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Medical Forum / General / Dentistry / August 2005Permanent crown placement - standard practice?
Is it standard practice not to use local anesthetic while replacing a temporary with a permanent crown, if removal of the temporary & excess cement causes a lot of pain? What's the usual MO in this situation (assuming the patient has specified beforehand that they wish to be numbed for anything that might be painful)? Cheers :-) ! > Is it standard practice not to use local anesthetic while replacing a > temporary with a permanent crown, if removal of the temporary & excess > cement causes a lot of pain? What's the usual MO in this situation > (assuming the patient has specified beforehand that they wish to be > numbed for anything that might be painful)? In my experience, the process should not be painful, with the possible exception of some tenderness in the gums. As the dentist glues in the permanent crown, he/she needs your help to tell if it fits right. You can't do that if you have no feeling. If the crown ends up a bit high, you could be in for some pain in the coming weeks and the inconvenience of an extra visit to your dentist to get things right. Vaughn (just a dental consumer) Many thanks for the input - makes sense. I don't know what sort of temp cement was used in this scenario, but it sounds like it took an awful lot of tugging to get it off and by that time, the tooth was pretty sore ?? Does this happen frequently? The fit and inability to remove the temporary can be a problem. Let's say its a ten-unit splint, ten temporary croiwns all cemented in as one piece. THE TRICK: Spatulate in a small amount of Vasoline into the temporary cement mix. This provides the slippage when its time to remove same. Conversely, when a temporary crown comes off too easily, spatulate in some zinc oxide to the mix, if one is using something like Temp Bond that comes in two pre-prepared tubes. The stiffer mix stays put! OKAY ... SURVEY: What do you guys use for temporary cementation? Joel  SignatureJoel344 Maybe I should clarify a bit more - this is a single crown, nothing fancy. On another website (http://www.drsklar.com/ptinfo/crown.htm ), I read that "When we see you next, we'll gently remove your temporary crown. If your tooth is sensitive, you may require some anesthesia (or laughing gas)." So should anesthesia be provided if the patient is obviously in a lot of pain (and asks for anesthesia)? Yes and yes. Pain is ALWAYS a subjective thing. Joel SignatureJoel344 > Yes and yes. Pain is ALWAYS a subjective thing. Thanks for clarifying that :-). Except - now I'm left wondering how the dentist knows that it's seated correctly (as Vaughn said, "As the dentist glues in the permanent crown, he/she needs your help to tell if it fits right. You can't do that if you have no feeling."). So what's the story there? Is it easy enough for the dentist to tell if the crown fits right without the patient's input? *puzzled* One quick way ........ I snag a loop of dental floss on th contralateral (means other) side. I tell the patient to bite. If the floss pull through the crown is high ... way high! If it pulls through a bit compared to before the crown was placed, there is still a problem. I believe I can tell better, including articulating paper, than th patient can. The new crown often feels weird. Joe -- Joel34 I prefer (and usually the patients does too!) not to numb the tooth prior to cementation of the permanent crown. It usually just isn't necessary as long as you are careful with the tooth. If the patient is very sensitive with the tooth though then of course I numb it for the patient. It would be unnecessary to put the patient through the procedure feeling pain the whole time! I can tell when the crown is fitting when the patient is numb...its a bit easier to tell when they are not numb though. > > Yes and yes. Pain is ALWAYS a subjective thing. > [quoted text clipped - 4 lines] > the story there? Is it easy enough for the dentist to tell if the crown > fits right without the patient's input? *puzzled* Thanks for all your answers :-) !! >The fit and inability to remove the temporary can be a problem. >Let's say its a ten-unit splint, ten temporary croiwns all cemented [quoted text clipped - 12 lines] > >What do you guys use for temporary cementation? Just like what you said. You can get Temp-Bond in these nifty little single use packs now. For all porcelain restorations am using spot bonded bis-acryl temps. >Joel -- W_B Take out the G'RBAGE wubbabubbazG@RBAGEyahoo.com What is temporary cement? Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. 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. ...................... > > The fit and inability to remove the temporary can be a problem. [quoted text clipped - 15 lines] > > Joel Look at all the fun you are missing ....! Joe -- Joel34 What's a temporary? Signature~+--~+--~+--~+--~+-- Stephen [What's a Temporary?], D.D.S. 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. ...................... > Is it standard practice not to use local anesthetic while replacing a > temporary with a permanent crown, if removal of the temporary & excess [quoted text clipped - 3 lines] > > Cheers :-) ! |
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