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strong569: So the dentist I’m going with said I need a crown. Also this dentist tried to sell me aligners called Dandy. Wanted 1500, then found out I had insurance and wanted another 1500… so total 3k I just go for cleanings. I can’t tell if he just wants money My tooth isn’t bothering me, also I’m moving in a few months. I asked him if can’t be put off and he said I’m rollling a dice… Thank you for your help! Dr M: This tooth does have a large filling, but does not appear cracked. Based on this photo, and the lack of any symptoms, you don't need to crown the tooth right away. If a part of it breaks in the future, you can then consider a crown. adodplantation: It's completely understandable to feel skeptical when a dentist suggests additional procedures, especially when you're not experiencing any discomfort. I'd recommend getting a second opinion from a different dentist. They can independently assess your situation and provide alternative treatment options or recommendations. It's also important to understand the potential consequences of delaying treatment, such as further damage to the tooth or surrounding area.

Do I need a crown?

ERJ: I have broken a chunk off of an upper molar. I am not having any pain. I am 81 years old, have all my own teeth, and have never needed a filling, crown, root canal, etc., so I am a total novice when evaluating my options; i.e. a crown, an extraction and bridge, a single tooth implant, etc. Where can I find straight forward information simple enough for an "aging novice" to understand my options? Thank you in advance for any advice you can provide. Dr M: Best option would be to see a dentist in person. He can then explain or show examples of the different treatment options based on your scenario.

Seeking info to make decision on best dental procedure

Logan: I took a bite of some food and had toothache since, it is a tooth with a filling. Due to the virus no Dentists are doing fillings. I am keeping the tooth clean, I am eating on the otherside, brushing twice a day with sensodyne repair and protect toothpaste, using mouth wash as well as swishing around salt water. Also when I go to bed I put some of the toothpaste onto the tooth as well. I am only drinking water, tea and milk. I have cut out all sugary foods and drinks. The filling is still in place, I do not really have pain when drinking hot and cold things, just a slight discomfort. I can chew on it ok, but only done it for a test, again just brings discomfort. I have a constant dull ache that throbs every now and then. I also have a metallic taste in my mouth as well. I did this on Tuesday 7th April, will the tooth be ok? As soon as the restrictions or some of them are lifted for the dentist I will be making an appointment. I had my check up in Feb and all my teeth were fine then. MattKW: Not much else you can do. Logan: MattKW said: Not much else you can do. Click to expand... How long would it take for the tooth to get worse MattKW: How can anyone tell? Logan: MattKW said: How can anyone tell? Click to expand... A Dentist should be able to give advice MattKW: I couldn't even tell a face-to-face patient how long it would take; what do you expect over the internet with no examination or Xrays? Logan: MattKW said: I couldn't even tell a face-to-face patient how long it would take; what do you expect over the internet with no examination or Xrays? Click to expand... Best guess. Could I have possibly bruised the tooth by biting down? As well as maybe chipped the tooth or filling a little bit? As the ache has eased a lot, its not really sensitive to hot and cold things its just general discomfort when eating on it which i am trying to avoid. It still feels odd in my mouth though. I am keeping the area as clean as I can. Can a dentist do a filling without drilling? flomodental: If a filling has become damaged, seeing a dentist as soon as possible is crucial. A damaged filling can expose your tooth to bacteria, leading to decay, infection, or further structural damage. Waiting too long can exacerbate these issues, resulting in more extensive and costly treatments, such as root canals or crowns. Ideally, you should schedule an appointment with your dentist within a few days of noticing the damage. This prompt action can prevent complications and ensure your tooth is properly protected. If you experience pain, sensitivity, or any signs of infection, it's essential to seek dental care immediately. For those looking for professional and prompt dental care, FloMo Dental offers comprehensive services to address issues like damaged fillings and more. Our team is experienced in providing high-quality dental solutions to ensure your oral health remains in excellent condition.

If a filling has become damaged, how long is too long to wait to see a Dentist?

Bluebellas: Hi, so I have done a RCT on my upper left molar but 2 weeks after the treatment, pain presented in the gum area near the treated tooth. This subsided but there’s still some pain (2 out of 10 pain level) and the treated tooth hurts on pressure. Dentist says to observe for a month. My gut feel is the RCT has failed. During observation, I used my right side to eat. My right lower molar had a bad chip and my gums hurt badly. This subsided after abt 3 days. I have since gone for the first session of RCT with another dentist for this tooth. My question is, I’m due to visit the first dentist on the “failed” RCT before I meet the second dentist to complete the RCR. If the first dentist suggests retreatment, should I do it after I complete the RCT for the second problem tooth or even after the crown is completed? Dr M: Do you have any x-rays you could share about the tooth in question? The pain could be,because of a lot of reasons. Sometimes the filling is a bit too high, or sometimes there is a gap, leading to food impaction, which leads to gum pain, which can feel like tooth pain.

Doing a root canal treatment on lower right molar while left upper molar is healing from RCT

djaychela: I recently had two onlays. My #6 and 7 teeth on the lower right-hand side had old amalgam fillings from when I was 20 or so and one of them had broken up a bit. So my dentist said I needed both of them replaced (he's always angling for replacing the amalgam as he says they look bad; I don't really care about that as I've had them for 30 years)... and £750 later I had two new onlays. One definitely felt proud when the anaesthetic wore off. I was in pain straight away, and this is on a tooth with no history of pain (and was NOT the one where the filling was starting to break up). It's constant discomfort, and eating or cold makes is really bad - a sharp stabbing pain that takes minutes to subside. I've been taking paracetamol so I can sleep. Left it a week as my wife said I should see if it settles down, which it didn't. So I called the dentist, went back a couple of days later with my concerns, and was asked to sign a root canal authorisation before I'd even seen the dentist, which I refused to do (as aside from anything else the paperwork said I'd seen the dentist and discussed the situation and my questions had been answered, none of which was true). So he dressed the proudness (took three goes to do it), plus there was some (UV?) light shone in there as well. He gave me a week's course of antibiotics. I'm a few days in and there's no change, and if I continue on his suggested course then I'll be back in for a root canal, and according to his price list this will be at least £650 for this. I don't see why a tooth with no history of pain or tenderness would suddenly start hurting unless something was wrong with the inlay? When I brought this up with the dentist he just sidestepped the question with a "not every procedure works every time" kind of answer. Dr M: It does sound like the nerve was damaged. Drilling on a tooth, if there is no clear indication to do so, unfortunately always caries a risk. The risks, as well as possibility of a root canal, should have been discussed with you as part of the informed consent process,

Pain after onlay

bowis: question Woke up this morning with intensen pain from a tooth (that spreaded to my cheek) that was already hurting randomly when drinking sth cold etc. Thought the worst, called my dentist, was able to get an appointment today. I get an xray, he tells me its "just a cavity" and I get the filling. Now about 5 hours later, I'm having these random pains that don't seem to be triggered by biting, just when sitting. My hypochondriac self got the better of me and I started googling, finding all these things about abcesses, pulpitis etc etc. Are these pains "normal", or did the dentist not spot something? Dr M: Difficult to say without the x-ray. If the pain persists, go back to your dentist.

Scared for pulpitis after minor filling

Tido: I had a dental implant done around six months ago. Did x-rays and was cleared for the crown. Crown was placed and since then I have noticed a bad smell when I recognize as decay. Smell coming from that area. One complication is that I am currently doing Invisalign and paused in treatment to install crown. X-ray showed the crown to be appropriately placed with a slight stretching the ligament (I don’t know if this is the right phrasing…) on the tooth in front. Dentist is watching this. Any insight into what might be going on? Dr M: Do you have any x-rays that you can share?

Bad taste after dental implant crown placed

oceanmd: Hello, Please help me better understand the benefits of each of these materials for a bone graft for the implant: Nova Bone by Osteogenics and Straumann BoneCeramic Which material do you have experience working with or prefer to work with ? With which material do you achieve better results? I would appreciate your help.

Advise Needed to Choose between Two Different Synthetic Bone Grafts

Shodan: Hello, I am terrified my dentist won't be able to fit a crown so it doesn't keep coming off. Regards a (root canal) crown that has come off five times in the last four years, he keeps telling me there is not enough tooth left to hold the crown. He is devoted to never extracting a tooth if at all possible. I've read about tooth surgery, I guess to expose more tooth for the crown to grab, and tooth extraction - the most terrifying part for me; losing a tooth - and then an implant, costing thousands... Is there a dentist out there who used to work for NASA? Like using advanced technology to solve the problem of insufficient tooth for a crown to remain for years? Thank you for any suggestions... oceanmd: Hello, In order to have more tooth root exposed to be able to secure the crown, the dentist will have to cut some bone around the tooth root. Later on, if you have to place an implant, cutting the bone around the tooth root will make it more difficult. This is how the periodontist explained to me the cons and pros of crown lengthening procedure.

Not enough tooth to hold a crown

oceanmd: Hello, Did anyone have your own bone scraped from your jaw as bone graft for implant? These bone scrapes are going to be mixed with either synthetic bone or your own plasma and used as a bone graft for future implant placement. Does anyone have this experience? Thank you in advance.

Did anyone have your own bone scraped from your jaw as bone graft for implant

PaulY: Five months ago I had a post and core crown fitted. After two weeks it fell out. I had the crown re-glued and four months later it has come loose again. This time the post is still firmly glued in but I believe that the glue between the old root and the new crown has deteriorated and come away and now the tooth wobbles. My dentist is reluctant to put pressure on the tooth to try remove the post and re-glue it in case he fractures the root so has not offered any treatment . Can anything be done to stop the tooth from wobbling? Dr M: Do you perhaps have any x-rays of the post that you could share? It is strange that it comes loose so often PaulY: Unfortunately I don't have the x-rays. I have a feeling that it might be my dentist's first attempt as he told me he had sent pictures to his professor of the finished work. With this in mind maybe he used the wrong glue or didn't ensure everything was dry the first time. The tooth in question is number twelve and fractured leaving only the root. I assume that when it was glued into place a certain amount of glue was used between the base of the crown and the root as well as the post ( a sliver came out a couple of weeks before the tooth loosened ) and that it is this which has come loose creating a small gap. I don't know how it all works and just wondered if a dentist was able to unsolidify the glue to re-position the crown. As I said he hasn't offered to do this. Do I have to just put up with my wobbly crown? Dr M: You can use a ultrasonic scaler tip, that vibrates, in order to loosen the post. If your dentist is not experienced in this, ask him to refer you to someone, that might be able to assist in your area PaulY: Thank you that makes a lot of sense! MattKW: When you say tooth 12, do you mean American numbering (UNS) or International numbering (FDI)? If FDI 12, then those lateral incisors have a very poor chance of success with post and cores. I would normally advise patient to start saving for an implant. I have done hundreds of posts, both direct and indirect. PaulY: MattKW said: When you say tooth 12, do you mean American numbering (UNS) or International numbering (FDI)? If FDI 12, then those lateral incisors have a very poor chance of success with post and cores. I would normally advise patient to start saving for an implant. I have done hundreds of posts, both direct and indirect. Click to expand... Sorry it gets a bit confusing with all the different ways of identifying teeth but it's the first premolar. Only the root was left after the tooth fractured and then deteriorated over time. I read elswhere that this was a prime candidate for a post and core. Unfortunately my dentist has indicated that he thinks it a minor miracle that he managed to perform the procedure and seems at a loss as to how the crown has loosened. In your opinion how strong should the crown be and could using floss and interdentals on it be the cause of it loosening?

Loose post and core crown.

DFLERCH: I had a permanent crown put on about 4 weeks ago. I didnt have much pain with the temporary crown but now I have like a constant pain almost like a sharp ache. Its mostly just really annoying but sometimes gets bad enough to take advil. It doesnt hurt when I eat and its not sensitive to hot and cold. The dentist took xrays and exam and senstivity test. Everything looks normal. He said the only other thing is to do a root canal. Im wondering if I should give it more time but I dont think it should hurt like this after 4 weeks. Dr M: Did he check the bite to make sure the permanent crown is perhaps not too high? smithwilfer: Do discuss the dentist maybe root canal issue be their DFLERCH: Dr M said: Did he check the bite to make sure the permanent crown is perhaps not too high? Click to expand... Yes he did check and adjust the bite. MattKW: About 5-10% of crowned teeth develop the need for an RCT. I can't say exactly why in your case, but generally speaking, a tooth that needs a crown has already had extensive fillings, so the "nerve" has been damaged many times. A crown prep can be all that's needed to push it over the edge. If not settling within 2 weeks, I start getting ready for RCT. The risk of an RCT is normally discussed when talking about the pros and cons of crowns.

