Replacement of Dental Crowns?

[accountingsucks]

Thanks for replies. Yup I did try one of those night-guards. First one I didn't form it right and the second one I botched abit too such that the "track" is not quite right for my molars....so I'm worried about wearing it and choking or something....and likely from China not 100% comfortable with whatever material it might be made from long term. I'll just bite the bullet on the one from dentist

 

[Sunset]

Thanks for replies. Yup I did try one of those night-guards. First one I didn't form it right and the second one I botched abit too such that the "track" is not quite right for my molars....so I'm worried about wearing it and choking or something....and likely from China not 100% comfortable with whatever material it might be made from long term. I'll just bite the bullet on the one from dentist

I'm pretty sure the dentist one will be from China as well, and will cost $400 or more..

Just be sure it's a FULL size one, some dentist's were touting the short front ones only. Then people found the back molars erupted (grew out longer) and these people cannot bite front teeth together anymore.

 

[ncbill]

Thanks for replies. Yup I did try one of those night-guards. First one I didn't form it right and the second one I botched abit too such that the "track" is not quite right for my molars....so I'm worried about wearing it and choking or something....and likely from China not 100% comfortable with whatever material it might be made from long term. I'll just bite the bullet on the one from dentist

The endodontist will let you know if the tooth is salvageable for a crown or needs to be removed for an implant.

Because of an abscess I just had a root canal done on a back molar that already had a crown placed over the live tooth 25+ years ago because of cracking around a filling.

Next week I go back to the dentist for my permanent filling & temporary crown.

 

[Gevans17]

I had a dental exam this morning with a new dentist who appears conservative and not overly aggressive with suggested work needed.

At the conclusion of the exam, she gave me a run down of the issues she found in my mouth (and some of these are obvious and not a surprise) and ranked them in order of priority.

At the bottom of the list, lower priority, she mentioned two older crowns (both are at least 20 years old, probably older) that should be replaced since the gums have receded around these teeth and now the underlying natural tooth portion that still remains is now above the gum line - she says that this makes these teeth now susceptible to decay - but she did not find any decay yet.
To my mind - this sounds like a nice to have - but then maybe the decay could lead to me needing a root canal somewhere down the road?
Nevertheless, I plan to have fixed the other more pressing issues - but I was curious if any um...other middled aged people here - have experienced gum recession around a crown and their dentist recommended pre-emptively replacing it?
The good news is that my periodontal health is good.

What about the teeth without crowns? Are they more prone to decay? Recession around an existing crown is not a reason to replace the crown.

 

[FLJim]

I had a dental exam this morning with a new dentist who appears conservative and not overly aggressive with suggested work needed.

At the conclusion of the exam, she gave me a run down of the issues she found in my mouth (and some of these are obvious and not a surprise) and ranked them in order of priority.

At the bottom of the list, lower priority, she mentioned two older crowns (both are at least 20 years old, probably older) that should be replaced since the gums have receded around these teeth and now the underlying natural tooth portion that still remains is now above the gum line - she says that this makes these teeth now susceptible to decay - but she did not find any decay yet.
To my mind - this sounds like a nice to have - but then maybe the decay could lead to me needing a root canal somewhere down the road?
Nevertheless, I plan to have fixed the other more pressing issues - but I was curious if any um...other middled aged people here - have experienced gum recession around a crown and their dentist recommended pre-emptively replacing it?
The good news is that my periodontal health is good.

I am 74 now and lost 2 crowns a week apart. They were 20 years old, maybe a bit older. The don't last forever. So the question is, pay me now or pay me later?

 

[Gevans17]

Nothing is permanent in dentistry, not even permanent teeth. Dental restorations eventually wear out.

 

[Swilliams97]

40 year dentist here. Recession, where are the gum lowers around the tooth and exposes the edge of the crown, is not necessarily a reason to replace a crown. It actually sometimes makes the crown easier to clean because a toothbrush and floss will be able to reach the margins. Unless it is a cosmetic concern, a crown with exposed margins can continue to last for years and years.

