Dr. (Capt.) Douglas Grabowski, 49th Aeromedical Squadron advanced clinical dentist, and Raedawn Davis, a civilian dental technician, prepare to make an impression of a patient’s teeth at the Holloman Air Force Base, N.M., June 13. The process of making an impression is an extremely detailed process. In this instance the impression ensures a secure and comfortable design can be made for a crown. (U.S. Air Force photo by Airman 1st Class Daniel E. Liddicoet/Released)
Raedawn Davis, 49th Aeromedical Squadron dental technician, cleans excess impression material out of a patient’s mouth at the Holloman Air Force Base, N.M., June 13. Different colors of the impression substance with varying qualities are used to ensure that an exact replica of the patient’s teeth can be made. (U.S. Air Force photo by Airman 1st Class Daniel E. Liddicoet/Released)
Senior Airman Melissa Barnes, 49th Aeromedical Squadron dental laboratory technician, prepares the ingredients for a dental impression at the Holloman Air Force Base, N.M., June 13. The dental laboratory technicians use a wide variety of tools to help in assisting clinical procedures. (U.S. Air Force photo by Airman 1st Class Daniel E. Liddicoet/Released)
Senior Airman Melissa Barnes, 49th Aeromedical Squadron dental laboratory technician, puts a finished dental impression in the oven at the Holloman Air Force Base, N.M., June 13. Dental laboratory technicians help analyze and create many of the instruments used to perform dental procedures. (U.S. Air Force photo by Airman 1st Class Daniel E. Liddicoet/Released)
Senior Airman Melissa Barnes, 49th Aeromedical Squadron dental laboratory technician, uses a microscope to check the seal of an impression at the Holloman Air Force Base, N.M., June 13. Ensuring a proper seal allows the laboratory technicians to make a more precise crown for the patient. (U.S. Air Force photo by Airman 1st Class Daniel E. Liddicoet/Released)
A military dentist puts a completed provisional crown into patient’s mouth at the Holloman Air Force Base, N.M., June 13. The provisional crown is used to restore function to the tooth until a permanent crown can be put in. (U.S. Air Force photo by Airman 1st Class Daniel E. Liddicoet/Released)
Commentary by Dr. (Capt.) Doug Grabowski
49th Aeromedical Squadron
6/21/2012 - HOLLOMAN AIR FORCE BASE, N.M. -- Once a year, Airmen are filled with a certain anticipation and nervousness.
It's kind of like the Hunger Games where kids hope that their names are not read aloud.
Unlike a gruesome battle to the death, Airmen are required to have an annual dental checkup, and hope to hear something a little bit more positive: the simple phrase, "Good job brushing and flossing, I didn't find any cavities."
Although nearly everyone can attest to brushing twice a day and dabbling in some sort of flossing, sometimes things happen to teeth that are out of our control. Take, for instance, the cracked tooth. Almost always, a patient will come in complaining of pain arising from a misguided bite into something.
Unfortunately, if the pain results from a cracked tooth, dental work needs to be done. Everyone has heard the dreaded words "root canal" and "crown," so in efforts to increase the education level of the public, I would like to share with you a dental appointment leading to a crowned tooth.
After all the pain has been resolved, a crown or cap is needed to prevent the tooth from breaking down further. A crown is often referred to a cap because it covers the tooth and protects it from everyday chewing forces.
The first step when preparing a crown is shaping the tooth. The dentist will numb the patient with local anesthetic and then use special burs to cut down the tooth to the perfect shape. Depending on the final material, the dentist has to be very precise with their shaping: we are talking tenths of a millimeter!
Once the shaping is done, a small cord is placed at the gum line and a nearly exact impression is made of the shaped tooth. This impression is very similar to a forensic molding used to recreate a footprint or a gun chamber for bullet matching. Once this impression is made, the dentist's job is almost complete. A temporary crown, or provisional, is created and lightly cemented to the tooth. This provisional will allow the shaped tooth to be functional while the dental lab makes the final crown.
From the impression, the dental lab is able to create a crown. Crowns come in different styles, either gold, tooth-colored porcelain or a combination of both. In a perfect scenario, a crown takes about three weeks to make. First, the lab takes the impression and pours liquid stone into it. About 40 minutes later, the stone hardens and the lab has a nearly exact copy of the teeth.
From this copy, the lab is able to take wax and recreate the tooth into its perfect original shape. The perfect shape is comprised of esthetics (how it looks) and function (how it bites). Once the wax copy is made, the wax is separated from the stone tooth and covered in a new stone.
An oven is then used to melt the wax out of the new stone and a pathway is created for melted gold to enter. Using the lost wax technique, gold is placed into the melted wax chamber and the foundation of the crown is made as the gold melts. This technique is what jewelers use to make rings, earrings and necklaces.
After the crown is allowed to cool, the dental lab technicians use their skills, and like artists, a polished tooth is made. The dentist is now ready to place the crown on the tooth and permanently cement it. When all is said and done, many people work together to create a one-of-a-kind crown. Typically, a crown costs anywhere from $800 to $1,300 dollars, and if you are active duty, this is provided by the Air Force.
A trip to the dentist doesn't have to cause anxiety. These processes are not as painful as they may sound, and the dental clinic staff here do everything they can to mitigate pain and nervousness. So next time your number comes up, don't think of the Hunger Games - think about how great it will be to be able to chew and function with a healthy mouth!