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Medical Forum / General / Dentistry / November 2004Dentist couldn't get crown off
I had an onlay chip off and a gold crown put on about 4-5 months ago. The tooth developed a problem and root canal was done in July. The endodontist had some difficulty getting the gold crown off, but after some vigorous "tapping" he managed to remove the crown and proceed. About 3 weeks after the root canal, I saw my dentist who suggested we leave the crown on with the temporary cement put on by my endodontist. I reluctantly agreed and left his office. I became concerned and posted here where the consensus was permanent cement should be used. I contacted my endodontist and he said permanent cement should be used. I called my dentist for an appointment to have the crown permanently cemented. There was a delay as my dentist became ill and a new appointment had to be made. Time passed and last week I went to my dentist to have it cemented permanently. My dentist gave it a few taps with that tapping instrument and tried to pry it off but it wouldn't budge - stubborn crown or weak dentist ;-) I told him that the endodontist got it off but my dentist said it's on so well and afraid he would damage the tooth and said to make another appointment one month later and meanwhile he will contact my endodontist. So, here it is months later and the gold crown is still on with temporary cement until the next visit when hopefully he will have had his "Wheaties" and be able to remove the gold crown. Does it make sense that there should be so much trouble for my dentist to remove the crown when the endodontist took it off? Does it make any sense that he said he was going to contact my endodontist to ask him what kind of cement he used when I told him it was temporary cement? >I had an onlay chip off and a gold crown put on about 4-5 months ago. The >tooth developed a problem and root canal was done in July. The endodontist [quoted text clipped - 21 lines] >that he said he was going to contact my endodontist to ask him what kind of >cement he used when I told him it was temporary cement? OLD PROBLEM! I have tried on crowns with NO CEMENT and sometimes .... I can't get the darned crown off WITH NO CEMENT! Now hammering too hard can break some tooth structure, particularly with an endodontically-treated tooth. So go gentle ...... Are you planning on a new crown? If so, why not drill it off? Joel > I have tried on crowns with NO CEMENT and sometimes .... I can't get > the darned crown off WITH NO CEMENT! [quoted text clipped - 3 lines] > > So go gentle ...... A very small dose of plastic explosive? (also good for opening those pesky lids on food jars and for freeing sticky sash windows) Vaughn > Are you planning on a new crown? If so, why not drill it off? > > Joel > I had an onlay chip off and a gold crown put on about 4-5 months ago. The > tooth developed a problem and root canal was done in July. The endodontist [quoted text clipped - 21 lines] > that he said he was going to contact my endodontist to ask him what kind of > cement he used when I told him it was temporary cement? It's unlikely the tooth is in any imminent danger. I use a pneumatic crown remover that is quite effective. If it can't be removed and there is no plan to replace the crown it should be watched and x-rayed periodically. Steve >> Does it make sense that there should be so much trouble for my dentist to >> remove the crown when the endodontist took it off? Does it make any sense [quoted text clipped - 7 lines] > >Steve I agree. The crown that won't come off is sure better than the crown that ALWAYS comes off. Joel >> I had an onlay chip off and a gold crown put on about 4-5 months ago. The >> tooth developed a problem and root canal was done in July. The endodontist [quoted text clipped - 28 lines] > > Steve Steve, I don't see why it can't be removed since the endodontist removed it before doing a root canal. There is no plan to replace the crown. The only purpose for removal is using permanent cement. I have to say the endodontist worked very hard at removing the crown with that tapping tool. My general dentist didn't try anywhere near as much as the endodontist who really banged away. How often should it be watched and x-rayed? I generally go for a dental check-up every 6 months. What is the purpose of an x-ray? Mel >>>I had an onlay chip off and a gold crown put on about 4-5 months ago. The >>>tooth developed a problem and root canal was done in July. The endodontist [quoted text clipped - 43 lines] > > Mel To check for decay. If you are concerned, I would tell your dentist your concerns and ask him/her to try again. We have to use our best clinical judgement as to whether we are risking cracking the tooth. Steve > To check for decay. > If you are concerned, I would tell your dentist your concerns and ask >him/her to try again. We have to use our best clinical judgement as to >whether we are risking cracking the tooth. > >Steve A signed waiver and INFORMED CONSENT is also in order. Joel >> To check for decay. >> If you are concerned, I would tell your dentist your concerns and ask [quoted text clipped - 6 lines] > > Joel Yup. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >>>>I had an onlay chip off and a gold crown put on about 4-5 months ago. The >>>>tooth developed a problem and root canal was done in July. The endodontist [quoted text clipped - 50 lines] > > Steve So it seems that the consensus here is leave the gold crown on the molar with temporary cement and have it checked for decay? I assume that would also include checking to see if it developed any spaces? And how often would you recommend an x-ray be taken? Every 6 months? My dentist had originally said he'd check it at each 6 month visit by visual inspection - no mention was made of an x-ray. The only reason I got concerned was when posting here about whether to leave the gold crown on with temporary cement or have him use permanent cement, the overwhelming opinion was strongly for having him take it off and put back with permanent cement. Mel >So it seems that the consensus here is leave the gold crown on the molar >with temporary cement and have it checked for decay? I assume that would [quoted text clipped - 10 lines] > >Mel In the past, we often temporarily cemented crowns forever. We'd remove them and recement of course. Joel >>>>>I had an onlay chip off and a gold crown put on about 4-5 months