 

[Buckeye]

Thanks for replies. Yup I did try one of those night-guards. First one I didn't form it right and the second one I botched abit too such that the "track" is not quite right for my molars....so I'm worried about wearing it and choking or something....and likely from China not 100% comfortable with whatever material it might be made from long term. I'll just bite the bullet on the one from dentist

This is my fave bite guard right now. I've been wearing something like this for more than 10 years with no ill effects. I would probably be on my fourth dentist made one due to changes due to crowns and/or fillings. That's a lot of money!
https://smile.amazon.com/gp/product/B0036WTV2C/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1

 

[sroby2020]

restoration

I recently had some gum recession. My dentist added a small extension to the crown to allow for the recession. It took about 15 minutes. The crown itself was replaced about 5 years ago after I chipped it somehow.

 

[ncbill]

40 year dentist here. Recession, where are the gum lowers around the tooth and exposes the edge of the crown, is not necessarily a reason to replace a crown. It actually sometimes makes the crown easier to clean because a toothbrush and floss will be able to reach the margins. Unless it is a cosmetic concern, a crown with exposed margins can continue to last for years and years.

+1

I only lost an existing crown (over a live tooth, #18) after 25 years when the root started to abscess & so the endodontist drilled through it to work his magic.

The old one was porcelain over metal, I was told the new will be zirconia...wasn't asked my preference, is there any advantage to gold?

 

[Koolau]

+1

I only lost an existing crown (over a live tooth, #18) after 25 years when the root started to abscess & so the endodontist drilled through it to work his magic.

The old one was porcelain over metal, I was told the new will be zirconia...wasn't asked my preference, is there any advantage to gold?

Not familiar with zirconia, but supposedly gold lasts longer. I've had problems with porcelain chipping or failing. Gold - seems to last forever. I had a tooth fail under a gold crown after 25 years and the gold crown (still in my desk drawer) looks perfect. Not an expert so YMMV.

 

[ncbill]

Not familiar with zirconia, but supposedly gold lasts longer. I've had problems with porcelain chipping or failing. Gold - seems to last forever. I had a tooth fail under a gold crown after 25 years and the gold crown (still in my desk drawer) looks perfect. Not an expert so YMMV.

Thanks...I'll ask the dentist when I go in for the permanent filling & temporary crown next week.

 

[accountingsucks]

Not sure if this is the spot for dental queries but here goes. Nearly 50, teeth are in good shape, cleanings and checkup every six months. At cleanup last time six months ago dentist noted possible signs of clenching which I've never had before. We agreed to keep an eye on it and that mouth guard probably not needed. Fast forward to I guess 2-3 months ago and something felt off on one of my bottom right molars. No pain, no soreness perse...almost like my bite shifted. Only lasted two days didn't think of it again.

Two weeks ago that tooth had abscess. Dentist drained it and said would investigate further in two weeks as I was due for another checkup then. During this checkup/cleaning today I heard them saying that gum went from 2mm recession to 10mm in that six months. I do recall at some point biting on a kernel really hard and being abit sore next day. Possible crack? That molar does have 2 or 3 filings as my oral hygiene was not great in my teens

He has referred me to an endo in about four weeks. Best case scenario is root canal needed otherwise extraction. He thinks endo can save tooth but can't say for sure as he does not have I believe Cone Beam xray needed to investigate. My doctor friend told me to insist that the endo has microscope to check for crack and I called them and they do have that tech too. I will be fitted for mouth guard in 2 weeks by dentist as well.

I'm abit bummed out by it as I have good hygene and not really clear what has caused this. As far as I know my gum in that spot will always be receded. Is that correct? Sounds like in a previous reply in this thread they can fill that in?

Update, endodontist said tooth cannot be root canaled, infection too big on CBCT xray. No pain because abscess at gumline was draining so relieved the pressure. Will have to get extracted and then implant. Still not sure why this happened as neither dentist or endo could say definitively, just theorize. At my last checkup (every six months) dentist said showing signs of clenching which I never have had and said we will do mouth guard probably "down the road" but for now just monitor on checkups. Wish he had made me one then but my Doctor friend thinks it was simply a cracked tooth as had a couple older filings on that molar.

