Crown Repair?

[BunsGettingFirm]

I'm far, far away from my regular dentist, and I just cracked the side a molar crown by chewing on an unpopped corn kernel. Only a small sliver is missing from the side of the molar, but I'm now starting to feel some pain. The new dentist I went to see today says that the crown is not matched to the tooth, so that's why it cracked. He wants to make a new post and a new crown. Is he fleecing me, or can a cracked crown be repaired? The cost is $1,100 USD.

 

[lazygood4nothinbum]

no dds here but sure have paid them lots of money. i can understand a new crown because if he has to do any work to the tooth or if the tooth was damaged, the crown probably should be molded to the new form of the tooth for proper fit. you definitely want a proper fit so you don't get any decay under the crown. a new post sounds odd unless you snapped the existing one off. bummer about the pain. if you are lucky you will not require root canal work. a properly fitted crown will help insulate that nerve.

 

[frayne]

Maybe not relevant to the initial post but my dentist tells me today I need a root canal on a tooth that is crowned, for $1700. I'm 55 and have put some serious money in my mouth, just wondering at what point is the point of diminishing returns. Sounds kind of silly but at what point do you bite the bullet and say pull em all out and get either dentures or implants ?

 

[Patrick]

Maybe not relevant to the initial post but my dentist tells me today I need a root canal on a tooth that is crowned, for $1700. I'm 55 and have put some serious money in my mouth, just wondering at what point is the point of diminishing returns. Sounds kind of silly but at what point do you bite the bullet and say pull em all out and get either dentures or implants ?

The day you die. Don't do it unless you have to. It's not pretty.

 

[Gumby]

..

 

[Donzo]

Keep your REAL teeth as long as possible. I have all my wisdom teeth - they all grew in w/no space issues. A couple years ago one of my wisdom teeth needed a cap and the dentist asked if I wanted to pay...or have it pulled. After a couple of questions I found out that if I had that tooth pulled - "the correspondent tooth would "search for its partner and also have to be pulled - w/in a couple of years(cause and effect). I payed and am happy to still have all my teeth.
There have been studies showing longevity related to tooth retention....
Hold on to the original parts as long as possible!

 

[BunsGettingFirm]

OK, thank you for your advice. It would appear that a new crown is necessary, but that the extra $280 for new posts could be just padding his bank account.

 

[haha]

Maybe not relevant to the initial post but my dentist tells me today I need a root canal on a tooth that is crowned, for $1700. I'm 55 and have put some serious money in my mouth, just wondering at what point is the point of diminishing returns. Sounds kind of silly but at what point do you bite the bullet and say pull em all out and get either dentures or implants ?

I think one should avoid that if at all possible. Implants don't last forever, and do you want dentures?

Ha

 

[haha]

OK, thank you for you advice! It would appear that a new crown is necessary, but that the extra $280 for new posts could be just padding his bank account.

Consider gold. It is hard to impossible to crack. Plus, your mouth will have a nice Goldfinger look to it.

Ha

 

[SonnyJim]

Odds are that the old post will become dislodged when the old crown is removed. Don't try to save a couple of bucks on the post as it is the foundation for the new crown. Listen to Ha re the gold, it is the best and should last the rest of your life. Also, as Gumby stated you could get a temp crown placed if you are going to be home in the near future, but you will have to pay for the temp then pay for the whole new shebangs when you get home.

The pain you are feeling concerns me, I assume you had a root canal in the past (it is where the post goes), so if you are feeling pain, you may have a leaking root canal that will need to be redone (best case) or you may have a cracked tooth for which the cure is cold steel and sunshine (obviously, worst case).

Good Luck

usual disclaimer, this is not medical advice, merely a discourse on a web forum, go see a licensed dentist for diagnosis and treatment.

 

[dex]

I really don't like the idea of crowns. It seems as if dentists are pushing them more than the new composites that replaced the mercury based fillings.