ago. The >>>>>tooth developed a problem and root canal was done in July. The endodontist [quoted text clipped - 65 lines] > > Mel The short answer is that it depends. You really have to look at the individual tooth and evaluate how much risk leaving the tooth in temp. cement is likely to pose, vs. the risk of forcefully removing it. Unless the patient has a very high caries rate, I'd prefer to get it off and cement it permanently, but I wouldn't sweat it if I couldn't get it off. X-rays are also discretionary, based on perceived need. Steve >>>>>>I had an onlay chip off and a gold crown put on about 4-5 months ago. The >>>>>>tooth developed a problem and root canal was done in July. The endodontist [quoted text clipped - 75 lines] > > Steve Well, perhaps it also comes down to how hard the dentist is willing to try getting it off. My endodontist really spent a lot of time using that tapping instrument and banged away pretty darn hard while my dentist just gave a few light taps and quit. I haven't had a cavity in years. My dentist wanted to leave it on with temporary cement _before_ trying to get it off. He did say on this last visit, after giving it a few light taps, that he didn't want to harm the tooth structure. If it makes any difference, the tooth in question is last molar on the bottom with a gold crown. Mel >Well, perhaps it also comes down to how hard the dentist is willing to try >getting it off. My endodontist really spent a lot of time using that [quoted text clipped - 10 lines] > >Mel Maybe you should talk to your dentist about him getting a WamKey. Some dentists on other forums I read really seem to be into this thing for removing C&B. http://www.wamkey.com/k/gb/accueilgb.htm They have a nice little demonstration of how it works on the website. Sure, it's a hole in the crown, but it may be able to be repaired. And, when it comes down to it, what's more important, your tooth which you only get one of, or a crown that any dental lab could supply? Adenosine > Maybe you should talk to your dentist about him getting a WamKey. Some > dentists on other forums I read really seem to be into this thing for [quoted text clipped - 8 lines] > > Adenosine This is what I use--works nicely in most cases. http://www.dentcorp.com/Removereng2.html Steve > Well, perhaps it also comes down to how hard the dentist is willing to try > getting it off. My endodontist really spent a lot of time using that [quoted text clipped - 10 lines] > > Mel I think your reading of the facts is correct. If the dentist was comfortable with leaving it in with temp. cement, it seems unlikely he'd try very hard. For that matter, the tooth might break if he tried harder. Just one of those imponderables--I wouldn't worry. Steve > I think your reading of the facts is correct. If the dentist was >comfortable with leaving it in with temp. cement, it seems unlikely he'd >try very hard. For that matter, the tooth might break if he tried >harder. Just one of those imponderables--I wouldn't worry. > >Steve Agreed. Once put a 6-unit (6-->11) in with tempbond. Couldn't get it off. Informed patient to have it checked 2X/yr. Moved so didn't get to follow up. Always wondered about that case. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >> I think your reading of the facts is correct. If the dentist was >>comfortable with leaving it in with temp. cement, it seems unlikely he'd [quoted text clipped - 17 lines] > wubbabubbazG@RBAGEyahoo.com > Take out the G'RBAGE I have a patient with a multi-unit bridge, put in with trial (non-setting) cement over 10 years ago. Couldn't get it out. As of last checkup a couple of months ago bridge and abutment teeth were doing fine. Of course, this is a patient with very low caries activity. Steve >>> I think your reading of the facts is correct. If the dentist was >>>comfortable with leaving it in with temp. cement, it seems unlikely he'd [quoted text clipped - 20 lines] > I have a patient with a multi-unit bridge, put in with trial >(non-setting) cement over 10 years ago. What did you use ? If there is good adaptation of the margins and the bridge prep is within 5 degrees of parallel, it's not coming off even with tempbond. Good history BTW. >Couldn't get it out. As of >last checkup a couple of months ago bridge and abutment teeth were doing >fine. Of course, this is a patient with very low caries activity. > >Steve -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>>> I think your reading of the facts is correct. If the dentist was >>>>comfortable with leaving it in with temp. cement, it seems unlikely he'd [quoted text clipped - 22 lines] > > What did you use ? I used Opotow A only. Of course it sets eventually even without the catalyst, but still... This was a lower posterior bridge, with a mesially tipped distal abutment. There was some difficulty with path of insertion as I remember, but once it was on... Steve > If there is good adaptation of the margins and the bridge prep > is within 5 degrees of parallel, it's not coming off even with [quoted text clipped - 13 lines] > wubbabubbazG@RBAGEyahoo.com > Take out the G'RBAGE I have had a couple of "round-house" bridges over the years which went in with trial cement and would not come back out. Stayed fine for decades. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>> I think your reading of the facts is correct. If the dentist was [quoted text clipped - 25 lines] > > Steve >Well, perhaps it also comes down to how hard the dentist is willing to try >getting it off. My endodontist really spent a lot of time using that [quoted text clipped - 10 lines] > >Mel I say leave it be, and get it checked at least twice/year. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>Well, perhaps it also comes down to how hard the dentist is willing to try >>getting it off. My endodontist really spent a lot of time using that [quoted text clipped - 12 lines] > > I say leave it be, and get it checked at least twice/year. The problem is obviously the gold crown with temporary cement fitting so well that getting it off is a big problem. Never had a problem getting off a porcelain fused to metal crown. Maybe there's a lesson here like stick with porcelain fused to metal crowns. Just seems kind of silly having to worry about a crown that my dentist can't get off and have to get it checked at least twice a year. I go every 6 months and have no plans to go more frequently. The other thing that really irks me is the endodontist got it off, although he tried much harder than my dentist. Mel >>>Well, perhaps it also comes down to how hard the dentist is willing to try >>>getting it off. My endodontist really spent a lot of time using that [quoted text clipped - 25 lines] > >Mel Quit worrying about it. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>>>Well, perhaps it also comes down to how hard the dentist is willing to try >>>>getting it off. My endodontist really spent a lot of time using that [quoted text clipped - 27 lines] > > Quit worrying about it. Quit worrying about it? Now that solves everything! I remember when I posted here with the question if my dentist should use permanent cement on this crown. Everyone, including you, said he should use permanent cement. Now, until that time, I was not concerned beyond curiousity. However, while all said the crown _should_ be permanently cemented, no one said except in such and such case - like my situation right now. So, when giving advice such as get that crown permanently cemented, if it's nothing to worry about, then you and anyone else should say except when removing the crown is so difficult as to put the tooth structure at risk for damage. Of course no one seems to be addressing the fact my endodontist got the crown off with some hard work. Mel >Quit worrying about it? Now that solves everything! I remember when I >posted here with the question if my dentist should use permanent cement on [quoted text clipped - 5 lines] >about, then you and anyone else should say except when removing the crown >is so difficult as to put the tooth structure at risk for damage. It's hard to list every single exception that could make a plan of treatment be correct or incorrect. You can't go and list every single exception for why you'd leave a crown on with temporary cement. New information may mean an altered treatment plan. Why didn't you mention the trouble that the doctor had removing the crown in the original post? >Of course no one seems to be addressing the fact my endodontist got the >crown off with some hard work. > >Mel Did you see my post about the WamKey? I think that may be the solution if you really want to put it back on with permanent cement. Adenosine > Path: uni-berlin.de!fu-berlin.de!in.100proofnews.com!in.100proofnews.com!cycny01.gnilink.net!cyclone1.gnilink.net!gnilink.net!wn13feed!worldnet.att.net!4.24.21.153!newsfeed3.dallas1.level3.net!news.level3.com!newsfeed1.easynews.com!easynews.com!easynews!easynews-local!news.easynews.com.POSTED!not-for-mail > From: Adenosine <adenosine@nospam.com> [quoted text clipped - 29 lines] > the trouble that the doctor had removing the crown in the original > post? In the original post, I went back to my dentist to have it permanently cemented and _without_ trying to remove the crown he suggested to leave it alone with temporary cement. >>Of course no one seems to be addressing the fact my endodontist got the >>crown off with some hard work. [quoted text clipped - 5 lines] > > Adenosine The only reason I became concerned goes back to my original post asking if it should be cemented permanently. I think at least one exception should have been noted like if the crown fits so well that it is difficult to remove and might cause harm to tooth structure would be reason enough to leave it be with temporary cement. Seems like that would be one very obvious problem to acknowledge. Mel >>>>>Well, perhaps it also comes down to how hard the dentist is willing to try >>>>>getting it off. My endodontist really spent a lot of time using that [quoted text clipped - 29 lines] > >Quit worrying about it? Now that solves everything! Actually it does 8^]] > I remember when I >posted here with the question if my dentist should use permanent cement on >this crown. Everyone, including you, said he should use permanent cement. That is most often the correct answer, every situation is unique however. >Now, until that time, I was not concerned beyond curiousity. However, while >all said the crown _should_ be permanently cemented, no one said except in >such and such case - like my situation right now. So, when giving advice >such as get that crown permanently cemented, if it's nothing to worry >about, then you and anyone else should say except when removing the crown >is so difficult as to put the tooth structure at risk for damage. There is a risk of root fracture if too much force is used. You must address the risk v. benefit. If the temporary cement is holding well, get it checked 2X/yr. >Of course no one seems to be addressing the fact my endodontist got the >crown off with some hard work. Then go back and see the endodontist and see if the crown can be removed if you are worried. >Mel -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > Path: uni-berlin.de!fu-berlin.de!news.maxwell.syr.edu!border1.nntp.dca.giganews.com!nntp.giganews.com!newsfeed2.easynews.com!easynews.com!easynews!easynews-local!news.easynews.com.POSTED!not-for-mail > From: W_B <no_one@nowhere.net> [quoted text clipped - 75 lines] >> >>Mel And what is the endodontist to do about it now? Should I expect him to take it off and put back with temporary cement? If that were the case, then my dentist should have suggested that. In my original post asking if it should be permanently cemented because my dentist wanted to leave it with temporary cement _without_ trying to remove the crown, and my dentist saying there are no spaces, I was told here that there are spaces and it should be permanently cemented. So, what am I supposed to think? Of course now I am concerned. I don't like the idea of having a situation that could develop into a major issue just because the crown isn't permanently cemented. On the other hand, I don't like the concern of damage to the tooth, although my endodontist used _excessive_ force repeatedly to get the crown off. Now maybe another round of excessive force would damage the tooth? This is kind of a gamble as you and others have stated. After my dentist gave it a few light taps and gave up, he told me to make an appointment for next month and in the meantime he would contact the endodontist and find out what kind of cement he used. This sounds a bit ridiculous to me as my endodontist used temporary cement and told me to have my dentist use permanent cement - and I told that to my dentist. Mel Sorry you're having trouble. A lot of dentists and/or endodontists would have just cut a hole in your new crown to perform the