One and Done: Why Same‑Day Crowns Are Changing Patient Expectations

A crown used to mean two appointments, a temporary that never feels quite right, and a week of hoping nothing pops off at dinner. We want to change that expectation. Dr. Stephen Blank digs into what makes a same-day crown possible and why patients often love the “one and done” approach once they experience it for themselves.

We talk through the real downsides of temporary crowns, from the inconvenience of a surprise debond to the way temporaries can flex and sometimes leave edges less sealed than a final ceramic restoration. Dr. Blank shares why eliminating the second visit can matter so much: less time away from work, fewer rounds of anesthetic, and fewer after-hours calls that start with “Hey doc, my temporary came off.”

Then we get practical about the technology behind modern dentistry. You will hear how digital dental scanning compares to traditional rubber impressions, why a digital copy stays consistent, and how removing old analog steps like plaster models and wax-ups can reduce places where error can sneak in. Dr. Blank also walks us through in-office milling, what materials like zirconia mean for durability, and why patients are not getting an inferior product just because it is made in the office.

Same-day is not always the best option, and we cover that too. For multiple units, very large teeth, or highly aesthetic front-tooth cases that demand advanced color and ceramic artistry, a trusted dental lab can still be the right call. If you like understanding your options before you sit in the chair, this conversation will help you ask better questions and feel more confident about your treatment plan. Subscribe, share this with a friend who needs a crown, and leave a review so more people can find the show.

To learn more about Dr. Stephen Blank visit:
https://www.PSLdentist.com
Dr. Stephen Blank, DDS
184 NW Central Park Plaza 
Port St. Lucie, FL, 34986
772-878-7348  

Transcript

Welcome To The PSL Dentist Podcast

SPEAKER_00 0:03

Welcome to the PSL Dentist Podcast, where healthy smiles meet real talk. Hosted by Fort St. Lucie's very own Dr. Stephen Blank, the one dentist who's been making the treasure coast smile for decades. From one-the-stic crowns to clear aligns, botox, and even lifting threads, yep, your dentist does that too. So sit back, open wide, not literally free. And get ready to sink your teeth into today's episode.

The One-Visit Crown Promise

SPEAKER_01 0:35

Imagine walking into the dental office needing a crown and walking out the same day with the final restoration. There's no waiting, no second appointment, and no temporary that pops off at the worst time. Welcome back, everyone. Frederick, co-host and producer here, back in the studio with Dr. Stephen Blank, your Port St. Lucie dentist. Dr. Blank, how's everything going today?

SPEAKER_02 0:57

It's a wonderful day, Frederick. Good to be here with you.

SPEAKER_01 1:01

Awesome. Good to be here with you. So, Dr. Blank, today we're talking about something that patients love once they experience it. Can you explain the benefits of skipping temporary crowns altogether and going straight to a same-day permanent crown?

Why Skipping Temporaries Matters

SPEAKER_02 1:16

Sure, that's a wonderful question because so many people are not aware that there's choices to be had. They're used to the old system, which worked for the last hundred years of sending things to a laboratory, the old rubber goopy impressions and all that business. And they just kind of come to expect to have to have a temporary. And if they've had a bunch of crowns, they may have had one come off or more than one between visits. And then that's an inconvenience to the patient, and it's a difficulty. Sometimes their tooth is sensitive, depending on their age and the the what's been done in that tooth in the past. So when we can treat a patient in one visit, uh it means that they don't need to be anesthetized a second time. They don't have to take off from work a second time, or uh for my retired ones, they don't have to skip a day of golf. Um and uh everything is just easier, one and done. Uh so it it it's been very good. From my perspective, my most common after hours call used to be, hey doc, my temporary came off. I didn't get it a lot, but that's the one kind of call that I don't get anymore at all. Um almost all of my crowns are done, same visit. If we do multiple crowns, it might go to the laboratory, but multiple crowns are connected together and the temporaries tend to stay put for the duration. So for single tooth, one visit done.

The Real Problems With Temporaries

SPEAKER_01 2:50

Amazing, amazing. So I was gonna ask uh what the most common problems that patients experience with temporary crowns is is it the fact that they pop off, or is there a different, more common?

SPEAKER_02 3:02

Well, there's quite a few drawbacks on the old single unit temporaries. One is we had to make them. So that usually meant at the beginning we had to take another rubber impression that we would later use as a mold to make you a temporary. Um, or if we didn't have the benefit of a good-looking tooth at the beginning, we would just freeform one over your tooth. Uh, and that was a lot of carving and grinding and uh a mess and acrylic dust on your face and on our on us. Um and the acrylic that we pour, and when we mix it up chair side, put it in the mold, and then put it in your mouth, it smells like an ale factory. And then uh that goes in your mouth, and then you sit there with that for a few minutes and then we trim it, and it has more porosity in it than the temporaries I can either mill on my machine or go straight to a final product. So they were good and it was the best we had at the time, but now we have alternates. So while I still use those types of crowns from time to time, we've been able to avoid that most often. The other issue some patients get is when they bite down on a temporary, it can flex a bit. It's not as rigid as a ceramic, it's it's plastic of a type of resin. And sometimes the edges open up a little bit, so patients can get sensitivities, especially if they were sensitive before we began. Um, it doesn't necessarily seal the tooth as well. Um, it's a possibility. It's not a common thing, but we hear it enough where it doesn't go in a journal article, it's you know, just you know, pat them on the back and tell them, well, don't worry, we'll have your real one here soon. So way better to just one and done.