Recently, I had a back tooth chip. The dentist suggested a crown; I suggested using the composite. No problems so far - feels great!

 

[Nords]

OK, thank you for your advice. It would appear that a new crown is necessary, but that the extra $280 for new posts could be just padding his bank account.

Maybe he's upgrading from English to metric!

But I guess it's also possible that the post's alignment has moved, changed the tooth/crown configuration, and make them more susceptible to the type of damage you experienced. Can he show you from the x-rays why the post has to be replaced?

Recently, I had a back tooth chip. The dentist suggested a crown; I suggested using the composite. No problems so far - feels great!

I hear a lot of dental whining about how old & thin my fillings are and how they should be immediately replaced before I'm inconvenienced or even hazarded. But to me it sounds like all the military "preventive maintenance" where we broke more things by trying to replace partly-worn components at our convenience to avoid having them break at an inconvenient time. We usually paid a pretty high price in labor, expenses, and overall effort to avoid those imaginary problems.

As I was retiring the military was learning that monitoring was better than preventing. (Lots less labor, expenses, & effort too.) Maybe it's better to let a warning symptom or two accumulate (other than the dental whining) before action is indicated.

I wonder if there's a field of evidence-based dentistry...

 

[Ibid]

.

 

[Brat]

As long as we in a dental discussion...

Went for my regular cleaning and my dentist noticed a clacky jaw. He wants to do a lengthy exam to evaluate a disc. Postponed making the appointment because I didn't have my calendar and wanted to explore jaw discs. I have figured out that what he is talking about is temporomandibular joint disc. I have no discomfort, am 65 with osteoporosis. Have taken Fosamax, but not for several months (oral surgeons should know why that is significant).

So, I guess the bottom line is am I asking for problems, I don't see any treatment that doesn't have significant risks.

 

[Rich_by_the_Bay]

As long as we in a dental discussion...
So, I guess the bottom line is am I asking for problems, I don't see any treatment that doesn't have significant risks.

Beyond, say, routine x-rays or a custom bite plate if he thinks you have "bruxism" (clenching teeth at night) which might lead to TMJ problems, it is hard to see why anyone would do anything about supposed TMJ problems if you have no symptoms.

I would be very cautious about proceeding with anything nontrivial without a second opinion.

BTW, there are reports of fosamax type drugs (biphosphonates) causing serious jaw problems in rare individuals, almost all of whom were taking other powerful medications for cancer and other diseases, or who had serious preexisting jaw bone problems. Maybe he was thinking of that, but you don't sound like someone where that would be a worry.

 

[Sheryl]

I hear a lot of dental whining about how old & thin my fillings are and how they should be immediately replaced before I'm inconvenienced or even hazarded.

I heard the same thing - three or four teeth were "scheduled" for crowns. I asked why, if they ain't broke, did they need to be fixed. Got the same story. I said I'll wait and see. Went about 4 years with no problems, then three of them broke within a 2-month period. Still haven't done the crowns as my insurance had run out last year. The old filling remains in place with no tooth enamel around it, but I guess I'd better get the crowns now that I have another $2,000 worth of Delta Dental's money available.

My dentist uses something called CEREC www.cereconline.com. It makes a computerized model of what your tooth should be, then manufactures it right there in the office, goes on the same day - I love that it's only one visit and not the "temporary while waiting for final" routine.

I will eventually have almost every tooth crowned, as the 1960's and '70's fillings deteriorate. I had terrible teeth as a kid.

But I would never even consider implants instead of crowns - even if the crowns only last 20 years...

BTW, Donzo - I had one wisdom tooth pulled about 15 years ago - it's partner does not seem lonely at all.

 

[Brat]

Beyond, say, routine x-rays or a custom bite plate if he thinks you have "bruxism" (clenching teeth at night) which might lead to TMJ problems, it is hard to see why anyone would do anything about supposed TMJ problems if you have no symptoms.