Anyways I'm hoping extraction won't hurt too bad on an infected tooth, I'm kinda anxious about dental stuff. Neither prescribed antibiotics I asked them if I needed it and they both said no but not sure why.

 

[Koolau]

When I got 3 wisdom teeth extracted my dentist sent me to a place where they put you under in the chair. I was in the chair for maybe 30 minutes and didn't feel a thing. I assume they use propofol or similar fast acting/fast recovery anesthetic. I had a friend drive me home and when the local wore off, I think I took one Lortab for pain. Very good experience though I'm just a little leery of that type of general anesthetic in a clinic rather than a hospital. Good luck and YMMV.

 

[SunnyOne]

whenever I've had an infection, most practitioners have had trouble getting the novocaine to work on me - I guess the pH level of an infected tooth renders the anesthetic less effective.

In those cases, all I can do is nitrous oxide. I do enjoy the nitrous, however.

 

[athena53]

When I got 3 wisdom teeth extracted my dentist sent me to a place where they put you under in the chair. I was in the chair for maybe 30 minutes and didn't feel a thing. I assume they use propofol or similar fast acting/fast recovery anesthetic. I had a friend drive me home and when the local wore off, I think I took one Lortab for pain. Very good experience though I'm just a little leery of that type of general anesthetic in a clinic rather than a hospital. Good luck and YMMV.

I had a molar with a very bad abscess extracted- I already had an appointment with the oral surgeon and they had me come in early when they had a cancellation (thank heaven) because that side of my face was so swollen people noticed it! I think I got the same cocktail Koolau did- nice stuff. You stop talking in mid-sentence and wake up when it's over. I had one dose of Advil after the anaesthetic wore off. It did take a very long time to heal- oral surgeon even waited a couple of months to place the implant, which he usually does at the same time as the extraction. It was months before I could press against that side of my face up against the jawline without it feeling sensitive but no residual pain at all, even after the implant was placed.

 

[Koolau]

I had a molar with a very bad abscess extracted- I already had an appointment with the oral surgeon and they had me come in early when they had a cancellation (thank heaven) because that side of my face was so swollen people noticed it! I think I got the same cocktail Koolau did- nice stuff. You stop talking in mid-sentence and wake up when it's over. I had one dose of Advil after the anaesthetic wore off. It did take a very long time to heal- oral surgeon even waited a couple of months to place the implant, which he usually does at the same time as the extraction. It was months before I could press against that side of my face up against the jawline without it feeling sensitive but no residual pain at all, even after the implant was placed.

Wow. That is kinda scary. I was SO fortunate that I had no real issues following extraction (even though my wisdom teeth were impacted and barely erupted.) The only issue was the need to keep rinsing the wounds with salt water several times per day (with a plastic syringe.) I was religious about it and got zero infection or significant pain.

 

[accountingsucks]

When I got 3 wisdom teeth extracted my dentist sent me to a place where they put you under in the chair. I was in the chair for maybe 30 minutes and didn't feel a thing. I assume they use propofol or similar fast acting/fast recovery anesthetic. I had a friend drive me home and when the local wore off, I think I took one Lortab for pain. Very good experience though I'm just a little leery of that type of general anesthetic in a clinic rather than a hospital. Good luck and YMMV.

In Canada I wouldn't say sedation is rare but I think less common than in the US. Where I live there was a massive publicized case where an 8 year old died under sedation for a minor dental procedure (can't recall what). Lots of finger pointing between parents and dentist (claimed she had eaten before sedation). I do trust my dentist, I will ask him if it's an option at another place as he doesn't do it - he said the root canal wouldn't hurt (assuming it was possible to save tooth but it wasn't) despite the infection and he explained why but I didn't really understand the explanation. My Doctor friend said the tooth will "come out easy" as it is so infected per xray. He is very against sedation

 

[Samsung4321]

The old one was porcelain over metal, I was told the new will be zirconia...wasn't asked my preference, is there any advantage to gold?

My dentist uses lithium di-silicate, filling or crown measured, machined, fired and applied on site in one appointment. $A1,300 / crown.

https://en.wikipedia.org/wiki/Lithium_disilicate
https://www.ivoclar.com/en_au/products/metal-free-ceramics/ips-e.max-lithium-disilicate

Tough as gold alloy.