endodontics. That's the easiest for the dentist and the most predictable. After the endo the crown would have been patched (you don't really want that - but it can be done), or you would have then been told you needed another new crown. At least these two are trying to save the original crown. Your dentist is probably trying to find out what type of temporary cement was used - there are a lot of them out there. carabelli >Sorry you're having trouble. > >A lot of dentists and/or endodontists would have just cut a hole in your new >crown to perform the endodontics. That's the easiest for the dentist and the >most predictable. YUP, avoids liability as well. Sometimes the crown falls off after undermining the tooth structure, other times not. Joel > After the endo the crown would have been patched (you >don't really want that - but it can be done), or you would have then been [quoted text clipped - 5 lines] > >carabelli >This sounds a bit >ridiculous to me as my endodontist used temporary cement and told me to >have my dentist use permanent cement - and I told that to my dentist. > >Mel There are many different types and brands of temporary cement. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >>This sounds a bit >>ridiculous to me as my endodontist used temporary cement and told me to [quoted text clipped - 3 lines] > > There are many different types and brands of temporary cement. Okay, so? What difference would it be what kind of temporary cement was used? I mean, temporary means temporary and it's not permanent. All I know is my endodontist who took off the gold crown with some real hard effort said to have my dentist put it back on with permanent cement. The tool my endodontist used was a tapping thing just like what my dentist tried. The big difference is the endodontist spent like 5 minutes or more banging away with my head vibrating until he got it off. Now, if that didn't damage the tooth, then either I was lucky or I got one heck of a strong tooth. Mel >>>This sounds a bit >>>ridiculous to me as my endodontist used temporary cement and told me to [quoted text clipped - 15 lines] > > Mel Mel - once the RCT has been completed there is less tooth structure left - hence fracture is more likely. Your dentist is faced with removing a crown from a tooth that is now weaker than when your endo removed the crown. Did you read my other post today? After reading your posts I would be pretty damn careful pulling this crown off too. Why do I get the feeling that seeing your name on my schedule when I arrived at the office would set my stomach churning? carabelli >> with my head vibrating until he got it off. Now, if that didn't damage the >> tooth, then either I was lucky or I got one heck of a strong tooth. [quoted text clipped - 11 lines] > >carabelli Because you skipped breakfast ? -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >Because you skipped breakfast ? I think my former dentist did this. I could always hear his stomach turning as he was working on my teeth. It keeps the mind of the sound of the handpiece, I guess..... Adenosine "W_B" <no_one@nowhere.net> wrote....... > Because you skipped breakfast ? > -- > > W_B What's breakfast? carabelli > "W_B" <no_one@nowhere.net> wrote....... > [quoted text clipped - 6 lines] > > carabelli Does CEREC do that too? Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 It gives you time to eat a bagel and Lox while it mills. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >> "W_B" <no_one@nowhere.net> wrote....... [quoted text clipped - 11 lines] > > Steve >> "W_B" <no_one@nowhere.net> wrote....... >> [quoted text clipped - 10 lines] > >Steve Whoosh: sound of that flying past me the first time I read it. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Endodontists don't like to have late night phone calls that the crown came off. Matter of fact, they don't even like to work with crowns (why do you think they quit general dentistry?). They will often use a "temporary cement" that is incredibly strong. Not what we GP's tend to use. I have had situations just like this and not be able to remove the temporary (within the level of force I was willing to use). Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>>This sounds a bit [quoted text clipped - 16 lines] > > Mel High strung? -- > > And what is the endodontist to do about it now? Should I expect him to > take [quoted text clipped - 22 lines] > > Mel Melvin - Go buy some Jolly Rancher candy. Pop one in your mouth and bite into the candy on the tooth in question. It will 'melt' onto the crown over 5-15 minutes at which time it will be very difficult to open your mouth. Now, reach up with both hands and forcefully open your mouth by opening and pulling down with your hands on your chin as hard as you can. I use this technique in my office with great success even after lots and lots of tapping doesn't move the crown. The only thing is, don't try it if the tooth opposing the crown is a crown also because you might pull off the wrong crown! Good luck and let us know if it works. If it does, then gently place it back on the tooth and call your dentist to have it reseated with permanent cement. By the way we don't actually use Jolly Rancher but a sugar free hard candy very similar in consistency to it. > >>Well, perhaps it also comes down to how hard the dentist is willing to try > >>getting it off. My endodontist really spent a lot of time using that [quoted text clipped - 25 lines] > > Mel >Melvin - > [quoted text clipped - 10 lines] >permanent cement. By the way we don't actually use Jolly Rancher but a sugar >free hard candy very similar in consistency to it. Richwill crown remover. >> >>Well, perhaps it also comes down to how hard the dentist is willing to >try [quoted text clipped - 30 lines] >> >> Mel -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >Melvin - > >Go buy some Jolly Rancher candy. Pop one in your mouth and bite into the What I was thinking ....... >candy on the tooth in question. It will 'melt' onto the crown over 5-15 >minutes at which time it will be very difficult to open your mouth. Now, >reach up with both hands and forcefully open your mouth by opening and >pulling down with your hands on your chin as hard as you can. One guy couldn't get his mouth open and lost 65 pounds ..... > I use this >technique in my office with great success even after lots and lots of [quoted text clipped - 39 lines] >> >> Mel Ummmm, if you get your teeth checked every 6 months, isn't that what the dentist meant by checking it twice a year? Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>>Well, perhaps it also comes down to how hard the dentist is willing to [quoted text clipped - 28 lines] > > Mel >Ummmm, if you get your teeth checked every 6 months, isn't that what the >dentist meant by checking it twice a year? Except in JanWorld. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com Much too often the entire tooth will break off when trying to tap off a crown. The endodontist tried harder, because he/she probably did not care if a bunch of tooth broke off and the crown would need to be re-made (or worse). Not his/her problem. Your dentist has to live with what ever happens (as do you). In such cases, I NEVER try vigorously to get the crown off. Who knows what your endodontist cemented the crown with. Perhaps, as a consequence of the tooth dying, some pressure built up under the crown and made it easier to remove. Now that the tooth is "clean", the cement holds better. Lots of possibilities. Personally, I would try to loosen it again in 6-8 weeks. If it still does not come loose, repeat in another 6-8 weeks. If still tight, I would forget about it. It could easily be fine forever this way. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>>>>>>I had an onlay chip off and a gold crown put on about 4-5 months ago. [quoted text clipped - 117 lines] > > Mel > Much too often the entire tooth will break off when trying to tap off a > crown. The endodontist tried harder, because he/she probably did not care [quoted text clipped - 8 lines] > If still tight, I would forget about it. It could easily be fine forever > this way. Okay, I see your point here and it's well taken. This is a gold crown and no doubt fits better than porcelain fused to metal. I have all my teeth and would like to keep it that way :) What I am wondering about is what kind of problem is he supposed to check for every 6 months? Just to see if the crown gets loose? Any decay? I can't remember when last having a cavity. However, no doubt if there is a space, then I suppose some decay could develop. Should I have that tooth x-rayed every 6 months or just a visual inspection? Mel Also, if it got decay, you wouldn't feel it because you've had a root canal on the tooth > > Much too often the entire tooth will break off when trying to tap off a > > crown. The endodontist tried harder, because he/she probably did not care [quoted text clipped - 22 lines] > > Mel > Also, if it got decay, you wouldn't feel it because you've had a root canal > on the tooth That's why I don't like this gold crown on with temporary cement ;-) Sure would be a dandy if it somehow developed a space that could be detected and I changed dentists and new dentist has to cut it off and charge me for a new crown. My present dentist will guarantee the crown as long as I see him every 6 months. Maybe this whole thing is a ploy to keep me as a patient. Mel >> Also, if it got decay, you wouldn't feel it because you've had a root canal >> on the tooth [quoted text clipped - 6 lines] >long as I see him every 6 months. Maybe this whole thing is a ploy to keep >me as a patient. This is true, but it still gives you peace of mind ..... My guess is he is conscientious. Joel >Mel >>> Also, if it got decay, you wouldn't feel it because you've had a root canal >>> on the tooth [quoted text clipped - 14 lines] > >>Mel Peace of mind? Every day I'm checking the crown with a magnifying glass! Mel >My present dentist will guarantee the crown as >long as I see him every 6 months. Maybe this whole thing is a ploy to keep >me as a patient. > >Mel Doesn't sound as though you are that desirable as a patient. Give it a rest why don't ya ? -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>My present dentist will guarantee the crown as >>long as I see him every 6 months. Maybe this whole thing is a ploy to keep [quoted text clipped - 4 lines] > Doesn't sound as though you are that desirable as a patient. > Give it a rest why don't ya ? Give it a rest? Of course you know my dentist and can vouch for his absolute integrity, right? Of course you can. You can defend his use of dental assistants trying to remove a crown, right? Why I'll bet you can even defend his use of dental assistants taking an impression for a crown, putting the temporary on, and making an adjustment to the temporary, right? Yes, I'm sure you have full authority to tell people to "give it a rest". Just what this country needs, guys like you who can put us at peace with give it a rest. Thanks! Mel >You can defend his use of >dental assistants trying to remove a crown, right? Why I'll bet you can >even defend his use of dental assistants taking an impression for a crown, >putting the temporary on, and making an adjustment to the temporary, right? Assuming you mean the temporary crown in your first statement, MY dentist does this, and he was dentist of the year for the Washington Academy of General Dentistry. Just some food for thought. Adenosine >>You can defend his use of >>dental assistants trying to remove a crown, right? Why I'll bet you can [quoted text clipped - 8 lines] > >Adenosine Mel's brain is not hungry. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>You can defend his use of >>dental assistants trying to remove a crown, right? Why I'll bet you can [quoted text clipped - 8 lines] > > Adenosine The crown I was referring to was NOT a temporary crown! He had his assistant try to remove both a temporary and permanent crown. I am aware there are dentists who don't have assistants and do all the work themselves, although this is quite rare. There are also dentists who have assistants but still do the things I mentioned above as opposed to having dental assistants do the work. I was considering another dentist who does all the work himself but now with this gold crown an "iffy" situation, I am inclined to stick with my dentist for the guarantee - but I'm still thinking about making a switch. Mel >> Doesn't sound as though you are that desirable as a patient. >> Give it a rest why don't ya ? [quoted text clipped - 12 lines] > >Mel Repeat for the dense and ill informed: "Give it a f****** rest". -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>> Doesn't sound as though you are that desirable as a patient. >>> Give it a rest why don't ya ? [quoted text clipped - 16 lines] > > "Give it a f****** rest". For the very rude: If you are not interested in reading the topic, please don't click to download. This may come as a surprise to you, but even now this is a free country. Mel >>>Yes, I'm sure you have full authority to tell people to "give it a rest". >>>Just what this country needs, guys like you who can put us at peace with [quoted text clipped - 13 lines] > >Mel All your bitchin' and moaning about this one tooth has gone on for how long now ? ############################################# >I had an onlay chip off and a gold crown put on about 4-5 months ago. ############################################# And... has generated 61 responses, not counting this one. Your tooth is fine, get it checked 2x/yr. Sooner if it hurts. Gawd you are worse than JK. 