Well, I just had my appointment with my insurance-based dentist yesterday. I really liked this guy, and feel that he and his wife (the biologic dentist in my neighborhood) are very concerned about getting people the best care possible. This dentist was very open to all of my questions, and actually welcomes having patients that have done some homework before coming to his office. He was very matter-of-fact about the mercury issue, and did not side-step any of my questions. Bex, he also told me many of the same things about CEREC that you have been told by the dentists that you have researched. He thinks that this is the most bio-compatible material on the market today, and recommends it whenever possible. One interesting thing that he told me, is that they began moving away from the aluminum-oxide based CEREC's about two-and-a-half years ago, and have been placing the zirconium-oxide based CEREC's since then. He seemed to feel that this matched the existing tooth structure better than the aluminum-oxides. This particular dentist spends quite a bit of time in seminars trying to learn as much as he can about the new materials and techniques, to find what works best for people. He said that he has spoken frequently with Walter Clifford, and that Walter told him that the number of people requesting blood serum testing for CEREC's has actually been decreasing lately, because so few people are reporting any problems with them. This particular dentist also said that he has been placing CEREC's for years, and no one yet has reported any problems to him with them. He did say that he would not have any way of knowing if there were problems after placement, unless someone specifically complained to him about it. But so far, no one has done so.

Someone had also earlier asked the question about the 'finish lines' with the CEREC's, and their dentist being concerned about the difficulty of getting these correct. I found out that the 'finish line' has to do with how far the crown goes down over the tooth. The problem with CEREC finish lines comes when the crown needs to go extremely near to, or below the gumline. When this happens, a regular mould needs to be taken of the tooth, just as would be done normally with other non-CEREC crown materials. This mould is then sent away to a lab, where the CEREC crown would then be fabricated, instead of having it done onsite. This requires the use of a temporary crown, rather than getting everything done in one visit, which is usually possible with the CEREC's. I would assume that this probably has to do with the powder that the CEREC computer camera normally uses to create a one-visit crown placement. If the powder cannot get right up to or below the gumline, then a different method needs to be used to obtain the correct crown dimensions.

I think that this dentist that I talked to has also been taking cues from his wife's practice, as he employs most of the same procedures in removing amalgams as she does. He uses the rubber dam, high-powered suction, high-powered ventilation in a separate room and uses lots of water to keep the drill cool. He also drills around the filling as much as possible, and tries to break out the filling in chunks, to minimize the amount of mercury vapor created. He also offers supplemental oxygen in the form of a nitrous-oxide hood with positive pressure, rathen than a cannula-type of device. About the only thing that he does not offer is the ionizer that captures some of the mercury vapor in the ambient air.

I will be attending a qustion-and-answer session tomorrow with the biologic dentist that she puts on once a month for interested people. I will have to see if I can find out any other information at that time about amalgam removal procedures, etc.

Jason