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Medical Forum / General / Dentistry / February 2007Crown Removal and Replacement
I had my normal 6 month appointment last week where I found out that my previous dentist (the past 5 years) had sold the practice to a new dentist. He has installed all the new diagnostic tools that the previous dentist did not have. I had gone for 3 years with no work needed and now the new dentist says I need to have my 2 crowns on rear molars replaced due to decay at the gum line. He showed me all kinds of stuff with his new x-ray machine and oral cameral (seemed very excited about his toys). I'm concerned about the procedure and wanted to know what to expect. I guess the good news is he didn't find anything on other teeth but this procedure scares me. I appreciate any feedback. > I had my normal 6 month appointment last week where I found out that > my previous dentist (the past 5 years) had sold the practice to a new [quoted text clipped - 10 lines] > > I appreciate any feedback. If you have doubts about your new dentist I would always suggest a second opinion. Steve  SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 On Feb 21, 9:20 am, Mark & Steven Bornfeld <bornfeldm...@dentaltwins.com> wrote: > > I had my normal 6 month appointment last week where I found out that > > my previous dentist (the past 5 years) had sold the practice to a new [quoted text clipped - 22 lines] > > - Show quoted text - Actually this was not about lack of trust, as I have already scheduled the appointment. This was about the procedure, what to expect and if there could be any damage to the underlying tooth by removing the crown. Does the tooth have to be re-shaped? Just want to know what I'm getting into. Thanks! > Actually this was not about lack of trust, as I have already scheduled > the appointment. This was about the procedure, what to expect and if > there could be any damage to the underlying tooth by removing the > crown. Does the tooth have to be re-shaped? Just want to know what > I'm getting into. Thanks! Sometimes the old crown can be popped off, but usually it's cut off esp. if attempting to pop it off could be expected to put unsafe force on the tooth. This is a clinical judgement, and ordinarily there shouldn't be any significant risk to crown removal. The decay at the gumline will of course have to be removed, and the tooth will almost certainly need to be reshaped somewhat in order to extend past the area the decay was, as the crown will have to cover this area. However, the total amount of additional tooth cutting should be much less than when the crown was done the first time. Other than that, the procedure should be pretty much the same. Steve On Feb 22, 2:09 pm, Steven Bornfeld <dentaltwinm...@earthlink.net> wrote: > > Actually this was not about lack of trust, as I have already scheduled > > the appointment. This was about the procedure, what to expect and if [quoted text clipped - 14 lines] > > Steve if the crown was placed just for a short time and there is nothing wrong on the tooth, I mean the crown itself has some problem, how much more tooth will lose for the replacement? Does the tooth need to be reshaped? Thanks > if the crown was placed just for a short time and there is nothing > wrong on the tooth, I mean the crown itself has some problem, how > much more tooth will lose for the replacement? Does the tooth need to > be reshaped? > > Thanks No way to answer that question without seeing the tooth. Often when a defective crown is removed the dentist finds that the shape of the prepared tooth may have contributed to the failure of the previous crown. Sometimes the tooth has been 'under prepared' and there is not adequate space available for a properly made crown. Sometimes the tooth needs to be built up to provide a better foundation for the crown. Sometimes the line angles of the preparation are sharp. Sometimes the margins are not clear or not placed below existing fillings. Once in a while, I will cut off an old crown and think to myself, "That's a nice looking prep. I don't think it needs any work." Most of the time, I need to do at least minor reshaping, and it isn't uncommon to need quite a lot of work. OTOH, the actual number of old crowns that I replace in a years time is not very large. I'm sure that I check thousands of crowns each year on my patients and only replace 20-30. I probably see another 50 that have deteriorated to the point that I have to extract the tooth, but these are usually older patients who have had these crowns for many years (dental health often fails rapidly as overall health fails, and patients end up in nursing homes). JME, Steve JME, Steve > On Feb 22, 2:09 pm, Steven Bornfeld <dentaltwinm...@earthlink.net> > wrote: [quoted text clipped - 23 lines] > > Thanks What's wrong with the crown? Steve On Feb 24, 9:20 am, Steven Bornfeld <dentaltwinm...@earthlink.net> wrote: > > On Feb 22, 2:09 pm, Steven Bornfeld <dentaltwinm...