Pain with crown

cabie000: I recently got #19 extracted and an implant completed at the same time. The first 4 days were okay, but on Sunday it got really sore and it's not feeling any better. It's been 9 days now, and I'm starting to become concerned. However I don't see any other signs it's not healing properly. Just pain. Is this typical? Can one get dry socket in these situations? Dr M: I would recommend going to the oral surgeon for a follow-up visit, so that you can make sure there is no infection. Did the surgeon prescribe you any antibiotics? cabie000: Dr M said: I would recommend going to the oral surgeon for a follow-up visit, so that you can make sure there is no infection. Did the surgeon prescribe you any antibiotics? Click to expand... Yes, doxicycline. However I was advised by my doctor to ask him about stopping or switching due to it agitating my ulcerative colitis, so he had me stop it after 5 days. The pain level dropped over the weekend, but it still flares up at times. Dr M: Still go for a follow-up. If there are any signs of infection, an alternative antibiotic can be prescribed. cabie000: Dr M said: Still go for a follow-up. If there are any signs of infection, an alternative antibiotic can be prescribed. Click to expand... Thanks! That was a good call, I ended up getting elevated temperature and blood pressure as well. I called them to share my symptoms and he prescribed Cefalexin.

Simultaneous extraction and implant

maurive2014: Hi. I bought a Nobel Procera 2g Scanner. But I can't find the software to use it. Does anyone know where can I find this software?

Software to use Nobel Procera 2g Scanner

Crick74: Hello….this is the first time I’ve ever been in this forum so I appreciate your taking the time to read my post. I know this is long but please read bc I really need some help, please. About three weeks ago, my life changed completely. I was scheduled to have a root canal / crown on one of my front lower teeth at my dentist. I’ve had root canals and crowns before so I’m very aware of what the procedure involves. My dentist numbed my mouth and began working, and after about 45 minutes he stopped and told me that he wasn’t going to be able to save the tooth….that it cracked into when he was drilling. Then something happened that I had NEVER experienced at any dental office. My dentist, who I have been seeing for around ten years, begins acting very strange. It is very difficult to explain, you almost have to have been there and personally experienced this to understand what I’m talking about but he almost acted as if he was appalled by me and giving up on me as a patient. He looked like he had seen a ghost or something, just had this mortified expression on his face and acted like he was at the end of his rope with me. He told me that he doesn’t know what to do anymore with me. He said ‘Every one of your teeth are going to need some type of restoration. I see at least fifteen or so teeth that are going to need crowns because we can no longer continue doing patchwork with fillings. It’s time to decide if your going to want to restore your teeth or just give up on them.’ And it wasn’t necessarily what he said to me as much as how he said it that puzzled me. This dentist had done all kinds of work on me for ten years and he suddenly treated me very rudely and almost acted like he just wanted to wash his hands of me and move on. I am just a patient and don’t know anything about this stuff, so at this point I was feeling very shocked and uncomfortable. I was confused, and let me explain why I was confused. This was a few weeks ago near the end of February. Allow me to go back around five months to my last cleaning and appointment with him. I have my teeth cleaned twice a year, every six months….I would say I am in the dentist office more than the average person and I try to take care of my teeth but over the years, I have had to have a lot of work done. My teeth have always been prone to cavities and I’m sure some of my habits don’t help , but all my life I have had my teeth cleaned every six months and when something comes up that I need, I always have it done. Anyway, five months earlier I am having my teeth cleaned and at the cleaning, the following issues were discussed….. - I had a tooth in the very back that had a crown on it. I believe it was a crown that he had done a couple of years earlier. This crown had become loose when me and my family were visiting my wife’s mother in Orlando a few weeks prior to this appointment. This crowned tooth ended up just falling out when I was out of town. It just broke off. I didn’t do anything to cause this. I’m guessing that it had been gradually becoming loose wout me knowing and food had been getting up under the crown and causing more decay. That’s my best guess. I had never had anything like this happen. It just came out. And the root of the tooth remained. When he saw this, he almost acted rude about it, like it was my fault. He said ‘Well, I see you lost a tooth’ but in a very fed up tone. Like I caused this crowned tooth to fail and just fall out. He said ‘at some point we will need to remove the root of that tooth but it’s not urgent.’ - The next issue was another tooth in the very back that he said needed to be crowned and have a root canal. He said this is the priority. - He also said I needed a root canal and crown on a front bottom tooth. A few months prior to this I had come in to ask him about this one bc I noticed what felt like a filling come loose behind the front tooth and I could feel the place that it came out. I thought it just needed to be refilled. When I went in he said…..’no, that’s going to need a root canal and crown. Are you feeling pain or sensitivity?’ I said no, it didn’t hurt at all. I really questioned needing a root canal and crown. I thought it should just be filled. I didn’t have the money at the time so it was put on hold. - Other than these TWO bigger issues, they told me at my cleaning that I had only ONE OTHER SMALL CAVITY TO BE FILLED WHICH COULD WAIT UNTIL AFTER THESE OTHER TWO BIGGER THINGS WERE DONE. This is a key element in this story. At this cleaning ……I had ONE small cavity to be filled. *****THERE WAS NO MENTION OF MY TEETH NEEDING FIFTEEN OR MORE CROWNS, basically a full restoration to save the teeth I have left. ******* I made an appointment to have the root canal and crown on the back tooth and I went in the following week to have the work done. When he started drilling, same thing happened…..he said he couldn’t save the tooth, that it was too decayed. He extracted it instead. I then made an appointment to fix the front tooth a couple of weeks later. I ended up needing to reschedule the appointment bc I was still trying to save up a bit more money to have it done, and they knew this. I said I could have the money in two weeks, but they said the next opening for me was nearly four months away…..even though this was important. I took it. And when the time of my appointment rolled around, it ended up being too late to save the tooth and he made me feel horrible for waiting. I didn’t want to wait that long. I needed to get the funds together and when I had them, then they pushed me off for four months. So now, let’s go back to where I began the story. I am sitting there hearing him tell me that …… - The tooth in the front couldn’t be saved bc I waited too long (it was actually bc I couldn’t get an appointment sooner). - And now, the doctor is telling me that almost every tooth in my mouth needs ‘restoration’ or I will eventually loose them all. That he can no longer use fillings to fix any areas of decay. He pointed out around 15-16 teeth that he said needed a crown. He said that at this point these teeth are still healthy and can be saved but thinking long term, they will all need to be crowned. THIS WAS MAJOR. ****JUST FIVE MONTHS EARLIER AT MY CLEANING, I WAS TOLD I HAD ONE OTHER SMALL CAVITY TO BE FILLED BESIDES THE TWO OTHER BIGGER ISSUES I LISTED (the back tooth and the front tooth). Now 16+ teeth need to be crowned! I felt like this was a huge jump from my last cleaning. **** And it was also how he told me …..the way he made me feel. I have super thick skin. I have been through A LOT in my life. I don’t get my feelings hurt. When I left his office, I felt like a horrible person who cares nothing about themselves. I’m a 49 year old man, husband of 26 years, father of two 13 year old twins, and I went home and immediately called my sister crying. That’s how bad this dentist made me feel. How he looked at me. Dentists are supposed to be comforting and supportive, not break people down. I am paying him to work on my mouth. He made me feel like I would be lucky if he gave me another shot. He made a comment in front of a female assistant that I had some stuff in between my teeth and he said i obviously don’t have good hygiene skills. And I said ‘Well what is where that tooth was?’ He said he put a temporary in its place and that it would probably start giving me problems after awhile. He didn’t offer any other options , that’s all he said is that it probably wont last long. I said ‘so what do I need to do?’ He said….’well, my first thought is nothing bc it’s obvious that you don’t care about your teeth.’ I said I do care. And then he said in a very frustrated and rushed way…..’well, here. I have a few more minutes I can spare. Let’s take a look. ‘ then he started naming off tooth numbers to the assistant…..listed around 17 teeth…..he said these all need crowns because fillings wont work anymore and if you don’t crown them you’ll lose them and have to get dentures or implants . But if your not going to take care of the crowns there’s no sense in getting them. Let me say this…..I am not one to give excuses for my mistakes but this isn’t an excuse, this is reality. Fourteen years ago I injured my lower spine and I was never the same. After failed back surgeries, I was never able to be free of severe pain in both of my legs …..every single second for fourteen years. It never left, not one second. I’ve dedicated myself completely to raising my son and daughter who are now 13. Every bit of ME went into them. I haven’t been able to work full time in over five years. My wife supports us. We have no funds to spare. I have always cared about my teeth and oral hygiene, but I will admit, yes there have been times that I didn’t pay enough attention to taking care of myself exactly as I should as far as my teeth are concerned. I’m not making excuses, I’m just trying to say that life is hard and sometimes it’s easy to overlook things and not care for ourselves 100%. That doesn’t mean my dentist of ten years has the right to make me feel that I should just go bury my head in the sand bc my mouth looks awful and I’m a 49 year old man w poor hygiene. This embarrassed me! I am a fantastic father and a loving loyal husband and I went home literally crying to my sister about how much of a loser I have become and that I’m never going to find a way out of this. That my life is just a constant cycle of getting further and further into this hole that I can’t escape from. And now I can’t get out. The past few weeks have been horrible. I tried to put it out of my head. When I got myself together, I called them and asked for a treatment plan. The plan is for 19 crowns and it is $20,000 of dental work. And I was left w a temporary tooth in front with no indication of how long this will last or what to do. I can’t afford this. And I’m so confused. I thought this was the reason I went in every six months to have my teeth cleaned…..to avoid something like this coming up. Just five months ago…..ONE MINOR CAVITY! What happened, what changed? Now $20k of dental crowns????? I have done a lot of research into this. I was concerned that the root of that tooth that fell out could be creating bacteria that was damaging my other teeth but I asked them about that and they just ignored me. Now I am looking into going to Turkey to do this for much less money. Honestly, I don’t know what to do. I feel like this is the end for me. I have been feeling panicked. I don’t even feel like me anymore! Dr M: This case sounds complex. There is a chance that a lot of work is needed and the dentist failed to inform you about this earlier and only did ''patch'' work. I would suggest seeking a second opinion before doing any major restorative work such as crowns, since this can be very destructive to your teeth, if not indicated. Crick74: Okay, thank you. I do have an appointment with another highly recommended dentist to get their opinion. I may get their opinion wout even mentioning what my dentist suggested. So that it’s an unbiased opinion. Am I correct to think that it is strange that only four months ago I was told that I only needed one minor cavity filled? I think it’s also worth noting that I have already spent thousands of dollars on dental work in the past few years. Just a few years ago, I had four teeth done. Root canal and crown on all four. One crown I had done that was in the very back began getting food caught up under it and the tooth decayed so much that it just came out. I had no idea until it was too late . And he has extracted three of my back teeth. I know nothing about teeth except what I need to do on a daily basis to care for them. So I can’t on my dentist to advise me and do what’s needed to keep my teeth and mouth healthy. And bc of some of the things that have happened the way they did, I just can’t help but think that some of this could be his fault . I’m not trying to make excuses or cast blame but just four months ago I needed one minor cavity fixed. I’ve even wondered if this has something to do w him feeling that I am wasting his time when I come in and he cannot complete the root canal and crown on the tooth bc the tooth has died. Maybe he doesn’t like me for this and is giving me a treatment plan that will make me leave. My teeth aren’t beautiful but they also don’t look THAT BAD. But this is causing me major stress. If I think he may be to blame for some of this should I consult with a lawyer? Dr M: Wait for your second opinion first.

DENTIST NOW SAYS I NEED 19 CROWNS - a few months ago it was 1 minor cavity.

pol: Hello, My dentist recommend an emax inlay for a molar that needed biodentine filling. A composite is still possible but sold as less durable and less good. My concern is I don't see how a dentist could easil y remove a such piece from the tooth without risking the tooth. Could you explain me the way a dentist would remove a EMAX filling, the act, the duration. I'm especially very careful about the noise that can generate to the patient and eventually ear wear during the procedure (internal conact noise). I Regards

EMAX inlay removal question : What's the way to do / Difficulty / duration / Risks for tooth

Michael Thomas: Hello, I had a layered zirconia crown placed on my first molar (bottom left). It was a recommendation to prevent fracture as I have a history of grinding. Prior to the crown prep the tooth had a moderate divot on the surface and a dull ache (reoccurring PDL sprain). Aside from that the tooth was healthy and fully intact - no previous fillings and/or damage. After the crown prep I still had a dull ache but the tooth also became sensitive to hot and cold and painful to chewing. One year after the crown prep I had a root canal due to the symptoms persisting. Following RCT the tooth still has sensation - including a dull ache as well as occasional sensitivity and chewing pain. My 3D scan did not show signs of fracture and the endodontist reports a successful RCT as he did not find anything wrong with his microscope. It’s been suggested that the tooth may have been over-reduced during crown prep and that the RCT exacerbated the situation. The endodontist and my new dentist have speculated that the tooth has structural damage and needs to be extracted. I’m struggling with this opinion as the purpose of crowning was to prevent fracture, extraction. Question: Can a tooth that has potentially been over-reduced and has ongoing symptoms after RCT be re-crowned or is extraction the only option? For additional perspective, I’ve provided a 3D image of the tooth prior to RCT. Thank you. Brause: I am in a similar situation...and after hearing from a friend that one of his mandibular molars received RCT and he broke two crowns: extraction! One of my molars received RCT, which did absolutely nothing. It was extracted. This after a 5-month period of pain and $$$$ of useless treatment. I have talked to a lot of people, most of them had experience with RCT...and it worked well in the fewest cases. RCT is temporary patchwork imho...a time bomb in the end. Now I have a similar issue again and will not put up with all that crap again. Another issue I have after extended experience with dental specialists in my environment recently: they are really greedy! Excessive profits with pain: goes completely against my grain.