SPEAKER_01 4:45

Gotcha, gotcha. So

Digital Scans Versus Old Impressions

SPEAKER_01 4:47

with that being said, how does uh how does digital scanning improve the accuracy of same-day crowns versus traditional impressions?

SPEAKER_02 4:56

Well, that's another good question because we don't want to go to a new technique if we're giving up something. So the standard is can the digital scanner copy the tooth with the same accuracy or better than the rubber impression? And in most cases, the answer is yes. Uh we're able to capture the tooth just as well. And a digital copy is a copy. So if I send it to you or send it to the other side of the planet and back, it's still the same tooth. With the rubber impressions, we had some limitations based on the materials. There were multiple different types of those rubbery goop impressions from polyvinyls to lead polysulfide and um all sorts of other chemistry. Um, and each of them had a limitation on how long we could wait until we poured the plaster in the model before the model started to distort. The chemistry would change just a little bit. Um, most of that was overcome. The new materials are very good. Uh, but then we had the limitation of we had to pour plaster in there. Somebody had to mix that up by hand and pour it in and not trap air bubbles and create a nice model to work on in the lab. So there are multiple steps that are added when it goes through the old plaster or the analog method of doing things, the old manual method. Um, and then we waxed up a crown and then the wax had to be removed and then buried in plaster again and burned out and then casted, all sorts of steps that when it came back to the mouth, we had to see, oh, is this gonna fit? And they did pretty good. But now we get to skip a lot of those steps that were places where error could be introduced, and we get a nice product in one short visit, which is I'm the patient, that's what I want.

SPEAKER_01 6:44

Yes, yes. So you talked about a lot of steps, you know, the casting and all that stuff. Is that the old way of doing it? And then now, if you if there's a new, more modern way that you use, um, could you walk us through the new uh in-office milling process and how that works?

How In-Office Milling Works

SPEAKER_01 7:01

Sure.

SPEAKER_02 7:02

Well, the where the crown gets made is almost secondary now. The labs have some materials that we don't have. So there's certain cases I still send to my lab because they can do something better than I can do here. But for the most part, if we get a zirconia type crown, or there's a couple other materials, um, if I mill it in my office or my lab technician mills it at the lab, it's the same material or a very similar material. There might be differences in brands, perhaps. Um, so patients don't get an inferior product if I send it to the lab, or if I do it in my office, it's a similar product or the same thing. Um, so that's one thing to be assured of it because a lot of people question that. Uh, you know, is it going to be made out of plastic or you know, what am I getting? It's like, no, you're getting the same thing, which is reassuring to know. One thing that I like, it's more on the technical side, is when I drill in your tooth and prepare it to accept a crown, I create a little edge all the way around that has to be something I can read, something I can detect on an impression or on a scan. Um, when I send them to the laboratory, my lab technician has to find that edge, which is nice. And that's the way most crowns have been done in the country for the last 20, 30 years, or maybe even longer than that. Um, when I mill them in a house, I have to find that edge. I'm the guy that just created it. So I'm very good at being able to see it because I know what I just did. It takes one more error or potential error out of the loop when we make a crown. When I mark my margins or those edges myself and then design the crown. So I I personally like that. I like to be a hands-on person.

When Same-Day Is Not Ideal

SPEAKER_01 8:46

Are there situations where a same-day crown is not the best option?

SPEAKER_02 8:51

Very good. So there's some limitations that I have. The ceramic blocks that I use are a bit smaller than what some of the labs use. They work from much larger pucks. Uh that's what they call them, a puck of ceramic. Um, and theirs are half baked. So they'll mill a crown, but they'll mill like five or ten other crowns in that same puck. And then afterwards, they may have to post-fire it. So it goes in the oven overnight and it shrinks another 20% or so. And then that crown is the one that fits the patient's tooth. So they're able to do multiple units at the same time. Um, I can mill two for you at the same day. Um, after that, it becomes a lot of time in the milling machine where you might not want to hang around. So in my office, uh, two is seems to be my limit. Also, for anterior aesthetic cases, when we're doing the smile makeovers or replacing a single unit, one tooth in the front, one of the more difficult things that we do as dentists to make it blend in. Um, there's different materials, and I prefer to have my lab technician do those where they can do some interior or inclusive ceramic changes and then fire it in the oven, and the coloring is inside, not on its surface. So they can do some colorations and some artwork. That's the the place where they excel uh more than what most dentists are able to do. I do have a staining oven in the office, so I can do some of that, but it's not exactly the same. So when I uh have cases like that, I send them out and I plan that ahead of time. The patient knows that. Uh and then the other one is the size. If I get a tall cuspid tooth, it might be bigger than my ceramic block. So I've had one or two surprises like that where now they don't surprise me now. I know to look for things like that. But um uh those are cases where I plan from the beginning. Let's send this one to the laboratory uh because we have to.

SPEAKER_01 10:48

Gotcha, gotcha.

Wrap-Up And How To Book

SPEAKER_01 10:49

Wow. Well, thank you for that very comprehensive answer and for breaking all that down. Same-day cons really do change the experience for the patient. And uh, we all appreciate your insights. And for everyone tuning in at home, we'll see y'all next time.

SPEAKER_02 11:04

Thank you, Frederick.

SPEAKER_00 11:08

Dr. Rap for the PSL Dentist Podcast, where smiles are brighter and laughter always cavity-free. To keep your smile in shape, call 772-878-7348 or visit psldentist.com to schedule your appointment with Dr. Stephen Blank, the one stop doc for smiles, beauty, and everything in between. Until next time, keep closing, keep smiling, and keep listening.