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Medical Forum / General / Dentistry / February 2007

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How 'easy' is it to remove & re-do crowns?

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Jim S - 01 Jan 2007 16:36 GMT
How 'easy' is it for a Dentist to remove and re-do a (permanently
cemented) crown that is extremely problematic?  (The crown feels MUCH
'bigger' than the teeth around it and has a very strange 'curve' to it -
the back of the tooth is a lot shorter than the front, and the biting
surface is almost 'crescent' shaped..this makes my teeth bang like
crazy, despite numerous [5+ now] attempts to adjust & reshape it..)

From googling this, it looks like the Dentist has to 'cut' off the
crown and re-do.  Is this right?

Just trying to get a sense for how traumatic this is to the tooth all in
all to weigh the pros and cons.  (BTW, no RCT has been done on this
tooth).  As mentioned in my other post, tooth #14 has given me nothing
since problems after first having a CEREC (Dentist #1, removed by
Dentist #2 and a traditional procelain crown put on).

Thanks..

Jim
Steven Bornfeld - 02 Jan 2007 01:15 GMT
> How 'easy' is it for a Dentist to remove and re-do a (permanently
> cemented) crown that is extremely problematic?  (The crown feels MUCH
[quoted text clipped - 15 lines]
>
> Jim

    Sometimes the crown can be popped off with a crown remover, but
generally it is cut off.  If the dentist is careful there is little
chance of significant damage to the tooth.

Steve
Jim S - 03 Feb 2007 22:07 GMT
>> How 'easy' is it for a Dentist to remove and re-do a (permanently
>> cemented) crown that is extremely problematic?  (The crown feels MUCH
[quoted text clipped - 21 lines]
>
> Steve

Thanks, Steve.

I approached the Dentist about re-doing this, and he was hesitant..(said
"you don't want to do that - you'd wind up with a mangled mess in there").

My theory is this is a FUD (Fear, Uncertainty and Doubt) tactic to avoid
having me push to have it re-done.  Obviously, he's the only one who has
the knowledge of how it's in there, what he thinks it would take to
un-do it, but I'm inclined to think he's dodging a bit here to avoid the
time and expense of a re-do - which would probably cut into his profits
(I'm assuming).

I've had significant trouble (crown feels too "big" for the space it's
in, and it seems to be pushing on my gums weird and the teeth [13 and
15] to either side - which makes the whole area hurt - sometimes badly).
 This is going on 6 months now, and shows no signs of getting better.
(We've attempted to adjust the length of the crown about 6-8 times now -
and it STILL is a problem, so I'm assuming there's more going on than
just banging into the teeth below it).

Incidentally, I think that there's a pretty good chance that the crown
is too big because my mouth closes in many different places (badly
aligned bite to begin with) and making molds is an adventure and roll of
the dice in and of itself..so, I'm wondering if a misalignment during
mold making led to an incorrectly sized crown being made.  The tooth
"fits fine" if I bite on my back teeth, but doesn't fit if I bite
elsewhere.  Urgh.

What do you think?

Thanks..

Jim
Jim S - 03 Feb 2007 22:11 GMT
>>> How 'easy' is it for a Dentist to remove and re-do a (permanently
>>> cemented) crown that is extremely problematic?  (The crown feels MUCH
[quoted text clipped - 55 lines]
>
> Jim

PS: I've considered getting yet another opinion to keep the situation
honest here.  Would a Periodontist be a good option, or should I try
another family Dentist?  (A previous Dentist suggested I may be having
problems with 13-15 because of underlying gum issues.  And, Dental Rinse
[Ciclopirox - not sure of spelling] seems to help relieve the pain, so I
wonder if the tooth is pushing funny on the gums somehow).

I'd greatly appreciate any help/advice as I am going absolutely out of
my mind with constant (now 3-year long) pain from this [that's when the
first restoration [CEREC] was put on 14.  It was replaced by a porcelain
crown 6 months ago].
Jim S - 03 Feb 2007 22:17 GMT
Urgh..I had the name of the Dental Rinse that relieves the pain wrong in
my earlier post..It's Clorhexedine Gluconate.

So, question..why does that help with the pain?  Does this indicate that
14 is "too big" and pushing on the gums funny?  Doesn't the rinse just
help with Gum swelling?  (Doc had prescribed earlier for Periodontis,
and that's what I always thought C G was for - reducing gum inflammation).

Or, is it still "just" a bite problem?  (6+ months later, 8 adjustments
later..)

- Jim
Steven Bornfeld - 03 Feb 2007 22:19 GMT
> Urgh..I had the name of the Dental Rinse that relieves the pain wrong in
> my earlier post..It's Clorhexedine Gluconate.
[quoted text clipped - 8 lines]
>
> - Jim

    Chlorhexidene rinse may help with superficial inflammation, but if
you've got a significant perio problem it's not going to eliminate it by
itself.

Steve
Steven Bornfeld - 03 Feb 2007 22:18 GMT
>>>> How 'easy' is it for a Dentist to remove and re-do a (permanently
>>>> cemented) crown that is extremely problematic?  (The crown feels
[quoted text clipped - 69 lines]
> first restoration [CEREC] was put on 14.  It was replaced by a porcelain
> crown 6 months ago].

    As this seems to be primarily a restorative problem, I'd be inclined to
recommend you see a good general restorative dentist first.  If you need
to see a periodontist, the general dentist should be able to make an
appropriate referral.

Steve
Steven Bornfeld - 03 Feb 2007 22:15 GMT
>>> How 'easy' is it for a Dentist to remove and re-do a (permanently
>>> cemented) crown that is extremely problematic?  (The crown feels MUCH
[quoted text clipped - 55 lines]
>
> Jim

Really a tough call.  There are often inaccuracies in registering the
bite when a crown is made, but usually this can be checked and corrected
before the crown is cemented.

Steve
JimSocal - 03 Feb 2007 22:26 GMT
As a patient who's had more than his fair share of bad dental work by
bad dentists, I say that if I were you I would
1) get a 2nd opinion about the bad fitting crown
2) if the opinion is that it fits badly, and should be re-done, then
you have to decide: Is the dentist who did it CAPABLE of doing a good
job if you re-do it? Or will it just be botched again? Or should you
have it re-done by a - hopefully - more competent dentist?

Then you have to decide if you can get any money back from the
original dentist who did the bad crown.

I had a situation where my wife had a bad root canal causing her to
have to have an apicoectomy. We got severeal opinions that the root
canal had been botched, and so I sent a registered, certified letter
to the dentist stating that I knew the root canal had been botched,
sent him copies of the opinions from other dentists, told him that it
cost my wife a lot of pain in having to have gum surgery to fix it,
and that I wanted the money back that I paid for the root canal (and
if he would pay me that I would not sue for damages for having caused
the need for the gum surgery, pain and suffering, etc.)

After a couple months of follow-up phone calls and letters, and
finally threatening to file a law suit in small claims court, he
agreed to pay me back for the root canal which was around $600 as I
recall.)

So you probably do have some legal muscle in getting him to pay you
back for the bad crown if you can present enough evidence that it was
done badly. You can also threaten him with complaints to the American
Dental Association or local or state dental association if he's a
member, or whatever equivalent you have where you live.

Good luck.

Also: I had a crown re-done and it was no big deal, he just popped off
the old one, and put on a new one.

>Thanks, Steve.
>
[quoted text clipped - 29 lines]
>
>Jim
 
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