New procedure has patients smiling

For many, the thought of going to the dentist evokes images of Orin Scrivello, the evil dentist portrayed by Steve Martin in the 1986 movie "Little Shop of Horrors" using his medieval tools on unwilling patients. Thankfully, through medical and technological advances, going to the dentist is becoming less painful, faster and in some cases with far better results than ever before.

The latest model of the Chairside Economical Restoration of Esthetic Ceramics or CEREC machine has arrived in two dental offices located in Las Vegas and Boulder City and is already helping patients come away with better and stronger smiles.

Drs. David and Doug Sandquist, a father and son who practice dentistry in Las Vegas, and Dr. Eldon Clothier, who practices in Boulder City, have the only two known working model three CEREC machines in Nevada.

The CEREC machine allows procedures for partial and full crowns, veneers and other single-tooth restorations to be performed in one office visit. This is a big departure from the traditional method of treatment which can mean less time in the chair for the patient and a greater sense of accuracy for the dentist.

"It's like starting dentistry all over again," said Clothier who has been in practice in Boulder City for 25 years. "To me, it's a real revolution in dentistry."

The machine uses an components of the AutoCAD computer drafting program commonly used by engineers and architects. After the dentist paints the tooth with a reflective powder, a camera mounted to the machine takes a reading of it using three dimensional infra-red photography that can measure depths within the tooth. Once the picture is taken, the machine uses the information to design a ceramic piece to fix the problem. A single piece can be created in the machine within four to 15 minutes after the readings are analyzed.

The process takes the place of the traditional method of taking molds of a person's teeth and then sending those impressions to a lab to obtain a crown or filling in weeks. Another big change is the material used. Most dentists use a plastic composite or a mercury compound for such procedures, but this machine is able to make the same thing with ceramics. The ceramic can not only match the color of a tooth but bonds to make it stronger as well. The new material may also last an average of five years longer than others. "It depends on the patient," said Sandquist.

The Sandquists have had their machine since October 2000 and Clothier got his in May. Dentists who use the machine must go through training to learn how it works and usually it takes a few months to be working proficiently with it.

"All of our patients have been advised that we are learning," said Clothier. Already, the dentist said, he has had positive reactions to the procedure.

"Not every dentist is going to be able to use it," said Doug Sandquist.

"There's those of us who remain dinosaurs and those who try to stay on the cutting edge," Clothier said.

Mistakes are much more easily corrected using the CEREC than with traditional methods. With the CEREC machine, if the dentist accidentally mishandles a filling and it breaks, it can be reconstructed in a matter of minutes from the drawings in the computer. The other method requires a new impression to be taken and sent back to the lab resulting in more waiting for the patient. "Before, if you broke it, it was another two weeks," Sandquist said. "This kind of takes out the human element of fabricating it."

Perhaps the the most noticeable perk for patients is the appearance of the ceramic material compared to other filling materials.

"It does beautiful work. It's so nice to do something that's pretty and strong," Clothier said.

The procedure is covered by most major insurance companies which have dental plans. Sandquist said it usually doesn't cost much more than the other methods.