'nuff said. -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>>>Yes, I'm sure you have full authority to tell people to "give it a rest". >>>>Just what this country needs, guys like you who can put us at peace with [quoted text clipped - 31 lines] > > 'nuff said. Hey, you don't have to look! But for some reason you do find it important to look and that's why you keep replying - and adding to the post count. Mel >Hey, you don't have to look! But for some reason you do find it important >to look and that's why you keep replying - and adding to the post count. > >Mel Yep here's one more. As long as you keep entertaining me... -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>>> Doesn't sound as though you are that desirable as a patient. >>>> Give it a rest why don't ya ? [quoted text clipped - 22 lines] > >Mel If you were my patient, and were this obsessive over something so minor, I would invite you to go to a different office and have the crown re-made. Upon bringing me proof that the crown was re-done and giving me back the crown I made... a return of your money and a "please never return" .. Stephen Mancuso, D.D.S. Troy, Michigan, USA Writing on a tablet PC,so forgive me if the PC misreads my poor handwriting. >>>My present dentist will guarantee the crown as >>>long as I see him every 6 months. Maybe this whole thing is a ploy to keep [quoted text clipped - 18 lines] > >Mel Currently what you describe is legal in Michigan if the assistant is registered. .. Stephen Mancuso, D.D.S. Troy, Michigan, USA Writing on a tablet PC,so forgive me if the PC misreads my poor handwriting. >>>>My present dentist will guarantee the crown as >>>>long as I see him every 6 months. Maybe this whole thing is a ploy to keep [quoted text clipped - 21 lines] > Currently what you describe is legal in Michigan if the assistant is > registered. Crown and bridge impressions? Steve (I know, what's an impression) > .. > Stephen Mancuso, D.D.S. > Troy, Michigan, USA > > Writing on a tablet PC,so forgive me if the PC misreads my poor handwriting. SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 RDA only. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... >> >>>>>My present dentist will guarantee the crown as [quoted text clipped - 34 lines] >> Writing on a tablet PC,so forgive me if the PC misreads my poor >> handwriting. > RDA only. Interesting. Not in NY State. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >>My present dentist will guarantee the crown as >>long as I see him every 6 months. Maybe this whole thing is a ploy to keep [quoted text clipped - 4 lines] >Doesn't sound as though you are that desirable as a patient. >Give it a rest why don't ya ? Anyone want to bet how happy this dentist would be if Mel got mad and switched dentists??? .. Stephen Mancuso, D.D.S. Troy, Michigan, USA Writing on a tablet PC,so forgive me if the PC misreads my poor handwriting. >>Doesn't sound as though you are that desirable as a patient. >>Give it a rest why don't ya ? [quoted text clipped - 3 lines] >.. >Stephen Mancuso, D.D.S. Ecstatic ? -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE >>>My present dentist will guarantee the crown as >>>long as I see him every 6 months. Maybe this whole thing is a ploy to keep [quoted text clipped - 12 lines] > > Writing on a tablet PC,so forgive me if the PC misreads my poor handwriting. Oh? I don't think you are correct. The fact is my dentist wanted me to come every 3-4 months but I told him every 6 months is enough. Doesn't sound to me like he would prefer I go elsewhere. In fact, after the big mistake of that onlay that chipped, he made me the gold crown for FREE! This is all in my posts made months ago. And it's perfectly alright for the dental assistant to try and remove a permanent crown on with temporary cement in your state? Mel If it is on with temporary cement,,,,,,, yes. Signature~+--~+--~+--~+--~+-- Stephen Mancuso, D.D.S. Troy, Michigan, USA .................................................... This posting is intended for informational or conversational purposes only. Always seek the opinion of a licensed dental professional before acting on the advice or opinion expressed here. Only a dentist who has examined you in person can diagnose your problems and make decisions which will affect your health. ...................... > >>>>My present dentist will guarantee the crown as [quoted text clipped - 28 lines] > > Mel > If it is on with temporary cement,,,,,,, yes. Ahh, I remember the days when there were no dental assistants and the dentist did _all_ the work. In fact, I had one dentist who not only did all the work, but he also took the payment! There was no one in the office but him! But times have changed and many dentists are too busy to do little things like taking an impression. This is quite amazing in light of the fact people don't get cavities like in the old days before fluoride. My son and daughter both have a total of one single cavity and they are over 18 years old. So what keeps dentists today so busy that they need dental assistants? I know one dentist who recently got arrested because he was having his dental assistants do root canals while he slept in the office! Well, I guess he was tired and didn't want to keep his patients waiting. Mel >> If it is on with temporary cement,,,,,,, yes. > [quoted text clipped - 11 lines] >I know one dentist who recently got arrested because he was having his >dental assistants do root canals while he slept in the office! JOEL REPLIES: This is true ....... he got the maximum time for disturbing the patients with too much snoring ..... There is someone on DentalTown who is trying to capitalize on this by giving a course for root canal for