I would be very cautious about proceeding with anything nontrivial without a second opinion.

BTW, there are reports of fosamax type drugs (biphosphonates) causing serious jaw problems in rare individuals, almost all of whom were taking other powerful medications for cancer and other diseases, or who had serious preexisting jaw bone problems. Maybe he was thinking of that, but you don't sound like someone where that would be a worry.

"Bruxism" runs on my husband's side. To my knowledge I don't do that.

He told the scheduler to set aside 75 minutes for the exam so I am puzzled. He is very good and has extensive training above and beyond general dentist. Sometimes I wonder if we both have the over-analyzer syndrome.

 

[SonnyJim]

Beware of the lengthy exam for the pops and clicks of your jaw. They can lead to an entire new bite (you have to pay for a new crown on all of your back teeth) and a $25,000 dental bill. You stated that you are 65 with no panful symptoms, as long as you have good range of motion (can open greater than 25mm and can move your jaw from side to side) you may be able to live without treatment. I echo Rich in Tampa's advice of a second opinion. I'm not saying that your dentist is a quack, quite the contrary, I think he may be on to something, but sometimes the cure is worse than the disease. Many Pankey trained dentists believe that occlusion (how your teeth come together) can cause all sorts of maladies and they try to correct any occlusal abnormalities, sometimes they use a myogram (muscle tracing) to see how your muscles are affected by your malocclusion.

BTW Nords, some of the best dentistry I have seen has been done by Navy dentists (no, I am not a Navy dentist) and here is your evidence based dentistry link http://www.ada.org/prof/resources/positions/statements/evidencebased.asp

As for bisphosphonates, we have discussed this before, it is becoming an issue for dentists to deal with in the future. It is a real thing, check out your newspapers and I'll bet there is an attorney advertising that you may be part of a class action suit against fosamax if you get osteonecrosis "bone rot" etc.

usual disclaimer, this is not medical advice, merely a discourse on a web forum, go see a licensed dentist for diagnosis and treatment.

 

[Brat]

My guy is a former Navy dentist, takes care of a lot of Navy families. [Another relative sees a dentist in Portland who is a former submariner, he gets rave reviews.] I do think he is very good, but sometimes I think we all want to jump on the the latest medicine. As my now elderly Mom would admonish, "Patience Prudence!" (and no, that is not what she named me).

I think I will just forget making that appointment.

 

[FinanceDude]

Beyond, say, routine x-rays or a custom bite plate if he thinks you have "bruxism" (clenching teeth at night) which might lead to TMJ problems, it is hard to see why anyone would do anything about supposed TMJ problems if you have no symptoms.

I would be very cautious about proceeding with anything nontrivial without a second opinion.

BTW, there are reports of fosamax type drugs (biphosphonates) causing serious jaw problems in rare individuals, almost all of whom were taking other powerful medications for cancer and other diseases, or who had serious preexisting jaw bone problems. Maybe he was thinking of that, but you don't sound like someone where that would be a worry.

I have a bruxism problem that will be costing me about $3000 to fix.........

 

[Retire Soon]

Recently we relocated and I just went to a new dentist this week. After having my teeth cleaned, the dentist observed that I had a hole drilled in a porcelain crown which now had a silver filling in it (molar). This was something I was not aware of until then. I casually, responded, "I must have had a cavity there." The dental assistant blurted out in obvious surprise, "In a crown." I didn't know what to say at this point.