Re-crowning vs. Extraction

oceanmd: Hello, After a hard bite, the crown became loose and the crown with the attached post fell out. Now, there is nothing left of the tooth above the gum line. The original crown was placed 12 years ago after the root canals treatment. My question: is it possible to place another post with the new crown if the root is in good condition, without a crack? Did anybody have this done? 3-D X-ray is scheduled for next week. I am trying to educate myself about different possible options before my appointment. Thank you Dr M: It is an option if there is enough sound tooth structure left, to create adequate ferrule effect or ''hold''. If there is not enough sound tooth structure left, extraction might need to be considered. oceanmd: Dr M, What is your opinion on socket shield technique for implant placing? Dr M: This is a new technique and has various benefits as can be found in the literature. Especially when looking at preserving buccal bone. This is a good technique to consider, but then the implant has to be placed with someone familiar with the technique. I would avoid seeing a general dentist and rather go and see a periodontist , in order to place the implant

New Crown on the Post

Millenium: I tripped and fell into an iron gate and chipped my front tooth. The dentist x-rayed and said no root issues and bonding will correct the chipped edge. But, I can see a visible horizontal crack. The dentist says it's just superficial and to not worry about it but I'm terrified that it is an actual crack and I will lose the bottom half of my tooth. My bonding appointment is tomorrow and the dentist told me again, today, to not worry about the superficial crack and to whiten my teeth tonight to prep for bonding. Apart from x-ray, I do not believe any other tests (other than visual) were undertaken but I was upset at the time and still am! I've attached a picture where the chipped tooth is circled and further circled where the line appears. Can anyone assist? Thank you. Dr M: I would not stress about the line for now, if you don't have any pain on the associated tooth. A lot of times we also get what we call stress fractures in our enamel. This is due to normal function over time as well as grinding. Most of the time no treatment is indicated in case like this, especially if not accompanied by any symptoms. Millenium: Dr M said: I would not stress about the line for now, if you don't have any pain on the associated tooth. A lot of times we also get what we call stress fractures in our enamel. This is due to normal function over time as well as grinding. Most of the time no treatment is indicated in case like this, especially if not accompanied by any symptoms. Click to expand... Thank you very much, Dr M. My bonding was yesterday and now I am learning to live with this new reality! Thank you for helping put my mind at ease - really appreciated.

Horizontal Crack on Front Tooth

oceanmd: I bit hard an a popcorn and and a piece of it went under the gum along the crowned tooth #5. The crown was placed 12 years ago, root canals were done and a short post inserted. A few days after it happened I went to see a dentist to check on this tooth, and I felt discomfort and some pain when using water pick around that side of the tooth where the popcorn shell damaged the gum. The X-ray was done and no visible damage to this crowned tooth was determined. It was recommended to give it time for the gum to heal. Gradually after, the crown started to move. I have the appointment scheduled to go to the dentist and would like to be prepared for possible treatment options. What might have happened to the crown? Is there a chance to glue back the same crown? Might I need a new crown? I would appreciate the professional opinion Dr M: It might be that the post either came loose or fractured. If the post is only loose, it can be recemented, if the seal is good. If the post fractured, but the remaining tooth structure looks okay, a new post and crown can be made. If the post fractured in such a way, that it can't be removed without fracturing the tooth, the best option would be to consider extraction, with replacement of the missing tooth. oceanmd: Thank you, Dr M, for your reply. My dentist suspects the root fracture and referred me to a Periodontist / Implant specialist for a 3-D X-ray. I am still experiencing pain on one side of the tooth when using water pick on the side of the tooth. I am reading about implants now and have a few questions: 1) Do you absolutely always have to use bone graft after you surgically remove a tooth. 2) What is the best material for a bone graft? Dr M: The best material differs based on various factors, such as size and shape of defect, position of tooth in mouth etc. It is however not ALWAYS necessary to place a bone graft. If you did indeed have a root fracture, the extraction might be more of the surgical type and therefore lead to more bone destruction and therefore a graft might be more beneficial. oceanmd: Thank you, Dr M, Will a 3-D X-ray show if there is a fracture in the root? Can a body start the bone growth and create its own bone tissue after a tooth extraction? Dr M: The CBCT scan will more accurately be able to tell if there is a fracture, yes. If the extraction is atraumatic and the bone socket is more or less preserved, the body is capable of filling the socket with its own bone yes. oceanmd: Dr M said: The CBCT scan will more accurately be able to tell if there is a fracture, yes. If the extraction is atraumatic and the bone socket is more or less preserved, the body is capable of filling the socket with its own bone yes. Click to expand... Thank you for your reply, Dr M, Will the socket be filled by the existing bone kind of sliding into the hole? Or will my own bone be generating NEW bone tissues? Dr M: You can google bone formation in extraction socket. There are some nice videos that will most likely explain it better than me. But usually the socket fills with granulation tissue, that changes into woven or unmineralized bone, that eventually becomes fully hardened. The adjacent bone does not slide into the socket. It is new bone.

Crown is moving

sgoldstein527: A day after I went for a routine cleaning, I had a porcelain crown crack. I find it hard to shake the feeling that the two are related. Is it possible that the cleaning, including scraping to remove tartar and other deposits, caused the crown to crack? How should I raise this concern with my dentist? Dr M: Highly unlikely that a routine cleaning can cause a crown to crack. Usually after a cleaning you are more aware of your teeth. You most likely only became aware of a pre-existing crack.

Crown Cracks day after a routine cleaning

ericatphoto116: Hello, I came to this forum seeking help. I've searched for many years with no luck. I have a life long mid-facial deformity a Class III malocclusion with underbite. I'm 46 years old and I have been looking for help for many years. My former dentist did not do what he told me he could do to improve my condition. It's a very long story that I've told over and over. Long story short I'm in search of a qualified dentist who would be willing to treat me pro Bono. I'm currently unemployed and in the process of re applying for SSDI. I have no dental insurance only Medicaid which covers only $1,000 annually. I need crowns on my upper and lower teeth to stabilize my bite so I can chew food and improve my oral health which affects my whole health. I have severe nighttime bruxism, I bite the inside of my cheeks, jaw tension, and headaches. I've researched every available option and still can't find help. I'm in desperation mode. This treatment would change my life more than I could ever explain and I would be eternally grateful. I'm searching for a miracle. Thank you. alithedentalguy: Hi Erica, Hope you are doing well. I just saw your post. Could you please let me know if you are still seeking to have dental treatment so i can provide further informaiton. Look forward to hearing from you. Ali

Seeking help to get the dental treatment that I need.

: Joseph-Grant: Prior.: I have a leaking glass-ionomer-filling. A dentist told me it probably is just glass and resin. But I think all glass-ionomers convert to trace amount of fluoride, calcium, strontium, and aluminum [electricity conductor = yikes]. It broke during college 10 years ago; should have been replaced then; I've been sawing down part of it to try to get it off. But it's covering a lot of the tooth, tooth-~10. I now know that these fillings are stronger than regular enamel, which explains why it's hard to get it off and see where it ends and the tooth starts; and why it's damaging the enamel of the tooth below it when I saw down the side with dental sandpaper, because it shifts my bite a little. I know I should just get it fixed but money or something is keeping me from repairing it, maybe I'm angry/traumatized that it will break again. But that was because I didn't replace my lingual-upper-brace-retainer so my anterior front teeth bunched together breaking the tip of the glass ionomer, releasing whatever is inside it including desensitizing-chemicals, maybe aluminum and fluoride. At night, the resin-glue with the aforementioned characteristics would fill up the left cheeks where the saliva flows, desensitizing other teeth that did not need to be desensitized, blocking certain nerves like my spleen/liver/sexual organs from fully functioning. Now that I've been sanding it down more, the saliva is corroding more surface area but I know what the problem is so I can deal with it better. For my questions: 0) do all glass-ionomer fillcings convert into trace amounts of fluoride/aluminum when they wear down? is that why it's wearing more tough on my bottom tooth? or in this case are ruptured/broken and consequently corroded with saliva/citric acid/fruits etc? 0.5) are all glass-ionomer fillings made with Poly(acrylic acid) which polymerizes? that would explain why my mouth feels like there's goo in it; the resin is polymerizing with the food and nanoparticles, which in turn electrifies that side of my body at night. The resin is also getting on my hands and body when I spit it out. This is the article I've been studying about GIC's: A Review of Glass-Ionomer Cements for Clinical Dentistry This article is an updated review of the published literature on glass-ionomer cements and covers their structure, properties and clinical uses within dentistry, with an emphasis on findings from the last five years or so. Glass-ionomers are shown to ... www.ncbi.nlm.nih.gov 1) could I get it light-cured but without repairing it all the way with new glue/resin/composite/cement? or does it need to be filled over again with some external shell? I heat it up with a spoon and hot water and that stops the corrosion for an hour. 2) or just get it filled in again, but then how long will it last? research says composite fillings only last about 3-5 years; I don't want an amalgam 3-surface filling if it has metals in it. maybe the new filling/glaze/composite will last plenty long enough if I also get an upper-lingual-brace to keep teeth from falling inward again if I do things like car-accidents or gymnastics. Yeah I guess I'll just get it fixed soon when I have the cash. I'll leave this here because I want to be more certain about the structure of these fillings for my future health choices. Thank you so much for your feedback.

: glass-ionomer-[re]storation: questions.

apm: I got a zirconia crown placed on an upper molar and it has some sort of a bubble where I'd expect just a tooth groove. The dentist that put the crown told me he could shave it if it bothers me but I'm not sure how it could bother me besides looking visually weird and possibly meaning there is some issue with the crown. He didn't seem concerned but I'm a bit worried whether it is possible that this bubble means that the crown was poorly made or has some sort of a defect? (The crown was prepared by a lab after a scan by the dentist). Dr M: No, this is not a weak spot on the crown. This was just the design preference of the technician. If it does not bother you, other than visually, I would recommend leaving it. No one other than you will see it, and shaving down a crown unnecessarily, might compromise the integrity of the crown.

Bubble on newly placed zirconia crown

LeAnn Marie: The screws that attach my All-on-4 to my implants have broken three times this year. Comments Please?

Screws attaching denture to implants BREAKING more then once.

