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Medical Forum / General / Dentistry / January 2006

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Cracked crown

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Cacti - 24 Jan 2006 03:03 GMT
I got a crown done on an upper molar in 1999.  After a few months I was still
having a lot of pain in that tooth.  

I went back to the dentist and he told me he would have to do a root canal.
So he took the crown off, did the root canal, and then put the crown back on
(it did not crack when he took it off).  This was in 2000.  

This tooth has been hurting on and off since then.  The toothache visits me
about 2-3 times a year and sticks around for about 2-3 weeks.  My dentist
could not figure out why I was still having pain in that molar.  Nothing
showed in x-rays, etc.  

Then about 3 years ago, my dentist referred me to a root canal specialist who
could only tell me he would not be able to tell me what needed to be done
until he took the crown off, and suggested that I get both crown and root
canal done again at his office.  I said screw it, and did not go back to the
specialist.  

I had the toothache last summer for about 2 weeks and it went away.  Now it
is back with a vengeance.  I had my husband take a look and he said I had a
cavity.  I said no way and he offered to take a picture with his digital
camera.  He took the picture and showed it to me.  

The crown was cracked!  I have no idea when this could have happened.  I saw
my dentist (still the same one from 6 years ago) in Oct. 2005 and he didn't
say anything about the crown being crack, damaged, etc.  

The crack is right in the middle of the crown and it is about 0.1 cm in
diameter.  I can see the metal casting underneath it.  It hurts tremendously.

I'm in a crunch money-wise because I ended up dishing out 30% of $9,250 just
this morning to get my husband's teeth fixed (I have been telling him to go
and see a dentist for the past seven years and he ignored me until one of his
frontal teeth finally began to hurt!  Guess what?  He needs TWO implants
among other things.  We have to pay rest of the bill over the next 3 months
or so).  

Can anyone tell me what my options are?  

I do not want my dentist to work on this tooth again, because to be honest, I
no longer trust his work.  My husband is seeing an implant specialist instead
of my regular dentist (meaning no insurance coverage), so it may mean I don’t
have much of an option.  If I called up my regular dentist, is there any
chance he would offer to fix it for not too much money?  Or would it end up
being more expensive this time?  Should I just get the implant specialist to
work on it?  

I brush my teeth several times a day and floss everyday, too.  Since I began
flossing everyday, my regular cleaning hardly lasts more than 10 minutes
because the dentist tells me there is not much build-up.  You don’t think I
brushed my crown away, do you?  Is that even possible?  

This thing hurts like the devil!!!!!
drharry - 24 Jan 2006 04:18 GMT
A crown has two parts.  The porcelain for esthetics and a metal (either
gold semi precious or non-precious)  Sometime the porcelain will crack but
leaving the metal underneath intact.  (That is what you are seeing) This
will usually NOT be painful.  So therefore I think it is not the fractured
porcelain but some other problem.  Your original dentist did nothing wrong

However that still doesn't solve your pain.  Unfortunately sometimes there
is pain and it is impossible to diagnose the problem.  If it is definitely
in this tooth and not a referred pain than it is usually time to extract.
You've done everything asked of you but sometimes the best laid plans and
the best workmanship do not lead to successful results

I wish you good luck

drharry (I am a dentist with 33 years experience)

>I got a crown done on an upper molar in 1999.  After a few months I was
>still
[quoted text clipped - 71 lines]
>
> This thing hurts like the devil!!!!!
Joel M. Eichen, D.D.S. - 28 Jan 2006 13:38 GMT
Can you post the photo at www.tinypic.com and we can offer
a qualified opinion?

We have done that almost ten years now .....

Joely

Moyamensing Implants

>I got a crown done on an upper molar in 1999.  After a few months I was still
>having a lot of pain in that tooth.  
[quoted text clipped - 49 lines]
>
>This thing hurts like the devil!!!!!
Punisher - 28 Jan 2006 22:02 GMT
What molar are we talking about?
How does it hurt?
How does the paint stop, what do you do to get it to stop?
When does the pain usually start?
How long does it last?
Do you swell in that area?
Do you get a fever when the pain starts?
Does it feel weird when you bite down, when it dosent hurt?

There are lots of stuff that can go wrong.

You said it was a molar? Well, sometimes molars have root canals that
are very very hard to find and they "don't" show up on a X-ray because
another bigger root canal is over lapping it when taking the X-ray.
What could be the issue and why he sent you to a endodontic specialist is
that there could be a root canal that he didn't see and there for didn't
clean out. Which could cause you the problems you have, but you should have
other symptoms also.

Next you said you got your crown in 1999. And that it's cracked already.
Usually they should last longer. But if the crown has a porcelain esthetic
layer on a molar that can be normal or it might not be normal. First of all
I would never put a fully porcelain crown on a molar. The pressure that is
on the molars in normal occlusion is so great that porcelain just cant
compensate it, you see porcelain is a hard material it's not very elastic
unlike metal which is elastic and can compensate, adjust to and spread the
pressure much better. Where as porcelain cant and it in turn cracks, chips,
breaks. But the cracked porcelain has noting to do with your pain. Because
there is a metal layer underneath it which covers your tooth entirely.
What could have something to do with your pain is a badly made crown. Dental
prosthodontics  is all about the pressure. A badly planed and made crown can
cause all types of havoc and pain. Molars, especially the first molars (the
6-th tooth) are corner stones of dental harmony in occlusion and dental
prosthodontics . If your first molar engages in occlusion to early it puts
to much pressure on it. Which can  cause pain similar to periapical pain.
What happens is that the excess pressure on the first molar stress the
periodontal ligaments so much that they cant compensate and the tooth
littery slams into the alveroly bone in turn causing periapical type pain.
Maybe that is what is going on with you. But
no one on the internet cant tell you what's going on with your case without
seeing you in person.
Joel M. Eichen, D.D.S. - 28 Jan 2006 22:15 GMT
>What molar are we talking about?
>How does it hurt?
>How does the paint stop, what do you do to get it to stop?

What paint?

>When does the pain usually start?
>How long does it last?
[quoted text clipped - 34 lines]
>no one on the internet cant tell you what's going on with your case without
>seeing you in person.

... or a nice jpeg can substitute.....
Sue - 28 Jan 2006 22:30 GMT
> >What molar are we talking about?
> >How does it hurt?
[quoted text clipped - 42 lines]
>
> ... or a nice jpeg can substitute.....

Cool.  Another dentist.

Just call me a groupie

Sue

KIDDING
Punisher - 28 Jan 2006 22:42 GMT
> >What molar are we talking about?
> >How does it hurt?
> >How does the paint stop, what do you do to get it to stop?
>
> What paint?

Ops :) Well you guy's got the drift of it. I have fast fingers :P that "T"
snuck in there.

> ... or a nice jpeg can substitute.....

It really cant. Go to that endodontist, also go to a dental
prosthodontic specialist.
Joel M. Eichen, D.D.S. - 29 Jan 2006 01:33 GMT
>> >What molar are we talking about?
>> >How does it hurt?
[quoted text clipped - 4 lines]
>Ops :) Well you guy's got the drift of it. I have fast fingers :P that "T"
>snuck in there.

REPLY

Okay, but the paint stops when the bucket runs dry ......

>> ... or a nice jpeg can substitute.....
>
>It really cant. Go to that endodontist, also go to a dental
>prosthodontic specialist.
 
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