After leaving the dentist's office I went home and looked in the mirror. Sure enough, I noticed that I had a porcelain crown that had an obvious silver filling in the back of my mouth. At that point, I recalled that my previous dentist in San Diego had supposedly installed two new crowns in June. He had sent in for a pre-approval from my insurer, which had been granted. I even looked in my file cabinet and saw that my dentist had indeed billed my insurer for 2 crowns, at $900 a each. I remember clearly (now) that he had said one of my existing crowns had "leaked" and that the tooth under the crown had a cavity in it. This crown was defective and needed to be replaced. The one that had "leaked" was the one that this particular dentist had previously installed years ealier. Well, he experienced tremendous difficulty in his attempts to remove the crown, and was unable to remove it. A discussion took place between the dentist and the assistant about how they may have not followed the correct procedure in gluing the crown when the pair had installed it many years earlier. Then, they evidently drilled a hole through the crown and filled the cavity, but did not tell me about it. I had assumed that they had finally removed the old crown, and were drilling my tooth with the crown removed.

Has anyone else on this board had a hole drilled in a crown in order to fill a cavity or was it just my San Diego dentist who does these things?

 

[lazygood4nothinbum]

with what i've paid for crowns i would have screamed bloody murder if someone drilled through one.

bruxism also runs in my family. my little nephew almost wore his baby teeth down to the nerves. i grind but usually not so bad. but when i was dealing with all the stress of job, death & dieing, my grinding & clenching caused big time trouble. you could buy a bmw with what i've done to save my teeth (including regrowing bone.)

how important is good dental health? "Several theories exist to explain the link between periodontal disease and heart disease." http://tinyurl.com/ynhxxb

so when i was getting my bimonthly cleaning at the perio office, i said to the tech, our teeth need redesign. they shouldn't require this much maintenance. my dog went a complete lifetime with a full set of healthy teeth. i can pretty much keep the rest of my body healthy by diet alone. but even if i just survive on crunchy dog bones, mouth bacteria alone will destroy my teeth. if you don't believe me, just pick up any national geographic magazine.

so when i die, i'm not only going to complain about all the pain of life, i want a redesign of our teeth.

 

[cute fuzzy bunny]

My dad used to teach the fine art of pulling teeth at Tufts before retiring, so any specific questions...ask away.

For the OP, you want a new post and crown. Theres usually a mismatch between the old stuff and your gums as you age and its worse than that...theres usually a mismatch right off the bat as many dentists make impressions of your swollen gums instead of waiting a few weeks to take them when the gum tissue is back to normal. I forget the exact details of this but remember my dad mentioning it when I had a couple of crowns made a few years ago.

The links between periodontal disease and heart disease may not be correlative...many think that people who take better care of their teeth care more about their health, eat better and take better care of themselves.

The good news is theres a process being developed to completely regrow teeth. The bad news is that it'll be years before anything is remotely close to being productized and the worse news is that it requires wearing a power source and having some wires run from that into your mouth to stimulate the underlying bone of the jaw for 20 minutes a day, for four months.
http://science.howstuffworks.com/ultrasound-teeth-news.htm

 

[Nords]

BTW Nords, some of the best dentistry I have seen has been done by Navy dentists (no, I am not a Navy dentist) and here is your evidence based dentistry link http://www.ada.org/prof/resources/positions/statements/evidencebased.asp

Hey, thanks for the link. I didn't a dentist's version of EBM to actually exist!

I'm glad you had a good Navy dentist, because I was wondering if they were all as bad as the ones I've known. I spent most of my career telling them to get their hands off my wisdom teeth, because in the early days of the boomer patrols there was concern about having to MEDEVAC for impacted ones. By the time I joined the submarine force I was convinced that they were just trying to complete all the practical evolutions on their qualification cards.

We'd been underway one patrol for about eight days when the corpsman walked into the wardroom to discuss one of our sailors who'd had two wisdom teeth extracted the day before the departure. The CO asked "So, Doc, how's SN Schmuckatelli?"* The corpsman dropped a hunk of root about a half-inch long on the table and said "Sir, I got this out on my own but I think he's gonna be fine now..."

Maybe it's pejoratively offensive, but it's a typical submarine moniker for generic junior seamen. Officers are named "Ensign Schmeckel". Chief Petty Officers, of course, are referred to as "Chief Petty Officer" since there are no pejoratives in this rank...