consider enhancing your home care routine with the added benefit of a highly fluoride rinse . You can always come in to have me check it out and potentially rule that in or out.

I’ve enclosed several articles related:

Erosion: Stomach Upset and Your Teeth

Colgate’s Perspective

Dental Jounal

Robert Emilio,  with over his 24 years of experience continues to enjoy practicing on his friends and family Five days week ( and sometimes six days ). He enthusiastically seeks  additional training to advance his craft. He currently holds a Master in Implantology with the I.C.O.I. ( an internationally recognized professional establishment in Implant dentistry) and emphasizes Digital Dentistry. Services include pediatric dentistry, teeth whitening, dentures, porcelain veneers, tooth extractions, treating bruxism, and advanced full mouth dental implant reconstruction. He has on site state-of-art capabilities for same day crown delivery; prosthetic fabrication via CEREC. He also provides gentle care via routine general dentistry  including root canal therapy, and always in a cosmetic artistic approach. He employs both Guided and Non-Guided Implant  surgery techniques. In addition on site, he utilizes a CBCT to aid in diagnostic radiography.

Dr. Emilio Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  dremilio@robertemiliodds.com

Office (203)866-7164      www.robertemiliodds.com.

Instagram dremilio2018

Introduction to Me….

(2 minute read)

Wow. What a journey. A kid from Brooklyn with hopes and desires to be someone; to make a change. How did I make it here? The story is too long to mention for one post. Instead, I tell it in drips and drabs over the next several days, months and years. I am a product of my fantastic childhood growing up in Brooklyn, New York, USA ( Is there any other?????).

I feel compelled to create a clear picture of me to you all; dear friends, colleagues and patients; all interchangeable. I feel very fortunate to love what I do and love the people around me everyday for whom we care for and work with. This Blog is for you!

This Daily Blog venue will BE UNIQUE from other dentists’ blogs, offering a direct insight into my daily thinking, decision-making process, personal life, professional life-successes and failures. This Blog is not going to be all about teeth. Teeth fixing is what we “do”, and we are good at it , but  life is much deeper than that. I take my patients’ health very seriously.  I really want to humanize my profession(and me) and my fabulous staff to make a much deeper connection to you in the community  thru the amazing possibilities of social media. Dentists are people too……..(HaHa). Sometimes you may come across some technical dental stuff, and other times just fun light-hearted thoughts. I will incorporate some visuals here and there and maybe video. I love to story tell. We all need to laugh at ourselves every now and then. Life is too short!

A couple of rules:
No commenting on my grammar
No names of patients will be mentioned

Otherwise, feel free to engage me with questions and/or suggestions. I do have a sensitive side, so go easy.

Robert Emilio,  with over his 24 years of experience continues to enjoy practicing on his friends and family Five days week ( and sometimes six days ). He enthusiastically seeks  additional training to advance his craft. He currently holds a Master in Implantology with the I.C.O.I. ( an internationally recognized professional establishment in Implant dentistry) and emphasizes Digital Dentistry. Services include pediatric dentistry, teeth whitening, dentures, porcelain veneers, tooth extractions, treating bruxism, and advanced full mouth dental implant reconstruction. He has on site state-of-art capabilities for same day crown delivery; prosthetic fabrication via CEREC. He also provides gentle care via routine general dentistry  including root canal therapy, and always in a cosmetic artistic approach. He employs both Guided and Non-Guided Implant  surgery techniques. In addition on site, he utilizes a CBCT to aid in diagnostic radiography.

Dr. Emilio Always Accepts  New Patients. He especially exceeds at treating same day emergencies patients suffering from tooth ache pains.

His goal is to keep his patients Teeth and Gums Healthy For Life.

Feel Free to appoint a Consultation with the Doctor. Open Six Days A Week

OPEN on Weekdays.  7:30am -8:00pm  (M<T<W<T)

Fridays.  7:30am-2:00pm

Weekends (Saturday only).  8:00am-2:00pm

111 East Avenue, Norwalk, Connecticut 06851.

You can always contact me directly via email  dremilio@robertemiliodds.com

Office (203)866-7164      www.robertemiliodds.com.

Instagram dremilio2018