Jacques: I've just lost a 30 year crown on #15 upper left molar which also has deep decay below the gum line. No pain. My general dentist recommended extraction of the tooth, but I'm looking for an alternative solution. I moved to a new dentist who was willing to refer me to an endodontist and a periodontist. But I've heard that deep margin elevation is a relatively new procedure and that some specialists may lack the necessary skills. My question: Are there dental providers who specialize in deep margin elevation and if so how does one find them? Dr M: Do you have a recent x-ray of the decayed tooth? Deep Margin elevation might not even be an option if the decay is subcrestal. Jacques: Yes, I have an X-Ray taken a few weeks ago showing #14 & #15. I'm new to this Forum so I'm not sure how to upload the image. Jacques: OK, Image attached. Dr M: The best option would be to see a specialist in your case. The root canal treated molar, almost seems like there is root caries present on the distal root, which makes the long term prognosis questionable in my opinion. I would also possible opt for an extraction in that case. The second molar does have deep decay. In my opinion the tooth would need a root canal before permanent restoration can be attempted, and even then the tooth seems like a periodontally compromised tooth. In cases such as this, you have to think long term and not only short term. It is clear that you have some bone loss present between your teeth, which might be an indication of underlying periodontal disease. I would suggest seeking the opinion of a periodontist. He will do a tooth by tooth analysis and determine which teeth can be saved in the long run, once the perio has been stabilized. Might be better to extract if you are looking at the broader condition of your mouth. Jacques: Thanks very much for your reply. I have an evaluation referral to an endodontist the day after tomorrow. But just reading the posts in this forum gives me some hesitation about how to interpret his findings. I'm under the impression that the outcome may very well depend on how skilled he is and how cautious or conservative his approach might be. I take note of your advice about keeping the "long term" in mind. Did I mention that I'm 86 and that "long term" has a different ring to it than it did when I was 50? My principal concern at the moment is the preservation of those teeth so I can keep chewing. An excavation of my mouth at this age presents me with a number of difficult prosthodontic problems which may not have easy or affordable solutions not to mention potential healing issues. Since I was aware that #14 and #15 were compromised by decay at or below the margin, I looked at potential remedies other than extraction, which is why I raised the questions about Deep Margin Elevation and Crown Lengthening. A previous dentist did propose crown lengthening several months ago. In light of the above, my endodontist may recommend the more cautious remedy. I'm not at all sure what to do in that case given my reluctance to extract those teeth. You speculated that the root canal treated molar seems to have caries on the distal root. My untrained eye doesn't see it. So far I don't have pain or sensation in either tooth. I suppose the endodontist will test the root canal treated molar (#14) for caries and then also test #15 to determine whether root canal is indicated? In the forum (Matt KW, Verified Dentist), I came across a case like mine which was recommended to be treated with root canal and subgingival amalgam as the most cost-effective solution. Another case (also recommended by Matt KW) involved treating the decay with an onlay, filling the pulp chamber with amalgam and utilizing a post/core buildup. I appreciate your help and look forward to your insights. Dr M: Taking your age into consideration, I then tend to agree that alternative options should be considered rather than extraction. The decay I mentioned is distal of tooth number #14. The endodontist will most likely take a 3D scan to confirm restorability of both teeth. Deep Margin Elevation is a well documented procedure for teeth with decay below the gum line, although not all practitioners have the skill to perform this. Unfortunately this means that you will have to bring this procedure up during the consultation with the endodontist, and if he is not comfortable doing it, there is a chance he can refer you to someone in the area that can. Subgingival amalgam is also a good option, but to do a proper filling, you will need to ensure adequate marginal seal, and either crown lengthening or deep margin elevation will be required to achieve this seal. Jacques: Thank you so much for your guidance. Jacques: Dr M said: Taking your age into consideration, I then tend to agree that alternative options should be considered rather than extraction. The decay I mentioned is distal of tooth number #14. The endodontist will most likely take a 3D scan to confirm restorability of both teeth. Deep Margin Elevation is a well documented procedure for teeth with decay below the gum line, although not all practitioners have the skill to perform this. Unfortunately this means that you will have to bring this procedure up during the consultation with the endodontist, and if he is not comfortable doing it, there is a chance he can refer you to someone in the area that can. Subgingival amalgam is also a good option, but to do a proper filling, you will need to ensure adequate marginal seal, and either crown lengthening or deep margin elevation will be required to achieve this seal. Click to expand... Regrettably the endodontist yesterday did not see any alternative to extraction. I mentioned Deep Margin Elevation to him, but he seemed unaware at first of the procedure. When I showed him a diagram, he acknowledged having seen something like it under a different description. I asked whether he knew another specialist who might help me but he demurred. The endodontist I saw is part of a network served by the dental insurer which covers me. When I first mentioned DME, he called it a "heroic" procedure without much chance of success. It occurred to me (with no real evidence) that network dentists may not be paid enough to use procedures other than those which have been taught in dental schools for decades. Extracting #14 and #15 is an undesirable outcome for me, but finding someone skilled in DME who would be willing to restore them is more difficult than I anticipated. Today I became aware of a supply house named Garrison Dental which hosted online webinars on DME so I called them and got a list of their customers in my county. Possibly one or more will know someone who is capable in the field. The endodontist's report today said that I was asymptomatic upon presentation. It reminded me that I am lucky not to be in pain from #15 which lost its crown and that I may have "enough" time to locate a DME provider with the necessary skills. Thanks again for listening.

Question about Deep Margin elevation

Jacques: My upper left molars, one with a crown and one with a dislodged crown, have decay close to (and below) the gum line. My dentist recommended extraction, but I am searching for alternatives. Attached a recent X-Rays. Thanks very much for your help.

Looking for an alternative to extraction for #14 and #15 Upper Left molars.

Itsjustmeee: I had the permanent crown put on tooth number 11 today. I got home and notice this. It’s like a gap. There’s also a gap on the back between crown and gum. Is this normal or is it something I should have checked? Dr M: This is an ill fitting crown and something the dentist should have checked prior to cementation of the permanent crown. That area is a high risk for leakage and caries formation and also not aesthetic. I would go back to the dentist and insist he fixes the issue Itsjustmeee: Dr M said: This is an ill fitting crown and something the dentist should have checked prior to cementation of the permanent crown. That area is a high risk for leakage and caries formation and also not aesthetic. I would go back to the dentist and insist he fixes the issue Click to expand... I had a feeling it wasn’t correct. With my past experiences with this dentist and this combined, I chose to switch dentists. I need a second opinion on the work I’ve had done. This dentist has been very dismissive of my pain and shows no concern in taking time with patients.

Crown

annamichellexo: I recently got a six unit bridge on my upper teeth (for cosmetic reasons, no infection or root canal or anything. perfectly healthy teeth). My teeth were ground down and the temporary was placed on about five days ago. One of the teeth started hurting a few days ago and upon inspection with a mirror I found that there is a hole (about the size of a sesame seed now, it's about twice the size it was yesterday) on the inside part. The crown is just really thin in that area so I think it just wore away somehow. My question is, should I just leave it alone and keep up with brushing, or should I go back to the dentist and see if they can fix it? I get my permanent bridge in a little under a month, so it's quite a bit of time. Is having a hole dangerous to the tooth since it's been ground down? It hurts but I figure that's just because it's exposed. I don't want to get an infection or something and end up needing a root canal. Sorry if this was all over the place but I really don't know how to describe it any other way. Input/advice would be greatly appreciated! drmins: It would be better if you can consult the dentist and get it covered well. As the enamel are ground,you need to protect the dentin from getting exposed to food debris or other contamination. Stay cool. Keep smiling. dr.mins sendicott: How long does it take for a permanent crown to adjust to your bite MattKW: A small hole in a temporary crown may be OK for several weeks. The most likely issues that might arise are tooth sensitivity, or the temporary cement gives way and the temp crown/bridge comes off - so in your case, go back. You won't get an infection. However, a temporary crown is about the same thickness as a permanent crown, so this may indicate that your tooth was not prepared deep enough. Ask the dentist about this too. If you're getting a PFM bridge then it may not be a problem as these can have a metal backing of as little as 0.3mm. But if you're getting a full ceramic bridge, then it must be at least 1mm thick all over.

Hole in temporary crown... should I get this fixed?

Gorno: Vitablocs are not recommended for crowns over molars and are contraindicated for grinders and clenchers. I am one of both. Less than 3 years later, my crown on #19 has shattered. Is the dentist liable for malpractice? The contraindication from Vita-Zahnfabrik dates back to at least 2005. What exculpatory could the dentist have been thinking? Comments? MattKW: There's more to crowns than just the material. There's also thickness and preparation technique. I've never used it but if you have a link to the contraindication I'd like to see it. Gorno: MattKW said: There's more to crowns than just the material. There's also thickness and preparation technique. I've never used it but if you have a link to the contraindication I'd like to see it. Click to expand... Pages 6 and 7: https://1drv.ms/b/s!Atu_XilwEa0Xg-BzhV9N4tHDUBuKzA Or write to Vita-Zahnfabrik in Germany, who sent me this and many other publications. "No means no." MattKW: Thanks for the link. Yep, gotta agree with you, "Hyperfunction: • Restorations made of VITABLOCS are contraindicated for patients diagnosed with excessive occlusal function, in particular those who grind and clench their teeth. The use of VITABLOCS restorations for devitalized teeth of patients with hyperfunctions is absolutely contraindicated." So, I'd suggest you write to the dentist and try to have a civil conversation. If you manage to get a replacement crown of a more suitable material, that'd be ideal. Don't get aggressive and ask for pain, suffering etc. We all have insurance for incidents. For a bruxer I'd prefer full gold or PFM.

Contraindicated crown shattered after 2.9 years, is dentist responsible?

Ginette: I need a large bone graft for my top front teeth. I was advised that I needed a bone graft from my skull in oder to have the most chances of success considering the large amount of bone loss following an implant failure and lack of action on my part for many years. I was also told from a different source that bone graft using bone from the skull is a very old fashion method from the 70s and that there has been progress since then which allow as good a result without having to endure a night in hospital and general anaesthesia. Hard to know who to believe.

Cranial bone graft for front top teeth dental implant

1.T: Am I able to get an implant on an extracted lower left wisdom tooth which also had a cyst? Dr M: Why would you replace a wisdom tooth with an implant? Do you have other molar teeth missing as well? To determine if any area is suitable for an implant, the bone quality and quantity needs to be determined first. After an extraction, you would have to wait at least 3 months and then evaluate the bone in the extraction site, to determine suitability for an implant

Am I Able to Get An Implant?

1.T: Is it possible to do filling on a moist area of the upper left wisdom tooth to avoid extraction? MattKW: Well, you could use an amalgam. But if you have decay in a place that's hard to clean, then it's quiter likely you'll get decay there again. If the wisdom tooth is redundant, it's better to take it out while there's something to grab onto. John Morgens: It is not possible to do a filling on a moist area of a wisdom tooth to avoid extraction. If a tooth is decayed or damaged, a filling may be a viable option. However, if the tooth is severely damaged or impacted, extraction may be necessary. During the extraction, the area will be numbed with local anesthesia, and the dentist or oral surgeon will work to remove the tooth as gently and efficiently as possible. After the extraction, gauze will be placed over the area to help control bleeding, and ice packs may be used to reduce swelling. It is important to follow post-operative instructions carefully to promote healing and prevent complications. If you have concerns or questions about the extraction process, it is best to discuss them with your dentist or oral surgeon.

Filling on Wet Area of Wisdom Tooth

jdent106: Hi I had a RCT 2 months ago in May and got the Permanent crown on June 13. Ever since I got my crown I have not been overall well. It was too high and was causing pain and sensations in my jaw/neck. The dentist shaved the tooth above and the PFM crown multiple times. I still get weird burning sensations in the surrounding gums and as of this week starting feel constant nausea. The nausea is what's starting to bother me more. Is this a sign of sensitivity to the PFM or an ill fitted crown? I don't know where to start. I feel like I keep going back to a place that is not listening to me when I say something if wrong. A pic of post RTC and post crown. MattKW: Can't say why. RCT looks reasonable as does crown. I could understand if it was initially too high that it might cause issues, and perhaps even though the bite may have been solved, you may have entered into a pain cycle. Nausea is not directly related to high spots or RCTs or crowns. Maybe go elsewhere for 2nd opinion that the bite is fully corrected. If that checks out, then consider your general doctor. jdent106: Okay. I will get a second opinion and take it from there. The most odd thing that bothers me most, excuse the typo in the title #31 is molar on the right side, when I'm sleeping on the right side I get a jolting sharp pain that wakes me up out my sleep every time its so odd. jdent106: Its looking like a potential tooth fracture unfortunately.

Crown pressure and sensations lower left molar #31

worrier: I had a white filling only 2 days ago. It doesn't hurt or anything but I notice there is a small black spot on it. Does this sound normal? I'm not bothered about the cosmetic effect as it's a back tooth but am hoping this isn't something that could affect the health of the tooth and shouldn't be there. Dr M: Might only be a stain. Difficult to say without more information. worrier: Dr M said: Might only be a stain. Difficult to say without more information. Click to expand... Thank you for your reply. I thought two days was far too soon for a stain to appear on a band new filling but I'm really hoping that's all it is. John Morgens: It's not uncommon to notice minor color variations or imperfections on a newly placed white filling, particularly within the first few days after the procedure. Here are a few things to consider: Material Settling: The composite material used for white fillings may experience slight changes in color or appearance as it fully cures and hardens over the initial days. This settling process can lead to temporary discoloration. Staining: External factors such as food and beverages can cause staining on new fillings shortly after placement. Dark-colored foods or drinks may leave temporary marks on the filling's surface. Residual Debris: There might have been some residual debris or material on the tooth or filling during the placement, resulting in a small spot. This can happen even when the utmost care is taken during the procedure. Natural Variations: Natural teeth have variations in color and texture, which can become more apparent when a white filling is placed next to the natural tooth structure. Since you're not experiencing any pain or discomfort and the spot is on a back tooth, it's likely that this is primarily a cosmetic concern and may not directly impact the health of the tooth. However, to ensure that everything is progressing as expected and there are no underlying issues, it's a good idea to contact your dentist. They can assess the situation, provide guidance, and determine if any adjustments or further actions are needed. If the discoloration continues or if you have any concerns about the filling's integrity or your oral health, it's best to consult your dentist. They will be able to offer personalized advice based on their examination of the filling and your tooth. For getting more informations from Dental care professionals please Visit Mylifesmiles. worrier: Thank you for your reply. It's very helpful. I rang my dentist and she explained to me (by phone) that this sounds like a small stain and she is not concerned about this as she has seen me recently but to let her know if it gets bigger or worse. Otherwise she will review it at my next appointment in October.