the "dental assistant who has tried everything else." They cannot decide if it will be on tapes ($599) or just the slim booklet ($379). Joel >Well, I guess he was tired and didn't want to keep his patients waiting. > >Mel >>> If it is on with temporary cement,,,,,,, yes. >> [quoted text clipped - 25 lines] > > Joel :-) I wouldn't be surprised if in a couple of years dental assistants are all doing root canals, and dentists do more serious work like tooth whitening. Mel >>Well, I guess he was tired and didn't want to keep his patients waiting. >> >>Mel >>>> If it is on with temporary cement,,,,,,, yes. >>> [quoted text clipped - 36 lines] >>> >>>Mel Good one! I keep complaining that with all the "SELLING" and promoting and "HEART DISEASE ADVICE" there's no time left to clean the teeth. The dentist has to do it. Joel > > There is someone on DentalTown who is trying to capitalize on this by > > giving a course for root canal for the "dental assistant who has tried [quoted text clipped - 4 lines] > > > > Joel :-) > I wouldn't be surprised if in a couple of years dental assistants are all > doing root canals, and dentists do more serious work like tooth whitening. > > Mel This year the California legislature passed a law allowing dental assistants (of the RDAEF stripe) to place composite restorations, starting in 2007. This is intended to save the state money, as the taxpayers currently have to fund the cheap Medicaid rates for all those free fillings. As the state has not raised Medicaid fees since 1995, more and more dentists have dropped out of the Medicaid program. Rather than raise rates from the current 30% of market price, perhaps to 50% of the usual fee, the state prefers to keep payment lower, and just have the dental treatment rendered by lower-paid workers without a dental education. Unfortunately, lots of volume-oriented mass-production dental practices will use the legislation to continue to charge the general public full price, but for restorations placed by lesser-trained personnel. If you think that composite "bubble" voids, rough margins, poor contours, and open contacts are a problem now, just wait until 2007. -dentaldoc >> > There is someone on DentalTown who is trying to capitalize on this by >> > giving a course for root canal for the "dental assistant who has tried [quoted text clipped - 13 lines] >assistants (of the RDAEF stripe) to place composite restorations, >starting in 2007. We have it in Pennsylvania since 1994 legally .... twenty years before that "in limbo." Joel >This is intended to save the state money, as the taxpayers currently >have to fund the cheap Medicaid rates for all those free fillings. [quoted text clipped - 15 lines] > >-dentaldoc Then one could imply that you would choose your physician in the same way. He should be the one taking your temperature, blood pressure, urine sample, X-ray, drawing blood, giving injections, and cleaning up the rooms between patients. Not very effecient use of manpower. Fawks > Ahh, I remember the days when there were no dental assistants and the > dentist did _all_ the work. In fact, I had one dentist who not only did all > the work, but he also took the payment! There was no one in the office but > him! > Mel > Then one could imply that you would choose your physician in the same > way. He should be the one taking your temperature, blood pressure, [quoted text clipped - 11 lines] > >> Mel I wouldn't equate dentists with physicians. Mel Whether you 'equate' the two professions or not, the analogy remains valid. Fawks >>Then one could imply that you would choose your physician in the same >>way. He should be the one taking your temperature, blood pressure, [quoted text clipped - 15 lines] > > Mel > > Then one could imply that you would choose your physician in the same > > way. He should be the one taking your temperature, blood pressure, [quoted text clipped - 4 lines] > > > > Fawks > I wouldn't equate dentists with physicians. > > Mel Why? -dentaldoc >>> Then one could imply that you would choose your physician in the same >>> way. He should be the one taking your temperature, blood pressure, [quoted text clipped - 12 lines] > > -dentaldoc A physician has much more serious work than fillings, tooth whitening, etc. I honestly don't know how anyone can be so vain as to not understand the difference between physicians and dentists. Physicians diagnose and treat, and sometimes save lives. I just don't see how filling cavities or doing cosmetic dentistry compares. Mel "Melvin S. Schwartz" <me@privacy.net> wrote .................> > A physician has much more serious work than fillings, tooth whitening, > etc. [quoted text clipped - 4 lines] > > Mel Thanks for finally getting to the heart of the matter. You know, I may not like people in your profession either bub. carabelli > "Melvin S. Schwartz" <me@privacy.net> wrote .................> >> A physician has much more serious work than fillings, tooth whitening, [quoted text clipped - 10 lines] > > carabelli I don't dislike dentists anymore than I dislike physicians. My opinion of people regardless of their profession is solely based on my opinion of that individual. I see absolutely no point to continue this discussion with a group of dentists. Now, if you want to bring in some physicians to debate the issue of who is more significant to treating people, then I would be very interested. Mel "Melvin S. Schwartz" <me@privacy.net>............ > I see absolutely no point to continue this discussion with a group of > dentists. That works for me. Now, if you want to bring in some physicians to debate the issue > of who is more significant to treating people, then I would be very > interested. > > Mel Certainly some MDs treat much more significant problems a general dentist. OTOH, compare the scope of practice with respect to an OFS to a Dermatologist. Fawks' point was pointing out the inefficiency of not delegating a delegatable task. Not who provides the most important health care. carabelli Gee, for a minute there I thought I was typing in code. ;-) Fawks > Fawks' point was pointing out the inefficiency of not delegating a > delegatable task. Not who provides the most important health care. > > carabelli I fully agree with part of your statement. I am not a physician and I do not want to be one. The vast majority of the time (not always!), if I screw up someone might only lose a tooth. I don't want the stress of screw ups ending in someone's