Dr. Rachel Fehling uses technology and creativity to the art of dentistry. (Photos by JAKE SMITH)
In 1987, dentistry changed.
New technology was introduced to repair teeth, and over 30 years of advancement has eliminated weeks of labor and pain through design.
Dr. Rachel Fehling, who in 2012 opened Element Dental, located off Ironwood Drive in Coeur d’Alene, adopted this technology in 2016. This creative approach to health care uses a mixture of computer-aided design and 3D imaging.
“Everything we do is art,” Fehling said. “In theory, what we do is use art to restore back health in somebody’s mouth.”
The system of machinery is called Chairside Economical Restoration of Esthetic Creations (CEREC). It allows for crowns to be rapidly made and secured in patients’ mouths within a single office visit.
Teeth can be reshaped and rebuilt in hours.
Carol Scholz, an Element Dental hygienist, said this is significant because before, this was a highly involved, sometimes painful process that lasted for weeks with multiple visits to dental offices and labs.
Molded impressions of the patient’s damaged teeth would be made so that new crowns could be designed by separate personnel at a later date, to cover the tooth and restore it to its prior size, shape and strength.
Scholz said often the temporary replacement could break or cause pain, resulting in multiple emergency calls.
Fehling said the new process is straightforward.
A patient may come in with, for example, half a tooth broken off. Once in Fehling’s office, the patient’s mouth is numbed, the tooth is digitally scanned and the damaged area is prepared to have a new top bonded to its surface.
Josie Camplin, a dental assistant in Fehling’s office, said CEREC provides a digital impression of the tooth on an acquisition unit, which is a computer on wheels that allows health care specialists to shape and mold a digitally rendered version of the tooth based on the scanned area.
In the acquisition unit, Camplin said they can use the elements of design to create a medical solution that not only restores health, but also improves patients’ confidence.
Once the digital file is finalized, it’s transferred to a milling unit. A porcelain or ceramic material is chosen based on the patient’s individual needs.
“Picking what material you use is a big part of it too,” Camplin said. “It’s like picking what paint brush you want to use with acrylics or water-based paints.”
Once in the milling unit, the block of soft material is drilled out in a subtractive process to the specifications in the patient’s mouth, she said.
If patients would like to watch, those in the office can show them how their crown — or any of the dental options the machine can make — is drilled out in the complex machinery. She said it can help educate the patient and creates an open environment.
Camplin said she prefers to create a warm, inviting environment for patients.
“We comfort patients. We love them. We actually have a really good time and make them feel comfortable and safe,” she said.
Once out of the milling machine, the product is tested with the patient and subsequently finalized by baking it into a hardened form and painting it the correct shade, relative to the patient’s teeth.
A tooth can be restored to its original anatomy with immediate feedback from patients on esthetics and function.
“It definitely broke up the monotony of bread and butter dentistry, and all the design aspect in the past on crowns was on the dental lab,” Fehling said. “I love our dental labs, but before if something was wrong in the color, the patient would have to drive over to the lab and get the color changed and you would come back and ‘Ehhh, no, it’s still not quite right,’ then you’d have to go back again.”
Fehling said the real pleasure for her, though, is using design as a way to solve real problems through critical thinking.