The Future Of Dentistry
April 01, 2009
By Dr. Paul Tanaka, D.D.S.
Dr. Paul Tanaka, D.D.S.
Dentist
Interviewed by Melissa Moniz
Where did you receive your schooling and training?
I graduated from Saint Louis High School, then I went to USC, then I went to USC dental school.
Do you have an area of specialty?
We do general dentistry with an emphasis on “bonded restorations.” Our office is known for cosmetics dentistry, but when you say “cosmetics,” everyone thinks about the front teeth. Nowadays people want white crowns and white fillings in the back teeth - that’s cosmetic dentistry too. So what started out in the front is now moving toward the back.
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Your office offers the new technology CEREC (Chairside Economical Restoration of Esthetic Ceramics). Can you discuss how it works?
I’m really excited about the CEREC because I think that it’s going to be the future of dentistry. With the CEREC, you get a porcelain crown in one appointment. The patient comes in and the preparation of the tooth is made. A picture is taken with a special camera on the computer. I design the crown on the computer and send it, via air waves, to a lab unit that, in six to seven minutes, mills the crown out of a solid block of porcelain. I then polish and deliver the crown, and the patient is done! No impressions, no temporary, no second appointment. So, in about an hour and a half, they leave with their new crown. It’s very convenient for the patients, and the patients think it’s amazing.
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Can you talk about the accuracy of the CEREC?
The accuracy of the CEREC is phenomenal. We control the accuracy with the computer. We can be as accurate as we want - within microns! To put it in other words, the average thickness of a human hair is 50 microns - with the CEREC, we can obtain an accuracy of less than 10 microns. This is a big advantage for the dentist. It enables us to provide our patients with the best-fitting crowns possible.
What’s the comparison in cost for the patient in receiving a crown through the traditional approach versus the CEREC?
The traditional porcelain crowns are the same price as the CEREC crowns.
Do most of your patients choose a CEREC crown?
Yes, most of them do. About 90 percent of our crowns are done with the CEREC. There are cases where we need the strength of metal, as in a long bridge or a very thin crown. CEREC crowns would not be indicated in those situations. In almost all the other situations, a CEREC one-appointment crown can be done. It’s simply amazing!
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How long should fillings and crowns last?
All restorations can last a long time, depending if they were done well and if you take care of them (flossing and brushing daily, wearing a night-guard if recommended). They are made to last 10 to 20 years - that goes for fillings and crowns. Unfortunately, we sometimes fall short in caring for our teeth. Through neglect or abuse, a filling or crown may need to be redone.
What are the different types of crowns?
There are three main types of crowns: The gold crown, the porcelain to metal crown (PFM) and the all-porcelain crown. The advantage of gold crowns is they don’t chip. The advantage of PFM crowns is they look like teeth and are stronger than an all-porcelain crown. But the disadvantage of any crown with metal, as in the gold and PFM, is diagnosing decay in the checkup X-rays. It is difficult to tell if there’s recurrent decay under a crown with metal because the X-rays cannot penetrate through the metal. The advantage of an all-porcelain crown is when checkup X-rays are taken, the dentist can see if there’s any recurrent decay. There’s a major advantage if decay is detected early on a crown because more tooth structure can be saved if the tooth needs to be restored again. Losing a tooth due to massive decay under a metal crown is one of the most frustrating things that can happen in dentistry, especially since there is time and cost invested in getting a crown done in the first place. With the CEREC, we never have to face this problem.