death. However, this particular discussion is off track of the original argument. Just because you think dentists are simple mechanics filling a few cavities and scraping a little tartar, has no real bearing upon the value of assistants to the dental profession. You inferred that you liked it in the old days when your dentist did everything in the office by himself and didn't have assistants doing some of the more menial tasks. I said that you might want to pick your physician the same way. You said something to the effect that dentists and physicians are not comparable. I contend that they are comparable in many respects. One of which is certainly the delegation of simpler tasks to qualified 'assistants'. I am able to deliver a higher quality of care to more patients with the help of my staff. I am not going back to the 50's. JMO, Fawks > I see absolutely no point to continue this discussion with a group of > dentists. Now, if you want to bring in some physicians to debate the issue > of who is more significant to treating people, then I would be very > interested. > > Mel > > "Melvin S. Schwartz" <me@privacy.net> wrote .................> > I see absolutely no point to continue this discussion with a group of > dentists. Now, if you want to bring in some physicians to debate the issue > of who is more significant to treating people, then I would be very > interested. Mel, your way of thinking is common among many laymen who don't know the whole deal. I would like to remind you that once you had to get a medical degree in order to then train as a dentist. This was common in Europe, although I really don't know about the States. Who is more significant to treating people? Well, it kind of depends on the problem you're facing right. When you've been under the extreme pain of acute pulpitis for a couple of days and you're actually considering killing yourself cause you just can't take it anymore, you wouldn't give a cent about a heart surgeon. A dentist would seem like a god to you. The noble task of pain relief falling upon dentists is hard to understand or appreciate. Without us, life could be frequently miserable given modern culture's love of sugar. Moreover, who told you that we don't save lives? We do it every day! I have worked in a hospital and I have seen people dying because of a tooth, which caused an abcess, which spread and caused encephalitis or ludwig's ... (can't remember the english term, need a hand here guys). Who knows how the next cavity you have will develop if we don't fill it in time or perform root canal or extraction when you get an abcess? Don't forget that you could cut yourself while shaving and die if it gets infected, which was sadly something that happened not so rarely before antibiotics were discovered. Lastly, we are responsible for treating the most frequent chronic diseases in the world... dental caries and periodontitis. I won't even touch on the financial repercussions of those two diseases. We are in fact responsible for an entire, important region of the human body. Would you say that an opthalmologist is more useful than a gastrenterologist? We all have basic medical training, but have specialised in treating tissues that are unlike any other in the human body and face problems that are also unlike any other in medicine. George > which spread and caused encephalitis or > ludwig's ... (can't remember the english term, need a hand here guys). Ludwig's Angina Nice explanation, BTW... SP SignatureNot a real Addy, yet > > which spread and caused encephalitis or > > ludwig's ... (can't remember the english term, need a hand here guys). [quoted text clipped - 3 lines] > Nice explanation, BTW... > SP Thanks! >Now, if you want to bring in some physicians to debate the issue >of who is more significant to treating people, then I would be very >interested. > >Mel If you could bring in a more significant topic then maybe we would be more interested in you. But I doubt it. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > > Why? > > [quoted text clipped - 7 lines] > > Mel Just who is looking in your mouth every six or twelve months, looking for signs of oral cancers? A physician, with a little flashlight and a toungue depressor, or a dentist, with a real, focused light, loops, and a patient in a position to actually see something? Just who is making sure your teeth are not falling out of your mouth because of some gum disease or other? And who is recommending (based on what is seen) that you investigate other aspects of your health? Did you even think that there are upwards of 200 diseases that can be confirmed or diagnosed by looking properly into someone's mouth? When you have that ulcer on the hard palate that just won't go away, or keeps coming back, chances are the MD will tell you it's nothing serious. 'Nothing serious', especially it it's ignored for too long, may just land you in the oral surgeon's chair, swearing at all the incompetence around him, as he must now inform you that he must remove a goodly portion of your jaw bone, to stop the spread of this cancer, or that ameloblastoma. I dunno, man, but there are 'dental mechanics' who do nothing but bullshit treatments, and there are others, who take it seriously. Just like MDs, airline pilots, or whatever. Maybe you should start by going to a dentist who will really look into your mouth and medical history....?..... Just my chicken scratchin's SP SignatureNot a real Addy, yet >A physician has much more serious work than fillings, tooth whitening, etc. >I honestly don't know how anyone can be so vain as to not understand the [quoted text clipped - 3 lines] > >Mel Before the age of antibiotics an infected tooth could be life threatening. Sometimes still is. Treating oral infections is easier today but no less important. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com > I just don't see how filling cavities or doing >cosmetic dentistry compares. > >Mel Get thee to the Barber/Surgeon ! -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com >> I just don't see how filling cavities or doing >>cosmetic dentistry compares. >> >>Mel > >Get thee to the Barber/Surgeon ! Or to the dentist for a haircut? Did you try the candy trick to get the crown off yet? > >>>My present dentist will guarantee the crown as > >>>long as I see him every 6 months. Maybe this whole thing is a ploy to keep [quoted text clipped - 23 lines] > > Mel |
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