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Medical Forum / General / Dentistry / August 2007Debating Crown, Conflicted
My second lower molar from the back, on my right, had always given me trouble since a dentist put a truly massive filling in it when I was a child. I had sensitivity to cold in it as many as 15 years ago. It didn't feel "right" in other ways over the years, but wasn't a problem either. Then a fragment of it came off while chewing gum about four years ago. I had it patched, and then another fragment came off a couple years ago and I had that patched. I didn't want to have major work done but the writing was on the wall when I lost either a patch or another fragment about three months ago so I went to a highly-recommended dentist who planned to do an onlay but that plan changed to a crown as he discovered much more advanced decay than thought during the drilling. He warned that he might have to do a root canal as he went quite deep, but a crown turned out to be sufficient. He took the casting and had the crown prepared and then put it in 10 days or so later. I's been a couple months and I regard the result as nothing short of brilliant. The molar feels and looks wonderful and solid. I know that time will tell but I'm optimistic they'll cremate me at the age of 107 with that tooth and crown still in my noggin. It is not sensitive at all and feels better than it did even before it started falling apart five years ago. It was quite expensive but I am an entirely satisfied and grateful customer. So why am I posting? My newly beloved dentist wants to do another molar, the one behind the aforementioned. He sees some shadow (I forget the word) in it and regards the previous decay of the repaired tooth as indicative of what's going on in this other one. But I never had any similar trouble or sensitivity with this one. True it has a large filling, though not as massive as the other was. But there was always something going on with that other tooth, I could "feel" it wasn't right, and I never had any of that with this other one. My dentist is unconvinced by these sentiments, but neither did he tell me why they might not be meaningful. He says "I guarantee you there's something going on in" the other tooth. As wonderful as my crown is, I am unenthusiastic about getting another. I trust my dentist and take much note of the great work he has done so far but all the same I am greatly resistant towards fixing something that hasn't given me any problems. Should I have the work done? Most dental treatment is not only restorative but also preventive in nature, e.g. a small filling is placed into the void created by the removal of tooth decay (caries) before the caries works its way into the nerve and gives you a toothache, which then requires more and more extensive and expensive work. Periodontal disease is also painless until a tooth is so badly involved that it elicits pain, which usually means extraction. What I am saying is that your lower right last molar that has a large filling, may need to have that filling replaced. Since the new filling may be larger than acceptable, and since there may be more damage uncovered than is detected on the x-rayw when the old filling is removed he may be unable to re-place a new silver-mercury or resin filling and therefore a crown or onlay may be needed. If you wait until it hurts you may regret it. You were lucky with the 1st molar restoration to not need a root canal. However, even on that one, I'm sure that most dentists will agree, that the jury is still out - that the other shoe has not dropped. Waiting can be a big mistake. Sort of like the many people who don't go to see a dentist for 5 years or more because they don't have dental "insurance" but they can afford to support a carton a week cigarette habit with no problem financially. Whether you have this lower right 2nd molar properly repaired is up to you and your priorities. A lot cheaper to fix it now rather than wait for root canal or even worse extraction. If you trust your dentist and your dentist says you need some work done, then do the work. John >If you trust your dentist and your dentist says you need some work done, >then do the work. > >John Yep, it's a "you can pay now, or pay later" type thingy. > If you trust your dentist That's a good laugh. Made my day. Keep it coming. > and your dentist says you need some work > done, then do the work. > > John > As wonderful as my crown is, I am unenthusiastic about getting > another. I trust my dentist and take much note of the great work he > has done so far but all the same I am greatly resistant towards fixing > something that hasn't given me any problems. Should I have the work > done? If your other tooth had larger than apparent decay it seems logical enough that this hold true for the neighboring tooth as well. I have had the "hey that decay is larger than what I expected" reaction from my dentist three times in the last 3 months and am now looking forward to 2 more root canals. Two of those teeth had not been giving me any problems at all. So it might make sense for you to have it crowned well before anything feels wrong. On the other hand make sure that the previous restoration is complete otherwise it might be difficult to find out which of the two crowns is causing problems later on. Thanks to all responders for their comments. I am going in on the 14th to have him do the work he deems prudent. |
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