 

[Koolau]

In Canada I wouldn't say sedation is rare but I think less common than in the US. Where I live there was a massive publicized case where an 8 year old died under sedation for a minor dental procedure (can't recall what). Lots of finger pointing between parents and dentist (claimed she had eaten before sedation). I do trust my dentist, I will ask him if it's an option at another place as he doesn't do it - he said the root canal wouldn't hurt (assuming it was possible to save tooth but it wasn't) despite the infection and he explained why but I didn't really understand the explanation. My Doctor friend said the tooth will "come out easy" as it is so infected per xray. He is very against sedation

My dentist really does not (routinely) do extraction - and certainly not impacted wisdom teeth - so he sends his patients to a limited number of specialists that he trusts. I honestly can't recall who "suggested" anesthesia, but I think it was the specialist I visited. He suggested it would be much more comfortable and was quite safe. Anecdotally, I am still here, so I guess he was right.

Many years ago, I had the other wisdom tooth pulled by my regular dentist (the one that doesn't routinely do it - and he broke it off!) Whereupon, he sent me to an oral surgeon! I think this is why he no longer does extractions, routinely. I concur with that decision on his part though YMMV.

 

[Buckeye]

Update, endodontist said tooth cannot be root canaled, infection too big on CBCT xray. No pain because abscess at gumline was draining so relieved the pressure. Will have to get extracted and then implant. Still not sure why this happened as neither dentist or endo could say definitively, just theorize. At my last checkup (every six months) dentist said showing signs of clenching which I never have had and said we will do mouth guard probably "down the road" but for now just monitor on checkups. Wish he had made me one then but my Doctor friend thinks it was simply a cracked tooth as had a couple older filings on that molar.

Anyways I'm hoping extraction won't hurt too bad on an infected tooth, I'm kinda anxious about dental stuff. Neither prescribed antibiotics I asked them if I needed it and they both said no but not sure why.

I had an infection in a tooth that had had a root canal so didn't feel anything. Found the issue because I had what looked like an infected pimple on my gumline by that tooth. That area had bled during a cleaning appointment and the hygienist didn't catch that there was something going on. I don't go to that office anymore. Endodentist said basically a 50/50 chance of saving the tooth by redoing the root canal. He's very good and he saved the tooth. The original root canal and crown were at about 25 years old.

I had a second tooth that got infected (no pain because of root canal) but there was a post in the canal and my endodentist said there was too great of a chance he would crack the root trying to get it out to redo the root canal. The root canal had been done 22 years prior. He said I would just be mad at him when it failed and I had wasted money on a redo and had to now pay for an implant.

The implant took quite awhile because my dentist was conservative between each step. Had to have bone grafting done so that increased the cycle time. Very happy with the result. Getting the tooth pulled was done under Novocain (or whatever they inject now) and was a non-event. The gum line was a little slack in that area to start with and I had to be diligent about using my Water-Pik to keep it clean (stinky!) but everything has tightened up so no food can hide down there anymore.

 

[RobbieB]

A cracked tooth has to come out, no way to fix. Proceed from there.

 

[ncbill]

My dentist uses lithium di-silicate, filling or crown measured, machined, fired and applied on site in one appointment. $A1,300 / crown.

https://en.wikipedia.org/wiki/Lithium_disilicate
https://www.ivoclar.com/en_au/products/metal-free-ceramics/ips-e.max-lithium-disilicate

Tough as gold alloy.

After discussing it with the dentist and another one I know socially I decided on gold instead of zirconia.

I want gold's softer surface given there's still an opposing tooth.

I am very glad I am able to have the tooth re-crowned instead of needing an implant at this time.

The previous crown (over a live tooth) lasted over 25 years...hopefully they can bury me with the new gold one still in place.

 

[Koolau]

...hopefully they can bury me with the new gold one still in place.

Heh, heh, do you trust your funeral director? A gold crown could easily be worth $50 and up in the dental gold market.

https://core-scientific.com/how-much-are-gold-crowns-worth/