Guest: Dr. J. Mark Barry - DDS, MBA
Host: Dr. Linda Austin – Psychiatrist
Dr. Linda Austin: I am Dr. Linda Austin. I am talking today with Dr. Mark Barry, who is a Dentist and an Associate Dean for Clinical Affairs in the MUSC College of Dental Medicine. Dr. Barry, here is a really basic question - a crown, what is a dental crown?
Dr. J. Mark Barry: A crown is a structure that completely covers the tooth, what we say full coverage in dentistry, what a crown does. It can be either made out of gold, it can be made out of porcelain, it can be made out of porcelain with a base metal, or it can be made out of glass. Dentistry has materials in dentistry that have just come so far in technology and there are so many options in crowns, but essentially what a crown does is it covers the tooth and that’s why the traditional word ?cap? has been used in dentistry because it covers the entire tooth.
Dr. Linda Austin: So, everything that you can see then of the tooth to the gum line, is that right?
Dr. J. Mark Barry: That’s correct.
Dr. Linda Austin: Now, why would a dentist want to apply a crown, what are the situations that require?
Dr. J. Mark Barry: Well, there are many reasons for crowning a tooth. The main reason though is to restore the tooth with an excellent predictability and prognosis so it can be used functionally and also would be aesthetic. The reasons that teeth are crowned can run the gamut from very, very large restoration or filling that you may have had as a teenager that has started to breakdown or may be the tooth structure around that filling has broken down or may be you have a cavity underneath that filling; for those reasons then a crown would be utilized to cover the tooth to basically strengthen the tooth and give you the ability to have that tooth in your mouth for the rest of your life.
Dr. Linda Austin: So, typical situations then would be cavity, so what other sorts of situations might require crown?
Dr. J. Mark Barry: Oftentimes, patients will come in, especially the baby boomer generation, who came up in the 60s, in the 70s with lots of fillings in their teeth and they are now into their 40s and 50s and 60s, and a lot of these teeth are breaking down and so for instance, one example would be you have a large filling in a tooth and you are out at dinner somewhere in a nice restaurant and you break off, what we call it cusps and now, you have that filling with a broken part of the tooth and in order to restore that to the best ability in preservation of the tooth and keeping that tooth for a lifetime, a crown would be the most appropriate restoration to place in there.
Dr. Linda Austin: You mentioned that there are a number of different materials a dentist use, how do you know which is the best filling for a given patient?
Dr. J. Mark Barry: The answer is that it depends on the patient. It really does -- as dentist, we can do so many things, but primarily when we are restoring teeth, the first thing we want to look at is function and so we look at the patients what we call occlusion and that is how the teeth come together, the habits that the patient may have, the patient may be a grinder or clencher and that has an influence on what type of material you use. The aesthetic materials we have, the porcelains, the all-ceramics, and the glasses make the teeth look wonderful and it really makes this as dentist look like wizards that we really do a great job making teeth look good. So, it depends on function and it depends on aesthetics and it depends on preservation of the tooth, the longest lasting material that you feel is appropriate for that particular patient.
Dr. Linda Austin: How long do crowns last?
Dr. J. Mark Barry: Well, it is a question, again that it depends. If a crown is done right and the patient takes care of it, a crown could potentially last a lifetime.
Dr. Linda Austin: I recall hearing a friend of mine who is a dentist saying that when a dentist does his work, it’s like looking at his professional signature that another dentist can look at that work and know the quality of it, so there must be a number of different approaches to these questions.
Dr. J. Mark Barry: You are exactly right because another dentist can look at a dentist’s work and be critical of it or look at it and say that’s very good work and so there is somewhat of a built-in 04:04 system out there amongst dentist because if I as a patient come to one dentist and I get something done and I go to another dentist, I know that dentist is going to look at the other dentist’s work and dentist know what is good dentistry and may be what is instead the right dentistry.
Dr. Linda Austin: Am I right in thinking that there is almost a bit of artistry to it then?
Dr. J. Mark Barry: Dentistry is very much an Art and a Science. The scientific training obviously goes without saying, but there is a great bit of artistry that goes into smile design and being able to prep teeth that right down to the millimeter and having perfect margins. So, there is definitely an artistry part of dentistry.
Dr. Linda Austin:Smile design. There is a topic for another podcast, I think?
Dr. J. Mark Barry: Yeah, sure it is.
Dr. Linda Austin: Dr. Mark Barry, thank you so much for talking today.
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