Normal for new white filling?

Eric2005: Three days ago I got a crown (#12) where the tooth got broken. The new crown is not painful but it does not feel natural. Hard to explain - I just feel conscious of it. The inside of the tooth feels too thick. In general it feels heavy. As I said, it just doesn't feel natural. No pain however. I don't recall having this problem with other crowns. Is this a matter of getting used to the new crown? I should point out that the tooth next to to the crown was extracted and an implant put in at the same time that the dentist worked on the mold for the crown. Then on the last visit when the dentist installed the crown he also extracted another molar in the same area and installed an implant. John Morgens: If your new dental crown does not feel natural and is causing discomfort or doesn't match your bite properly, it's important to address the issue. Here are a few steps you can take: Contact Your Dentist: Reach out to your dentist and let them know about the discomfort and the fact that the new crown doesn't feel natural. Explain the specific issues you're experiencing, such as discomfort, sensitivity, or difficulty biting. Schedule a Checkup: Your dentist will likely want to examine the crown to assess the fit, alignment, and your bite. They might take X-rays or use other diagnostic tools to ensure that the crown is properly placed and isn't causing any underlying issues. Adjustment or Refinement: If the crown is not fitting properly or is causing an unnatural sensation, your dentist may need to make adjustments. This could involve refining the crown's shape, adjusting its alignment, or modifying the bite to ensure proper occlusion (how your teeth come together when you bite). Temporary Discomfort: Keep in mind that it's not uncommon for there to be a brief period of adjustment after getting a new crown. Your mouth and bite might need some time to adapt to the changes. However, persistent discomfort or an unnatural feeling should be addressed promptly. Follow-Up Appointments: Your dentist might schedule follow-up appointments to monitor your progress and ensure that the issues are being resolved. Be sure to attend these appointments and communicate any ongoing concerns.

New crown does not feel natural

John C: Hi, I have had a crown with a post at the upper front for approximately 45 years. All those years ago the tooth snapped at the gum due to football/soccer injury. A root filling was performed and the crown was fitted. Around 5 years ago the crown came loose and my privately funded dentist refitted it. All was well until recently and it came loose again. I have moved house since then and I am now registered with a national health system (NHS) dentist and he refitted it. I'm sure he did a good job, but it came loose within a few days. He told me that within the NHS I can only have the tooth taken out and a replacement tooth on a pallet fitted. The NHS in the UK is the state partially funded dentist system. As far as I am aware the remaining tooth is sound and it has been there since childhood, albeit only half the size for 45 years. I would like to know what my options are for a replacement tooth. Another crown and post? Implant? I am 68 year old and that may have a bearing on my choices. Any help appreciated. John MattKW: Without an Xray, I can only give an opinion based on my experience. 45 years for an RCT/post/crown is an excellent outcome for a front tooth. When they eventually fail, it often means that some of the remaining natural tooth has fractured off, leaving it even weaker than the original accident. It's likely that another post/crown would fail within a short time; better to consider an implant. John C: MattKW said: Without an Xray, I can only give an opinion based on my experience. 45 years for an RCT/post/crown is an excellent outcome for a front tooth. When they eventually fail, it often means that some of the remaining natural tooth has fractured off, leaving it even weaker than the original accident. It's likely that another post/crown would fail within a short time; better to consider an implant. Click to expand... Thanks for your reply. I appreciate your advice. I will look into finding a suitable dentist in my area for an implant. John

Crown with post issue

Scorp: I'll try to keep it short. A little backstory. About 7 years ago I got my first crown in my life on my lower-left molar (not the last one, but the one next to it). I had no prior experience with crowns. For the next 3 days the crown had me on my knees in pain. It was horrible pain. And then for the next 12 months I always felt pressure there, and my gums were always sensitive. I didn't know if this was how it's supposed to be, so I lived with it. Then I changed dentists, and the new dentist removed that crown. Said it was way too big. I felt such a relief immediately, I remember that vividly. And for the next few years I always went to this new dentist, and I did about 10 crowns there. All of these crowns are Cerec crowns. The same-day crowns. This was like a dental office, so I had one person do my root canals, and another one take the print for the crown, make the crown, put the crown in, and cement it. Each person did what they're trained to do. I will say that I never had a single problem there. Not a single infection, not a single bad-fitted crown, not a single anything at all. It was a beautiful thing man. About a year ago I moved to my hometown, and I finally needed a dentist recently because my lower-right molar (not the last one, the one next to it) chipped - a piece broke off. So I looked for dentists online, and I choose one based on google reviews, and how his office looks, and how he looks, and I went there. He cleaned up a tooth and did the root canal. Eventually he took a print for the crown (using the paste method, not digitally). Eventually the crown arrived, and I went to get it put in and cemented. We agreed to leave it in uncemented for 2-3 days to see how I feel. The crown is pretty tight between the adjacent teeth, so it hasn't fallen off once, and it only wiggles a tiny tiny bit, barely noticeable. So I come home from the office with my new uncemented crown, and within the hour my head starts hurting, then my ear starts hurting, then my jaw/neck starts hurting a little bit. The crown is in the lower-right side of my jaw, but the pain I was experiencing was on the left side of my head mostly. And this pain remained with me for the next 30 hours or so. Then for the next 30 hours it was less painful, but still it was painful and I was feeling pressure in my head. And today, 7 days later, I still don't feel perfectly. I still feel weird, like pressure in my head (entire head, not just the left side). I went for a run earlier and the crowned tooth/area was pulsating a bit after. I'll just say, the root canal was done perfectly. No problem with that. I went and I got an x-ray. Here it is (the crown is the big one in lower-right side): I did get a second opinion. He looked at the crown, said it looks good, but he can't tell exactly unless I get an xray. I got a third opinion. She looked at the crown, and the x-ray, and did the bite test with the strips. She told me that "maybe" the crown is a bit high, maybe it's a bit too large. But still nothing conclusive! So here I am, I guess, looking for a fourth opinion. How does this all sound and look to you? Thank you so much. jdent106: Hi, were you able to get some type of resolve from this? Scorp: No, I didn't. This ruined my life. About 3 months after getting the crown, I got a filling on a tooth above the crown, and I got the crown next to the crowned tooth shaven down a bit after an occlusion check. On that day my headaches stopped So I was right, the problem was occlusion. A few days later while I was eating something, my TMJ (jaw joint) clicked on the right side, and it's all been downhill from there. My jaw joint on the right clicks, my right ear hurts, I have swollen lymph nodes on the right of my neck and under and behind my right ear. My right tonsil is swollen. And since about a week ago I have ringing in my head. I've been to about 25 doctors. Maxillofacial surgeons, oral surgeons, dentists, ENTs. They're all quite useless. I've had Xrays, CBCTs, and an MRI done. I learned nothing. I have no idea what the problem is, I have no solution. I'm holding on for dear life right now. I should have removed that crown after a few days and refused to have it put back in. But I didn't. I tried to make it work. I thought I'd find a good dentist and they'd know what the problem is and we can fix it. But no one cares. So there you go. Sorry, I wish I had some better news jdent106: Oh no. What kind of crown is installed? In your first post you mentioned you got Cerec crown. Is this new crown different. I recently got a PFM crown installed on my right lower molar 2 months and the dentist has just been brushing me off with the discomfort. I had shooting pain in my neck and ear. In this final visit I finally got a little relief in the last 3 days because they shaved the top tooth, and the contact has lessened but still odd sensations on this crown. Scorp: I got a zirconium crown. Well, if your problem is resolved, then you're good now, right? Are you still having discomfort? jdent106: I don't think its resolved because still having sharp pain after a specific point of contact on the crown that still shoots down my neck and ear. Also, get sporadic burning sensations in that specific gum area. Its weird, very uncomfortable, and affecting my sleep. Scorp: Did you have a root canal on that tooth? jdent106: Yes I did, the most odd thing that bothers me most, when I'm sleeping on the right side I get a jolting sharp pain that wakes me up out my sleep every night. Scorp: Are you sure the pain is from that tooth? Could it be from one of the other teeth nearby? Do you have pain in the tooth on hot/cold? Do you have pain in the tooth if you tap it with something? Does it hurt when you chew? jdent106: Most definitely isolated to that tooth. Tapping it is sensitive and there is a constant subtle throb sitting up right.. The xrays supposedly doesn't see infection. i don't know what to make of it at this point.

New crown gave me headaches, earache

worrier: I'm to have two fillings (composite molar restoration 2) on two teeth at the same side but one is upper, the other lower jaw. Is this likely to be unproblematic or should I request two separate appointments? Dr M: No it should not cause any issues.

'Composite molar restoration 2' on right upper and lower jaw at same appt.

Dental Impatient: My bite has been off for many years and I have insane bruxism. I've got two plans from two dentists on how to fix this. I'm biting on the inside teeth, and it seems my front teeth and back molars don't touch each other. One dentist wants to adjust the eight teeth that are taking the force of my bite down lower so my bite is more evenly distributed. The other wants to build up all the other teeth higher (with crowns) to make them even. Both options scare me for different reasons. Taking the teeth lower involves no new crowns, and is far less expensive, but I worry that my current situation is actually protecting my molars and front teeth from my bruxism, and I might start doing more widespread damage after that happens. The other option seems better in the sense that we're not grinding down teeth, but is much more expensive, and I'm concerned about getting a ton of new crowns. Any thoughts? I'm very conflicted.

Fixing a bite strategy

Goldzircstein: I just got a new temp crown on a lower back molar and my bite doesn't seem to fit as in the past. The temp is on the right and now the left side doesn't touch when my mouth is closed. I'm wondering if that's common and/or a potential problem I should be concerned about. I should be getting a permanent crown in two weeks. Dr M: It sounds like the temp crown is a bit high. Sometimes you can't tell initially due to it being numb. You can go back to the dentist to adjust it, otherwise there is a risk of you fracturing the temporary crown or you can develop severe headaches. Goldzircstein: Dr M said: It sounds like the temp crown is a bit high. Sometimes you can't tell initially due to it being numb. You can go back to the dentist to adjust it, otherwise there is a risk of you fracturing the temporary crown or you can develop severe headaches. Click to expand... Omg...thank you for letting me know. I emailed him and told him the left side barely touches anymore and he said it should be fine. Is there research or something I can show him to get him to adjust it rather than hoping it doesn't cause harm by the time I go for the permanent crown? Developing severe headaches doesn't really sound like that is a judgement call. Goldzircstein: Perhaps I should clarify that I am getting a crown because a large filling came out and I did not have a root canal. Goldzircstein: Dr M said: It sounds like the temp crown is a bit high. Sometimes you can't tell initially due to it being numb. You can go back to the dentist to adjust it, otherwise there is a risk of you fracturing the temporary crown or you can develop severe headaches. Click to expand... Yeah, every single dentist I've mentioned it to said roughly the same thing and that if the patient tells them it's high they always get them in to adjust it. Not sure why this dentist isn't having me back in to adjust it.

New temp crown, mouth doesn't completely close.

