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Medical Forum / General / Dentistry / May 2005

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DENTAL CROWNS (caps)

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BrianInNY - 04 May 2005 00:01 GMT
I am 47 years of age and have 27 of my permanent teeth remaining (14
upper and 13 lower), which include several molars. My upper teeth are
separated by a space of 1 missing tooth which was recently extracted
due to an infection. My lower teeth are separated by a space of 2
consecutive missing teeth which were knocked out in an auto accident in
February. Ostensibly, I am unhappy which the general appearance of my
teeth on several levels, including discoloation. My dentist recommends
crowning all my remaining teeth with one large piece upper as well as
lower, both of which would be made of porcelain. Here is my 3-part
question:
1) Is it prudent to crown all remaining teeth (including molars) as
opposed to dentures? I've never heard of crowning used so extensively
(all 27 teeth).

2) If so, is it advisable to use one large piece as opposed to
crowning each tooth indivually?

3) Finally, are there any long-term (or short-term!) health hazards to
having so many crowns cemented into my mouth?

Would greatly especially appreciate responses from dentists /dental
professionals. I'm very concerned about the entire treatment. Thanks so
much, in advance. Feel free to e-mail or post in the group --- Brian
Joel M. Eichen - 04 May 2005 01:44 GMT
> I am 47 years of age and have 27 of my permanent teeth remaining (14
> upper and 13 lower), which include several molars. My upper teeth are
[quoted text clipped - 6 lines]
> lower, both of which would be made of porcelain. Here is my 3-part
> question:

REPLY

Nope. Largely unnecessary (in my opinion).
How about two small bridges? UNLESS,
you want and can afford the cosmetic makeover,
then who knows? It could be great.

Joel

>  1) Is it prudent to crown all remaining teeth (including molars) as
> opposed to dentures? I've never heard of crowning used so extensively
> (all 27 teeth).

REPLY

Dentures are no good, unless that is your only out!

>  2) If so, is it advisable to use one large piece as opposed to
> crowning each tooth indivually?

REPLY

Well we can discuss that. Dentists are of two schools of thought on that.

>  3) Finally, are there any long-term (or short-term!) health hazards to
> having so many crowns cemented into my mouth?

REPLY

Nah. There isn't any mercury in the treatment plan, right?

>  Would greatly especially appreciate responses from dentists /dental
> professionals. I'm very concerned about the entire treatment. Thanks so
> much, in advance. Feel free to e-mail or post in the group --- Brian
Charlie - 04 May 2005 02:08 GMT
Teeth are crowned 1.to preserve them (if they have big fillings, are
breaking down or in danger of breaking down) 2.to reshape them (for
esthetic, biologic or functional reasons)  3.to change their color  4.to
support replacement, artificial teeth in order to fill spaces (bridgework).

Your questions are hard to answer without more information, but I'll do
what I can -

"Is it prudent to crown all remaining teeth (including molars) as
opposed to dentures?"  -dentures are an extreme choice.  They are an
inadequate replacement for natural teeth on many levels.  They can look
very nice, and you might even not dislike them all that much.  But you
won't know til you get them, and your brief description of your dentition
suggests you are not a candidate.

"I've never heard of crowning used so extensively
(all 27 teeth)."  -this treatment plan is not outside the norm in and of
itself.  The question is whether this is a good plan for you.

"If so, is it advisable to use one large piece as opposed to
crowning each tooth individually?"  -depends on which missing teeth are
being replaced, your bite, how much intact tooth structure there is to work
with, and the health/condition of your periodontium (gums/jawbone).  This
is called "splinting", and I would have to say that I rarely see good
reason to splint an entire arch (arch = all the teeth/supporting tissues in
either the upper or lower jaw).

"Finally, are there any long-term (or short-term!) health hazards to
having so many crowns cemented into my mouth?"  -a crowned tooth is
inferior to an intact tooth from a health perspective.  Crowns have a
finite life span (well, so do we!) and make it more difficult, in general,
to maintain a healthy mouth.

You have a fairly intact dentition.  Whether or not you place crowns on
part or all of it depends on how serious your dental issues are and what it
would take to fix them.  I would, were I examining you, do an assessment of
the esthetic, functional and biologic (health-seeking/maintaining) needs of
your dentition per my expertise and your personal goals.  The least amount
of dentistry that can achieve all of these is the best plan for you.

You mentioned your displeasure with your tooth color.  Is this an issue on
your back teeth?  And is it so bad that conservative methods (bleaching,
direct bonding, veneers) could not make a difference?

How many fillings have you had?  If your teeth are heavily restored then
crowning them may be a good idea.  If not, it's an extreme move.

Are the missing teeth causing problems?  Implant-supported replacements are
often a better idea than bridgework.

A second opinion is a good idea.  If you're having difficulty finding a
dentist you know to be conservative and ethical, consider being screened in
a reputable postdoctoral dental education program, lots of 'em in NY.

Charlie
Dr Steve - 04 May 2005 14:50 GMT
No way to intelligently comment on your questions with out a physical
examination.  To try would be foolish.  You need a second opinion IRL

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 am 47 years of age and have 27 of my permanent teeth remaining (14
> upper and 13 lower), which include several molars. My upper teeth are
[quoted text clipped - 19 lines]
> professionals. I'm very concerned about the entire treatment. Thanks so
> much, in advance. Feel free to e-mail or post in the group --- Brian
Joel M. Eichen - 04 May 2005 18:13 GMT
> No way to intelligently comment on your questions with out a physical
> examination.

REPLY

Please remove all your clothes and the nurse will be with you shortly.

RESPONSE: "Its too drafty here in the hall Doc. Can't I wait until I get
inside the room?"

To try would be foolish.  You need a second opinion IRL

> --
> ~+--~+--~+--~+--~+--
[quoted text clipped - 31 lines]
> > professionals. I'm very concerned about the entire treatment. Thanks so
> > much, in advance. Feel free to e-mail or post in the group --- Brian
Charlie - 04 May 2005 23:56 GMT
Shucks Dr. Steve, was that a shot?  Thought I was qualifying things OK.
Dr. Steve - 05 May 2005 00:51 GMT
>Shucks Dr. Steve, was that a shot?  Thought I was qualifying things OK.

Did it seem like one?

I had out seen your reply when I sent mine.
..
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting.
 
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