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Medical Forum / General / Dentistry / April 2005Suddenly I need 6 Crowns?
Recently I relocated from NJ to Arizona. I had been going to my dentist in NJ for 10 years & he never tried to "sell" me anything. A very large filling(25 years old) fell out of one of my molars & took half the tooth with it. So off I go to a new dentist in Arizona. I assumed this broken tooth would need a crown but she proceeded to tell me that 5 other teeth needed crown. Three of the teeth needed crowns because of excessive fillings & two of the teeth had root canals. All these fillings & root canals go back at least 20 years. According to this new dentist, these 5 teeth need crowns to protect them from breaking. I understand that root canaled & heavily-filled teeth do not last forever but would it be imprudent to crown these teeth as they fail? The tooth that just broke was originally filled in 1968. That filling was subsequently replaced in 1970 & 1975 due to decay beneath the filling and an additional filling was placed on the lingual surface at a later date. Based on this life expectancy I am not inclined to suddenly $3000 to "rescue" these 5 teeth. Your opinions are greatly appreciated. Thanks, Rich > Recently I relocated from NJ to Arizona. I had been going to my dentist > in NJ for 10 years & he never tried to "sell" me anything. A very large > filling(25 years old) fell out of one of my molars & took half the tooth > with it. So off I go to a new dentist in Arizona. I assumed this broken > tooth would need a crown but she proceeded to tell me that 5 other teeth > needed crown. I heard they got vigilantes out there too ......... I am beginning to understand. Joel >Three of the teeth needed crowns because of excessive > fillings & two of the teeth had root canals. All these fillings & root > canals go back at least 20 years. According to this new dentist, these 5 > teeth need crowns to protect them from breaking. I understand that root > canaled & heavily-filled teeth do not last forever but would it be > imprudent to crown these teeth as they fail? Sometimes yes, sometimes no. Its possible the dentist is being prudent here. Just possible ..... >The tooth that just broke > was originally filled in 1968. That filling was subsequently replaced in > 1970 & 1975 due to decay beneath the filling and an additional filling > was placed on the lingual surface at a later date. Based on this life > expectancy I am not inclined to suddenly $3000 to "rescue" these 5 teeth. OK, you are looking for "confirmation" of your decision which cannot be done without looking at the teeth in question. So why not find a second or a third opinion? Joel > Your opinions are greatly appreciated. > Thanks, > Rich No one can tell you anything about your teeth from the internet. We can tell you generalities and explain terms to you. In general, if you just broke one tooth, you *could* quite likely have 2-3 others ready to break as well. My experience is that this usually occurs in patients who clench with great force while sleeping. Very few of these patients are aware they are doing this until we show them all the signs of it. If the margins on the other fillings are beginning to chip, it may be wise to replace the others as well. I can make some guesses here: As far as crown vs. filling. If you had the crown done on that tooth in 1968, it would (in most cases) still be fine. You would have avoided the three (counting now) subsequent re-treatments of this tooth. You now have 30 years of inflation to pay for, you have already paid two other times to re-fill it, you will need to pay for it to be re-filled prior to getting a crown now (unless you choose to get an onlay), and you still have to pay for the crown. Each time the tooth was retreated, more tooth was removed. It would have been much cheaper to get the crown back in 1968. Possibly the filling was not big enough in 1968 to need a crown, but I bet it was large enough in 1970 or 1975. Who knows specifically about your teeth? Get another opinion if you like. Ten different dentists will come up with ten different treatment plans, so be prepared for differing opinions. When do we say a tooth should have a crown or an onlay done to protect it? That is a judgment call which is based on years of training and experience. Depends on lots of different factors. I assume we are NOT talking about a PPO or HMO/DMO type insurance scheme which forces dental offices to upgrade treatment offerings to cover their cost of doing business.  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. ...................... > Recently I relocated from NJ to Arizona. I had been going to my dentist in > NJ for 10 years & he never tried to "sell" me anything. A very large [quoted text clipped - 14 lines] > Thanks, > Rich > No one can tell you anything about your teeth from the internet. We can > tell you generalities and explain terms to you. In general, if you just > broke one tooth, you *could* quite likely have 2-3 others ready to break as > well. My experience is that this usually occurs in patients who clench with > great force while sleeping. I call this parafunction. Joel Very few of these patients are aware they are > doing this until we show them all the signs of it. If the margins on the > other fillings are beginning to chip, it may be wise to replace the others [quoted text clipped - 52 lines] > > Thanks, > > Rich I appreciate all who have answered my post. Yes, this is a health plan; Cigna. I believe it is an HMO. You all bring up excellent points. It seems that any tooth that has been filled earlier in your life will eventually require a crown. I suppose crowns are better than dentures or implants. The thing that annoyed me was that I agreed to to fix only the broken tooth and when I went to pay the receptionist I was billed an extra $125 for the crown because Cigna allows an extra $125 per crown for 6 or more crowns and I just so happened to suddenly need 6 crowns. It just doesn't smell right. Thanks again. Rich > No one can tell you anything about your teeth from the internet. We can > tell you generalities and explain terms to you. In general, if you just [quoted text clipped - 26 lines] > which forces dental offices to upgrade treatment offerings to cover their > cost of doing business. > Recently I relocated from NJ to Arizona. I had been going to my dentist in > NJ for 10 years & he never tried to "sell" me anything. A very large [quoted text clipped - 7 lines] > canaled & heavily-filled teeth do not last forever but would it be > imprudent to crown these teeth as they fail? When the root canal teeth "fail", they'll likely (with almost 100% certainty) fracture down the root and need extraction. If you don't mind losing the teeth, then wait until they fail. >The tooth that just broke was originally filled in 1968. That filling was >subsequently replaced in 1970 & 1975 due to decay beneath the filling and >an additional filling was placed on the lingual surface at a later date. >Based on this life expectancy I am not inclined to suddenly $3000 to >"rescue" these 5 teeth. > Your opinions are greatly appreciated. That's $600/crown. Seems cheap! Each time you had a filling that was patched, and re-patched, you lost more tooth and weakened the remaining tooth. Perhaps it *is* time to finally crown those teeth. > I understand that root >canaled & heavily-filled teeth do not last forever but would it be >imprudent to crown these teeth as they fail? Yes. Because you cannot predict the extent of a future fracture. -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com |
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