David L.: Hi, I have a molar that has been achy for weeks. My dentist says it needs a crown. The tooth is worn from grinding but has no cracks, chips, etc. and has never been filled. The dentist said filling is not an option due to the size of the divot and my grinding history. I’d prefer an onlay over a crown but his office does not offer an onlay option. I’ve considered finding a dentist who does onlays but first I’m wondering if an onlay would work on this tooth (#19)? Also, if a molar is prepped for zirconia, porcelain could the prep still support a gold crown at a later date? Or would the zirconia, porcelain prep remove too much tooth to redo the crown with gold? Thanks. MattKW: That is a typical erosion lesion, caused primarily by the intake of acidic foods and drinks, e.g. soft drinks, sports drinks, citrus fruits and drinks, chewable Vit C tabs, vinegar... Grinding habit is only secondary. Do you have any of these habits? How old are you? And do you have any Xrays (bitewings) so I can see other teeth? David L.: MattKW said: That is a typical erosion lesion, caused primarily by the intake of acidic foods and drinks, e.g. soft drinks, sports drinks, citrus fruits and drinks, chewable Vit C tabs, vinegar... Grinding habit is only secondary. Do you have any of these habits? How old are you? And do you have any Xrays (bitewings) so I can see other teeth? Click to expand... Hello and thank you. I'm 40. X-rays attached. I drank soda and ate candy regularly in my teens and twenties, but I've never had issues with my teeth other than a couple of cavities. I did buy an electric toothbrush a few years ago after the hygienist said my mouth showed signs of acidity. My diet is clean (post-workout sports drink, occasional citrus fruits). I floss and brush daily. This is the most worn tooth in my mouth. The tooth has dull ached before. It usually goes away after a few days, week. I assumed it was caused by grinding harder than usual (I wear a custom guard). This time the ache has persisted for over a month. The dentist says the enamel is gone from the chewing surface. He says filling could cause fracture. Also, continued grinding could cause fracture. He is recommending a zirconia, ceramic crown. MattKW: Thank you for the info and pics. Once you lose enamel, the teeth start getting sensitive. Yours are not the worst I've seen for a 40yo, but you're still only 1/2-way through your life. Also, it appears as if your front teeth have started chipping. If you still have a post-workout drink, at least rinse your mouth afterwards, and allow 30 mins for saliva to reach protective levels again. Really, I'd prefer you skipped sports drinks altogether (see attached). Also read conclusion to this. If you're eating citrus for the Vit C, then changing to bell peppers (capsicum), strawberries, tomatoes, cruciferous vegetables (broccoli, brussels sprouts, cabbage, cauliflower), or white potatoes will meet daily requirements. The cupping on that molar is moderate. It might be simply covered with composite. If there's not enough retention, then some minor drilling might be needed. At your age the pulp ("nerve") has receded enough to allow this. A crown is way overkill. Just drilling for a crown would potentially disturb the tooth much more than a small filling, and about 5% of crowned teeth need follow-up RCT due to such damage. IF... you did do a crown, then gold is the most conservative technique, and also the most tooth-friendly for the opposing tooth to chew. Prepping for zirconia is very destructive, and personally I think they are vastly over-rated. David L.: MattKW said: Thank you for the info and pics. Once you lose enamel, the teeth start getting sensitive. Yours are not the worst I've seen for a 40yo, but you're still only 1/2-way through your life. Also, it appears as if your front teeth have started chipping. If you still have a post-workout drink, at least rinse your mouth afterwards, and allow 30 mins for saliva to reach protective levels again. Really, I'd prefer you skipped sports drinks altogether (see attached). Also read conclusion to this. If you're eating citrus for the Vit C, then changing to bell peppers (capsicum), strawberries, tomatoes, cruciferous vegetables (broccoli, brussels sprouts, cabbage, cauliflower), or white potatoes will meet daily requirements. The cupping on that molar is moderate. It might be simply covered with composite. If there's not enough retention, then some minor drilling might be needed. At your age the pulp ("nerve") has receded enough to allow this. A crown is way overkill. Just drilling for a crown would potentially disturb the tooth much more than a small filling, and about 5% of crowned teeth need follow-up RCT due to such damage. IF... you did do a crown, then gold is the most conservative technique, and also the most tooth-friendly for the opposing tooth to chew. Prepping for zirconia is very destructive, and personally I think they are vastly over-rated. Click to expand... Thank you, @MattKW. I appreciate this information and your help. I will consult another local dentist about this issue and the potential of composite. You mention the possibility of "minor drilling" - would that be an onlay? Also, out of curiosity, I asked the dentist if a zirconia/ceramic crown could eventually be replaced by a gold crown. His response was, "Yes, the gold crown would just have to be thicker to accommodate the zirconia/ceramic prep." Is that true? Could a tooth that has been prepped for a zirconia/ceramic crown someday support a gold crown? Thanks again. MattKW: Minor drilling - I mean making the existing cupped-out lesion a bit deeper and squarer for a normal small composite filling. The dentist told an inaccurate statement. A gold crown prep is the most minimal thickness of any dental crown material. Monolithic zirconia (solid zirconia) requires slightly more drilling. Layered zirconia (zirconia with a layer of porcelain) or full porcelain requires more thickness again; and is liable to chipping. Porcelain-fused-to-metal is similar to layered zirc (attached 1 with my annotations). Also, gold is gentler to the opposing teeth when chewing, and zirconia is not advised in bruxers (attached 2). David L.: @MattKW, it's very kind of you to help people this way. Thank you. Goldzircstein: @MattKW , If a gold prep is the most minimal thickness, would that preclude a gold crown from being modified to go on a tooth that has received a pfm or zirconia prep? MattKW: No, you could place a gold crown on one that had been prepped for PFM or zirconia. The gold could be a bit thicker than necessary, so it would simply cost you more. Goldzircstein: Good to know, thanks for responding. Goldzircstein: How much metal would typically go into a crown for a molar? Is there a way of figuring out what the lab fees for a gold crown would be? There are dental fee guidelines in some places but sometimes they say " + Lab " w/o specifying how much that part would normally cost. MattKW: It would depend upon the quality of the gold alloy (preferably high precious) and the amount required (per gram). Unfortunately, the lab wouldn't be able to give an exact quote on the amount required until they had an impression of your prepared tooth and could see how much was required. However, they might be able to give you a range of usual costs. Most people want yellow high precious (yellow gold); my lab used Bego PontoLloyd G at 84.4% Au (see attached). You can see that in this brand, white high precious kicks in when the gold content drops below 80% Au. To qualify as a high precious there must be 60% noble metal, of which more than 40% must be gold. For a very good layperson overview of dental alloys, go to here. Goldzircstein: Hello again, and thank you for your invaluable assistance. I've heard that many dentists in North America use labs that are in far away Asian countries so as to be able to make more profit on the crown. The profit part doesn't really bother me but is there any way to be certain of the quality control? Are the dental prosthetics labs regulated with transparent oversight? Does the dentist and/or patient have a means of verifying that the crown is made of what it is supposed to be made of? MattKW: Ask your dentist if they use a local lab. Ask to see the itemised invoice if you want to check on the gold alloy used.

Onlay or Crown?

ChippedToothFairy: Last year I chipped a small part of my front top tooth on a fork... I was eating dinner quickly before going to the hospital. Bummer. I went to my dentist and they recommended a filling or shaving the tooth. I thought a filling sounded great. What I didn't know (and what no one told me) was that they would be shaving/drilling down part of the tooth to make room for the filling. Fast forward 7 months and the filling just fell out. Now I'm left with worse tooth damage than I had before. Photo attached at bottom of post! The dentist gave me three options: Put a filling back in Get a veneer on that tooth Shave down/smooth out the tooth (I added this one) do nothing I really don't want to lose more of the tooth since it's a healthy tooth otherwise. I use a bite guard at night, not sure if that's factor. What's my best option? If I do nothing is that bad for the strength of the tooth? Thanks so much for reading, this has been stressing me out and I'm just angry at the whole situation. No smoking, occasional drinks, no medical history. MattKW: Do nothing Reattach filling, a simple etch/bond/filling Smooth off, but only just enough to take off rough edges on the lip side (labial) of the tooth. Do not take away vertical height or it will look even worse. Do not veneer - too destructive Why are you using a bite guard? Is it custom made by a dentist or an internet one-size-fits-all type?

Chip Led to Broken Filling on Top Front Tooth... Dentist Gave Three Me Options...

oceanmd: Please help me understand and address the situation correctly. I have the zirconia implant-supported screw-retained crown placed today on a custom abutment on a bottom first molar (#30). After the procedure was complete, I was surprised to see a thin dark line at the gumline. There is this thin dark line between the manufactured tooth and the gumline. To me, it looks like the abutment is too long and shows above the gumline. I would greatly appreciate professional advice and opinion and also personal experience with the appearance of the implant-supported crowns at the gumline. MattKW: Pics? It's likely that it is the implant you are seeing, but who cares if it's out of sight to other people?

Urgent Advice Needed after Zirconia Implant-Supported Crown Placed

oceanmd: Please help me understand and address the situation correctly. I have the zirconia implant-supported screw-retained crown placed today on a custom abutment on a bottom first molar (#30). After the procedure was complete, I was surprised to see a thin dark line at the gumline. There is this thin dark line between the manufactured tooth and the gumline. To me, it looks like the abutment is too long and shows above the gumline. I would greatly appreciate professional advice and opinion and also personal experience with the appearance of the implant-supported crowns at the gumline.

Urgent Advice Needed after Zirconia Implant-Supported Crown Placed

dentalquestion: I have a molar with a large 30+ year old amalgam filling, and there now appear to be cracks in it (a known risk of amalgam filling metal expansion from heat). It may eventually need a crown... For crowns, my understanding is that gold alloy is generally the longest lasting and requires the least removal of tooth material. Are there any disadvantages of gold alloy versus other crown materials besides appearance (which is not a concern for me for a molar, since no one else outside a dental office will see it)? Is there any difference in how likely it is to fall off? Are other crown materials less opaque to X-rays, and does that make any difference in the usefulness of X-rays to detect problems under the crown? MattKW: Firstly, let's dispel the myth that amalgam causes cracking. It certainly doesn't cause it from heat expansion. It can weaken teeth more than composite because amalgam doesn't bond (glue) to teeth and sometimes need more tooth structure removed than a composite. As a teacher in clinical dentistry, I encourage students to try amalgam in selected cases; it is sometimes much better than amalgam; unfortunately it is grey! Gold alloy is my preference for 2nd molars. Minimal preparation and has similar wear characteristics to enamel of opposing teeth. Monolithic zirconia (not layered zirconia) can also be used in a similar fashion. but... crowning a tooth causes indirect damage and there is ~8% chance of the nerve dying. If that happens, then it is easy to cut through gold alloy and do an RCT, and keep the crown. If you cut through zircionia (really tough!), then you will have to replace the crown. If I ever need a crown, it will be a gold alloy. The glue that holds either a gold crown or a zirconia is about the same amount of grip. The glue should not be the determining factor in holding on a crown. With special treatment it is possible to get a better grip on zirconia than gold, BUT the preparation of the crown with fairly parallel sides is more important. Most crowns I have seen come off have been where they were over-prepared (too tapered). Radio-opacity doesn't really matter. If you develop decay under any crown, it will be at the margin where the crown meets natural tooth. Decay will go under the crown and also below the crown onto the root surface. So, it will be visible on the root surface anyway, and that's enough reason to assume the same amount is under the crown, and requires the removal of the crown. dentalquestion: Would lithium disilicate be similar to zirconia in the above (and similarly less desirable than gold alloy for molar crowns)? MattKW: Lithium disilicate should not be used for molars, only up to 2nd premolars. It has a better translucency and "look" than gold or zirconia, but much weaker.

Crown for molar: gold alloy versus lithium disilicate, zirconium, etc.

sunshower21: The tooth in question has already been drilled to a nub and a temporary crown put on top. No root canal was done. It started giving me pain all of a sudden when I would drink coffee and would last for an hour. I called my dentist thinking there might be a crack in the crown. He prescribed me antibiotics and it actually worked. I go in today, took an xray, there was no crack and he tells me he wont be able to do the root canal bc it would damage the crown and my insurance wont pay for a new one. He said I'd have to go to a specialist to get a hole drilled in my crown and do the root canal that way (which would take 2 hours) instead of taking it off. I'm a little angry at the whole insurance issue. Has anyone been in a similar situation and had to get a root canal through your crown? Is there any easier alternative? MattKW: So, do you still have the temporary crown in place or has the permanent one been cemented? Do you have xrays to show us? sunshower21: The temporary is still in place. Unfortunately, I do not have an xray MattKW: If it's only a temporary crown, then it's made of plastic, and glued on with a temporary cement. You haven't paid for the completed crown and therefore haven't claimed through your insurer. An endodontist would simply remove or drill through the temporary, then you can get the real crown cemented. There won't normally be much change to the underlying tooth, so if the permanent crown has been made and is waiting for you, it should fit on easily after the RCT is finished.

Root Canal Through Crown. Any Alternatives?

oceanmd: Hello, How can I see the difference between a Zirconia crown and Porcelain/Ceramic crown? There was some confusion in ordering the correct kind of crown. I am supposed to have an Esthetic screw-retained Zirconia Crown but the paperwork states Porc/Ceramic Crown. When I see the crown, how can I tell that it really is Zirconia? Thank you very much MattKW: Ceramic is a general term encompassing silicate ceramics (of which feldspathic porcelain is a subgroup), polycrystalline ceramics (of which zirconia ceramics is a subgroup), and resin matrix ceramics. So, the paperwork is a bit ambiguous, and you won't be able to tell just by looking at it. Ask to see the lab invoice which should have more details including a brand name. oceanmd: Thank you very much. I was told that there is no special code for Zirconia, so they had to use Porcelain/Ceramic code D6058. Is it unusual to ask for a lab invoice? MattKW: That sound fine. It would be unusual, but you are within your rights. For example, with implants I make sure to give the patient all the barcodes and related info so they know they are getting genuine parts, and can easily show to another dentist if any issues arise - I won't live forever! oceanmd: Thank you so very much for your help. I will see if I can diplomatically ask for the crown invoice.