@earthlink.net> > > wrote: [quoted text clipped - 27 lines] > > Steve I think the newly installed crown is too low and cause toothache on a neighbor tooth when biting down. If the crown is too low, will it be possible to cause enamel crack on the higher neighbor tooth? I see a long crack line across the chewing surface. I am not trying to against my dentist, that what he is able to do. just don't want that bad things happen on my teeth. Daytime I try not let the teeth touch each other. But every morning when I wake up, I feel tired on the tooth. I am worried it will damage the tooth even more if I have it replaced. Will the tooth adapt the new biting itself? Thanks You may be clenching your teeth at night. Why did you have this crown made in the first place? Had you cracked a tooth? Steve > I think the newly installed crown is too low and cause toothache on a > neighbor tooth when biting down. [quoted text clipped - 10 lines] > > Thanks > You may be clenching your teeth at night. > [quoted text clipped - 17 lines] > > > Thanks I had the nerve removed but no root canal was done. It had a silver filling for 8 years. One day, a small piece between two teeth broke off when flossing. If that is truly the case, a new crown is unlikely to fix your problems. JMO, D > I had the nerve removed but no root canal was done. It had a silver > filling for 8 years. One day, a small piece between two teeth broke > off when flossing. > On Feb 24, 9:20 am, Steven Bornfeld <dentaltwinm...@earthlink.net> > wrote: [quoted text clipped - 39 lines] > > Thanks No it will not. It is possible that you are putting too much pressure on the tooth when chewing, and/or that the bite discrepency may be stimulating you to grind or clench at night. If the bite is high it should be adjusted; this may be enough to help your symptoms. This should certainly be done before replacing the crown. It is also possible that the gumline cavities have caused a problem for the pulp, and this too should be evaluated. You may have a grinding and/or clenching problem apart from this tooth, and this should also be evaluated and addressed. Steve On Feb 25, 8:23 am, Steven Bornfeld <dentaltwinm...@earthlink.net> wrote: > > On Feb 24, 9:20 am, Steven Bornfeld <dentaltwinm...@earthlink.net> > > wrote: [quoted text clipped - 51 lines] > > Steve It will not cause enamel crack or it will not damage the tooth even more if I have it replaced ? The tooth I felt high is actually a complete healthy tooth. Should the dentist try to make adjustment on the crown instead of lowering the good tooth? Thanks > On Feb 25, 8:23 am, Steven Bornfeld <dentaltwinm...@earthlink.net> > wrote: [quoted text clipped - 73 lines] > > Thanks I personal never grind on such a tooth until the patient has worn an NTI for a week or two. Signature/ Amatus / > On Feb 25, 8:23 am, Steven Bornfeld <dentaltwinm...@earthlink.net> > wrote: [quoted text clipped - 68 lines] > > Thanks It is sometimes surprisingly difficult to pinpoint the high spot. I've been wrong on this in my own mouth. Each situation is different; whether I'd adjust the crown or the natural tooth depends on what precisely is there. I'd rather reduce an inanimate crown (acknowledging the risks of fracture, etc.) than a natural tooth, but there is nothing wrong IMO with equilibrating a natural tooth if the amount of grinding isn't too large and the grinding is not down to the dentine. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 On Feb 26, 11:09 am, Mark & Steven Bornfeld <bornfeldm...@dentaltwins.com> wrote: > > On Feb 25, 8:23 am, Steven Bornfeld <dentaltwinm...@earthlink.net> > > wrote: [quoted text clipped - 84 lines] > Brooklyn, NY > 718-258-5001 Now I feel better, I mean the pain become less. If it does not bother me very hard, is it better that I wait until the tooth accommodate the new relation themselves by chewing or abrasion? Any risk for this? I just concern that new dental adjustment may cause another problem, and there will be endless treatment. Thanks for your answer. > On Feb 26, 11:09 am, Mark & Steven Bornfeld > <bornfeldm...@dentaltwins.com> wrote: [quoted text clipped - 95 lines] > > Thanks for your answer. Generally speaking, unless you have been told you have outstanding dental issues, if the pain is diminishing there is little to be lost by waiting. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 Hope everyone noticed that V thinks the nerve was removed from the tooth *without* completing a root canal. D > Generally speaking, unless you have been told you have outstanding > dental issues, if the pain is diminishing there is little to be lost by > waiting. > > Steve > Hope everyone noticed that V thinks the nerve was removed from the > tooth *without* completing a root canal. [quoted text clipped - 6 lines] >> >> Steve I realized this after posting--it's been a long thread. ;-) Ya, this should definitely be addressed. Steve SignatureMark & Steven Bornfeld DDS http://www.dentaltwins.com Brooklyn, NY 718-258-5001 >> if the crown was placed just for a short time and there is nothing >> wrong on the tooth, I mean the crown itself has some problem, how [quoted text clipped - 6 lines] > >Steve The crown is fine, it's the tooth underneath that has a problem. <G> > The crown is fine, it's the tooth underneath that has a problem. <G> You don't mean that the tooth has had one trauma too many and now might need a root canal, do you? Hmmm..... Could be. Just need to be sure that the other molar isn't cracked and causing part/all of the pain. D |
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