Zirconia Crown vs Porc/Ceramic Crown on the Implant

Goldzircstein: Basically, the title is my question. I have gotten conflicting answers and would like to know whether there is a clear winner. I thought gold was the clear winner.

Is it possible to preserve a tooth and opposing teeth better with a zirconia crown than with a gold crown?

LSxBakakos: Hoping to hear some positive news lol 10 weeks ago I had 5 teeth extracted(wisdoms plus another) and one bone graft done. I had been seen at 1&2 week intervals. No infection was present, however I did have irritation but I was reassured i was healing great. I'm 10wks post op, have a part of gum tissue that seems to be alternating between a light reddish/pink and normal gum color. My camera makes it a little bit more red looking than in person. I am a smoker, however I believe I hit the graft site with a piece of crust the other day. When I got home last night it looked inflamed I had dabbed a tissue on it and saw a tiny bit of pink. Other than one time when I had caught a non absorbed particle has it bled, normal brushing normally does not seem to have any affect on it unless I still am brushing too rough. I'm paranoid with healing after I had a nasty infection prior to the surgery. I'm hoping it's just my mind and that I'm in good shape as far as healing but would like an experts advice. The few websites I've seen has similar images to 3,4,5mo intervals however I've only seen one other with this kind of pigment LSxBakakos: LSxBakakos: Update. I do believe where the bump was a tiny part of graft particle pushed its way out, this is how it's looked so far today. Spoke with a friend's wife who was a dental tech, she said it didn't look infected, but did look like it was irritated. Also was told salt water rinses shouldn't be longer than 2wks or irritation will occur, I've been doing them for the last 10... Still would prefer a doctor's opinion Thanks in advance MattKW: Looks OK. There is no problem with continuing salt water rinses; it's just a mild antiseptic. However, smoking is a risk factor in healing, and also for the longevity of implants. LSxBakakos: I can't even explain how greatful I am for your response, truthfully, thank you thank you thank you! That's also good to know I can continue salt water, since I've stopped using it and went to an alcohol free mouthwash the graft has less of a "raw" feeling to it. Also the spot where it keeps changing color(did it last night as well) is that just pigment or granulation tissue changing? As far as smoking I've recently been trying to cut down, I know it's not a cigarette/juul but regardless it's not a good habit to keep LSxBakakos: Sorry, tried to edit but it wouldn't allow. I meant it is not a cigarette, and is a juul, but I'm sure just as bad MattKW: If it contains nicotine, then unfortunately it's bad for gums, healing, and implants. And we still don't know the long term effects of the other ingredients in vaping yet, but it's not looking good. LSxBakakos: MattKW said: If it contains nicotine, then unfortunately it's bad for gums, healing, and implants. And we still don't know the long term effects of the other ingredients in vaping yet, but it's not looking good. Click to expand... Well thank you for that link, Ive been wanting to kick the habit for a while, and I think that may just get me to that point. Also I hate to bother you again. Fingers crossed the white is new tissue forming and not the graft becoming exposed? MattKW: If you mean the white tissue as arrowed, then this is just peeling skin outer layer because you haven't been able to brush it for a while. The mouth doesn't form dry scabs, just wet ones that can often appear white. LSxBakakos: MattKW said: If you mean the white tissue as arrowed, then this is just peeling skin outer layer because you haven't been able to brush it for a while. The mouth doesn't form dry scabs, just wet ones that can often appear white. Click to expand... No sir, but I always have wondered about that too, so thank you for that as well! I'm unsure if it's just non absorbed material since it looks different from the others but the almost white streak matter that's above the arrow here

Paranoid about preservation graft healing

kedalene: Hi All Please refer any Dentist near Seng Kang who is willing to do filling without adding pressure about root canel treatment? Kedalene MattKW: Maybe you really need an RCT. Any Xrays to show us?

Dentists who do filling

bobecus: I have existing implants on #8 and #10. They are a few years old and are very solid. An existing crown on #9 broke off at the gum line. Course of treatment is a 3 unit implant supported bridge on 8,9,10. 9 has been extracted, however the Dentist is requiring 8 weeks healing prior to doing the impressions. Is this length of time typical? What is the reason for the long wait. Any thoughts are appreciated.. MattKW: 8 weeks is the minimum, I would prefer 10-12 weeks. The gum will heal over within 2-3 weeks, but the bone keeps shrinking (remodeling) over following 2-3 months. If you do the bridge earlier, then a gap will slowly appear, and it'll be annoying. Wait for maximum bone shrinkage. bobecus: I’m scheduled for impressions at 8 weeks. He’s doing placement 3 weeks later as we’re embarking on a cruise 3 weeks after that. The temporary is acrylic and I want to vacation without the very breakable temp on my front teeth. I hope that this works out. Thank you so much for your opinion It’s 5 weeks today.

Implant Supported Bridge

william007: See your dentist right away if you've recently fallen and have a toothache. Even if the discomfort appears to be mild or goes away on its own, you can still have dental or gum issues that require attention. A toothache brought on by a fall may occasionally be an indication of a more serious injury, such as a cracked or chipped tooth. Your dentist will check your teeth and gums, perform any required X-rays, and provide you with medical guidance to help you manage your pain and avoid developing future issues. Make an appointment with your dentist right away if you have a toothache.

Don't Ignore Tooth Pain After a Fall

lindseyf193: I have a cerec crown on my back upper molar. It had to be adjusted some because my bite was too high. The dentist mentioned as he was shaving it down how he didn't want to do as much as he did because of the chance of it cracking, chipping, or breaking but my bite was still very uncomfortable until he did more. I am now worried, however, of the crown failing. What are the chances of this happening? I don't want it to mess up in my day to day. MattKW: Was this the very last molar, a 2nd molar?

Cerec Crown Adjustment

emilionorris: A root canal is a dental procedure performed by a dentist to treat a damaged tooth. This procedure involves removing damaged or infected pulp from inside the tooth, cleaning, and disinfecting the root canal. When the pulp becomes infected or damaged due to tooth decay, trauma, or other causes, it can cause severe pain, sensitivity, and swelling. If left untreated, the infection can spread to surrounding tissues and cause serious problems. This kind of dental problem is usually treated with the root canal method.

What is a root canal?

DDavid: My 18 year old daughter is missing a lateral incisor tooth. The orthodontist made room for a new tooth. We have 2 proposals (1) a maryland bridge and in 10 years an implant (2) right away an implant. One dentist saying it is too soon for an implant. The other one proposed to take images of the mouth and see if an implant is immediately possible. MattKW: It is generally assumed that by 18yo the face (esp the upper jaw) had ceased growing. The risk is that placing implants at an earlier age may allow the bone to overgrow the implant, so that the fake tooth starts to be left behind as the growing bone moves the real teeth downwards. The attached 2019 article 1 reviews this concept in patients <18yo, and shows cases of implants as early as 10yo. If you look at the parts I've highlighted, the successful studies (<10% failure rate with a long follow-up?) with young children involve small number of patients. The second study article 2 shows that studies suggest that facial growth usually stops at 18yo, but in some people may continue afterwards, and there was no absolutely reliable way of determine when facial growth stops. My daughter also missed growing her upper lateral incisors, and I forced her to wait till she was 21yo before implant placement. She is now 35yo without complications. Maybe I could've had them placed at 18? Maybe her growth might've continued after 21yo, and she was just lucky? Maybe as a female she really did stop growing younger than if she had been male? There are no absolute certainties. So, 18 is an acceptable age with usually minor risk. However, if you can wait a few years, then your risk lessens - just don't ask me for risk percentages! Placing Marylands bridges is a nice way of delaying the implant, but I see very few cases where Marylands can be successfully applied, and cases where they have caused more harm than good. If your daughter is badgering you, then I think 18yo in a female is quite acceptable; to wait until 28yo is definitely overkill. DDavid: MattKW said: It is generally assumed that by 18yo the face (esp the upper jaw) had ceased growing. The risk is that placing implants at an earlier age may allow the bone to overgrow the implant, so that the fake tooth starts to be left behind as the growing bone moves the real teeth downwards. The attached 2019 article 1 reviews this concept in patients <18yo, and shows cases of implants as early as 10yo. If you look at the parts I've highlighted, the successful studies (<10% failure rate with a long follow-up?) with young children involve small number of patients. The second study article 2 shows that studies suggest that facial growth usually stops at 18yo, but in some people may continue afterwards, and there was no absolutely reliable way of determine when facial growth stops. My daughter also missed growing her upper lateral incisors, and I forced her to wait till she was 21yo before implant placement. She is now 35yo without complications. Maybe I could've had them placed at 18? Maybe her growth might've continued after 21yo, and she was just lucky? Maybe as a female she really did stop growing younger than if she had been male? There are no absolute certainties. So, 18 is an acceptable age with usually minor risk. However, if you can wait a few years, then your risk lessens - just don't ask me for risk percentages! Placing Marylands bridges is a nice way of delaying the implant, but I see very few cases where Marylands can be successfully applied, and cases where they have caused more harm than good. If your daughter is badgering you, then I think 18yo in a female is quite acceptable; to wait until 28yo is definitely overkill. Click to expand... Thank you so much. Much appreciated. This is very helpful. MattKW: Glad to help. Those 3 extra years I made her wait made me age 10 years! She still loves me.

Replacing a missing lateral incisor tooth

RanaShiva: I have cavity on my front teeths(between the two teeths). The dentist cleaned the cavity and didn't put in fillings and asked me to keep them clean. Asked me to buy a flosser and floss after every meal. He said for fillings he will need to drill more. I can come later if that's what I want. Any advice please.

Teeth restoration

Emma B: HI is there a way of telling if your filling is stained or leaking ? i visited a NHS dentist recently who did not say there was any issue with a filling said the stain could probably be polished out. I had to go to a private dentist for other work who said the filling is leaking and needs replacing. How can i tell. is it worth replacing front tooth fillings for aesthetic purposes he said he wont need to remove more tooth but I'm really concerned about having a filling unnecessarily as would rather keep my tooth for as long as possible he is going to use composite filling. thanks in advance for any advice Dr M: A stain could be an indication of leakage, although an x-ray would be required for an accurate diagnoses. If there is indeed leakage and it is left untreated, the decay could spread and lead to further tooth destruction. MattKW: You can develop stains around the edges of composites if they were not etched widely enough, or if the bonding resin extended past the edge of the etch surface, or if the bond id degrading, or if there are large dorces applied to the filling over time. It is common to have to polish front composites back at say, 5-10 years. If the staining goes too deep, it may require a new filling, but it may not become apparent until you are doing the polishing back. If there's decay under the filling, it will show up farther away from the edges, and Xrays are not a reliable indicator. I'd go to the NHS dentist first and see how it goes. Emma B: MattKW said: You can develop stains around the edges of composites if they were not etched widely enough, or if the bonding resin extended past the edge of the etch surface, or if the bond id degrading, or if there are large dorces applied to the filling over time. It is common to have to polish front composites back at say, 5-10 years. If the staining goes too deep, it may require a new filling, but it may not become apparent until you are doing the polishing back. If there's decay under the filling, it will show up farther away from the edges, and Xrays are not a reliable indicator. I'd go to the NHS dentist first and see how it goes. Click to expand... Thanks for the advice Emma B: Dr M said: A stain could be an indication of leakage, although an x-ray would be required for an accurate diagnoses. If there is indeed leakage and it is left untreated, the decay could spread and lead to further tooth destruction. Click to expand... Thanks for the advice emilionorris: Replacing front tooth fillings is a common dental procedure that may be needed for a variety of reasons, such as: Wear and tear: Over time, dental fillings can become worn or damaged, leading to decay or other dental problems. Discoloration: If your front tooth fillings are discolored, they can affect the appearance of your smile. Cracks or Chips: If your front tooth filling has cracks or chips, it will need to be replaced to prevent further damage to your teeth. Decay: If decay has built up around or under your front tooth fillings, they may need to be removed and replaced to prevent further damage to your teeth. The specific materials used for your new filling may depend on your personal needs and preferences as well as your dentist's recommendations.

Replacing Front Tooth Fillings

Jonathon: I had a molar crowned six months ago. It still hurts to chew and cold is sensitive. I've been told I need a root canal. Can I wait or avoid the root canal if the pain and sensitivity are manageable? Or could not getting the root canal cause more damage to the tooth? Thanks. MattKW: Sure, you can wait. It won't get better, and won't do any more harm to the tooth.. Be careful the of type and quantity of painkillers you are taking. Jonathon: Thank you, @MattKW. I'm not using painkillers. If they become part of managing I would consider treatment.

Will tooth get worse without root canal?

Catirf: Hello! I’m struggling to tell which one is it. The restoration had recently been done when this X-ray was taken. A temporary glass ionomer restoration was made before the permanent resin one. It’s very radiolucent and defined. Thank you in advance! Dr M: It might be a space or it might be caries left over. Difficult to say exactly. I would make sure the cavity is clean, perhaps by using a caries indicating dye, before the permanent resin filling is placed MattKW: It would be easier to assess if that was a bitewing (perpendicular) Xray rather than the periapical (PA) that you are showing. Looking for possible caries using PAs can be misleading.

Is this a radiolucent base or lack of material?

Michael Thomas: Hello, I had a zirconia layered with porcelain crown placed on a molar in October of 2022. I'm still having pain when I chew, sensitivity to cold and an occasional dull ache. My dentist (who has gold crowns) told me it could take six months for the sensitivity to subside. I know that metal conducts temperature but my crown isn't metal. My dentist does not think a root canal is necessary but the only feedback he's offered is to be patient. My concern for the tooth is growing. It feels like the healing process has slowed, stalled. Should I continue waiting? Could waiting be problematic? I've considered consulting a different dentist. Feedback, thoughts are appreciated. Thank you. Dr M: It can always be helpful to get a second opinion. Has the bite or occlusion been checked? Do you have any x-rays of the involved tooth? MattKW: A few things to consider: A tooth that has got to the point of needing a crown has usually been filled a few times, and the pulp accumulates the damage. Then you get a crown prep which is a further insult. About 5-10% of crowned teeth end up needing root canal therapy (RCT) because of 1. and 2. All ceramic crowns require greater cut-back than a good gold crown, so there is more damage to the tooth than a gold crown. Bonding to zirconia is more tricky than other ceramics (or gold) There may be other issues e.g. poor margins If a crown isn't starting to settle within 2 weeks, I get concerned.

Crown Pain at Five Months

SonicExplorer: Hi, About 40% of the #30 (lower right molar) cracked off. See photo... Can this likely be crowned, assuming the integrity of the rest of the tooth is in good shape? My concern is the fact it cracked at the gum line (no pain tho). I'm hoping a skilled dentist can use that edge as the crown margin on that side? Just wanted to get some opinions to be better armed before seeking dental help. Sincere thanks, Sonic Dr M: A crown might be possible. If the pulp chamber is close to being exposed, an additional root canal might be needed. Do you perhaps have an x-rays? SonicExplorer: Yep, here's the wings and panoramic. Taken about 18 months ago right before I got the first few crowns done - so of course not reflecting the recent #30 break. Mouth always in great shape, never any issues or disease, only fillings as a young kid. But after having them filled 2 or 3 times during my lifetime they are now starting to fracture... Dr M: Should be possible to crown this tooth SonicExplorer: Much gratitude for the replies. Do the X Rays provide any insight as to the likelihood for root canal / pulp chamber being exposed? Asked another way, Is your inclination the tooth can likely be crowned with just a prep/build up? SonicExplorer: Forgot to ask, might an on-lay be another/better alternative to a crown in this scenario? MattKW: It's a bad break because it has gone below the gumline. A crown will not get much grip on the broken side (lingual). If you try another gold crown as on the adjacent tooth (I love gold crowns), it may well fail. Even building up some sort of core (pin retention?) is not much better. You need a bonded ceramic crown (or onlay encompassing the buccal cusps) and still cross your fingers for the long term. I would design the crown/onlay with quite flat lingual cusps with no contact during normal lateral movements. Sometimes we have to make a compromise if you want longevity. SonicExplorer: MattKW said: It's a bad break because it has gone below the gumline. A crown will not get much grip on the broken side (lingual). If you try another gold crown as on the adjacent tooth (I love gold crowns), it may well fail. Even building up some sort of core (pin retention?) is not much better. You need a bonded ceramic crown (or onlay encompassing the buccal cusps) and still cross your fingers for the long term. I would design the crown/onlay with quite flat lingual cusps with no contact during normal lateral movements. Sometimes we have to make a compromise if you want longevity. Click to expand... Thanks. I understood everything except the 'why' regarding a ceramic crown. Can you please elaborate why you suggest a ceramic crown is recommended over a gold crown in this instance? (Is bonded ceramic a 3D printed/Cerec type of crown?) Thanks MattKW: Gold crowns are not glued onto a tooth. Although a cement is used, the cement (glue) may stick (adhere) to the tooth, but will not stick to gold. So, in most situations with gold crowns, we want a lot of tooth structure with parallel sides so that the grip is more frictional than adhesive. The gold crown on your 2nd molar will be "glued" like that, and that's how most gold crowns are done. Similarly for zirconia crowns (which are a non-silica-based ceramic), it is technically very difficult to get a "glue" that sticks to the zirconia, so you want as much tooth structure as possible. Your fractured molar has very little real tooth left, so you would want a silica-based ceramic or a resin-crown which will allow a "glue" to stick reliably both to the tooth AND the crown. CEREC crowns are typically zirconia, although I think they make a resin type too. The main advantage to a CEREC crown is that it can be made on the same day as the preparation of your tooth - that's it, no special physical qualities. SonicExplorer: MattKW said: Gold crowns are not glued onto a tooth. Although a cement is used, the cement (glue) may stick (adhere) to the tooth, but will not stick to gold. So, in most situations with gold crowns, we want a lot of tooth structure with parallel sides so that the grip is more frictional than adhesive. The gold crown on your 2nd molar will be "glued" like that, and that's how most gold crowns are done. Similarly for zirconia crowns (which are a non-silica-based ceramic), it is technically very difficult to get a "glue" that sticks to the zirconia, so you want as much tooth structure as possible. Your fractured molar has very little real tooth left, so you would want a silica-based ceramic or a resin-crown which will allow a "glue" to stick reliably both to the tooth AND the crown. CEREC crowns are typically zirconia, although I think they make a resin type too. The main advantage to a CEREC crown is that it can be made on the same day as the preparation of your tooth - that's it, no special physical qualities. Click to expand... Excellent explanation, thanks for that. I am however somewhat perplexed in that I thought a build-up was to reconstruct portions of missing tooth so it could be properly crowned. Modern technology involves incredibly durable build-up materials (so I'm told). In my mind I picture leaving the buccal side largely in tact as an underlying lateral sheer stabilizer, with the lingual side built up, so under a gold crown it shouldn't fail from lateral forces. And the crown would have friction from buccal tooth material on one side, with build-up material on the lingual to hold it in place. Again, this is me knowing nothing but generalities, but hopefully I explained that adequately. I do understand the notion of wanting the best adhesion possible, but am still not quite following why a gold crown would be more likely to fail in this scenario than other teeth I've cracked above the gumline. Unless a build-up does not provide sufficient tooth substitute for friction to hold a crown in place over the longer haul. Is that basically the concern in my case with using a crown other than a silica-based or resin ceramic crown? MattKW: A gold crown made for tooth fractures above the gumline can be great. You need a fair amount of tooth all around to take the lateral forces of chewing, because there will be no bonding. Yes, if there's not a lot of tooth structure above the gum you can compensate by building up a composite core, but the main strength for an unbonded gold comes from whatever natural tooth you can use. In your case, you have NO natural tooth wall on the lingual side. If you did a core build-up before making this crown, the buildup would either be composite with pins(?) (bonded) or amalgam with pins (unbonded). Pins won't really help in such a big fracture, so I wouldn't bother. So, you might do a bonded composite core, then shape it to take a gold crown. The strength still depends on the bonding of the core - no advantage, just an unnecessary step. You are no better off (and arguably slightly worse off) than simply using a solid bonded ceramic, a lab-made bonded composite crown, or a CEREC bonded resin crown. So much depends on a good bond across that large fractured area. There's still a moderate risk that it will all fail. If this tooth was already dead and root-filled, I would extract and do an implant. You have an option to try and save the tooth only because it is still alive. SonicExplorer: MattKW said: A gold crown made for tooth fractures above the gumline can be great. You need a fair amount of tooth all around to take the lateral forces of chewing, because there will be no bonding. Yes, if there's not a lot of tooth structure above the gum you can compensate by building up a composite core, but the main strength for an unbonded gold comes from whatever natural tooth you can use. In your case, you have NO natural tooth wall on the lingual side. If you did a core build-up before making this crown, the buildup would either be composite with pins(?) (bonded) or amalgam with pins (unbonded). Pins won't really help in such a big fracture, so I wouldn't bother. So, you might do a bonded composite core, then shape it to take a gold crown. The strength still depends on the bonding of the core - no advantage, just an unnecessary step. You are no better off (and arguably slightly worse off) than simply using a solid bonded ceramic, a lab-made bonded composite crown, or a CEREC bonded resin crown. So much depends on a good bond across that large fractured area. There's still a moderate risk that it will all fail. If this tooth was already dead and root-filled, I would extract and do an implant. You have an option to try and save the tooth only because it is still alive. Click to expand... All I can share about the buildup is they use something (I think from different materials from a dual sided syringe?) and then used a UV light to harden it almost instantly. I recall they said the new bonding materials are so strong they can almost act as a tooth by themselves. But I suppose that doesn't necessarily mean it bonds well to the tooth...which is what I think you are trying to convey as one of the main issues with considering the gold crown vs. another type that is better suited for bonding in my case. Thank you (and Dr. M) for sharing your excellent knowledge and insight. It is tremendously helpful, and I'm sure it will help other forum members who read this discussion in the future. Sonic SonicExplorer: Correction, meant to type "I recall they said the new buildup materials are so strong they can almost act as a tooth by themselves." MattKW: No problem. It just seems like doubling-up unnecessarily to bond the crown to a bonded core. It's really just the bond of the core, or the bond of a ceramic crown directly to the tooth, that will ultimately determine your chances. And keep the cusps flat-ish.

Need Opinions - Can this likely be crowned?

Michael Thomas: Hi, I had a crown placed on a molar (bottom left). After three months of headaches my night guard cracked. The dentist said the crown was too high and filed it down. The headaches have stopped but my (once even) bite now feels much heavier on the right side. Is it possible a crown being too high for three months could change, damaged my bite? Would having the crown redone fix the problem or would it require braces, etc.? Thank you. Dr M: Good day I don't think it is necessary for a new crown and/or braces. The dentist most likely took the crown out of your bite, which now makes it feel like you are biting more on the right, than the left. This was done due to you having 3 months of constant pain. I would suggest getting a new bite plate made for now. Chances are you will get use to this new " normal".

Did crown damage bite?

Attire5515: https://imgur.com/a/GFA82vV Please see my current state above Long story short: i am 25, male, i have lose 6 teeth so far, so I have 26 teeth left and not in the best condition despite all efforts by me. My dentists haven't been the best ones so far for sure. I lost one tooth next to the left upper incisor because it was badly decayed so the dentist told me I required a root canal, but he didn't protect what was left of the tooth with a crown. One day my tooth literally broke to pieces, I had to wait 5 days till a clinic took out the remains of my tooth out of my gum. Ever since I waterfloss 2x a day religiously, never miss a day. Brush 2x or 3x a day for around 4 minutes each. All 3 surfaces of every tooth. Floss the lower arch with string floss. Cannot yet floss the upper arch with any sort of floss other than waterfloss, I have an upcoming appointment with the dental hygenist so I'll ask her to show me how I could do that because my mouth is very narrow, small and I can't get the angle right. My teeth still keep on hurting almost every day for a couple of hours even tho I really take as much care of them as possible. I also require jaw surgery because my jaws are very recessed, small, underdeveloped, just like my bite. My parents badly neglected my health when I was a kid by not putting me on braces, probably I wouldn't have anywhere near the issues I am having every day had they been good parents. Wouldn't it be best to take out all 26 of them, replace them with 2 all-on-4 implants (upper and lower arch) so with that not only would I get my bite back (I can't chew with most of my teeth, only with my maxillary and mandibular molars in the back on the sides) but also I could just get straight into the jaw surgery without wasting 2 years on braces. Again, I should have got braces back when I was 12 but my parents messed me up real good. If only I could turn back the wheels of time. Needless to say, I have completely changed my diet ever since. Take every vitamin, mineral, eat a dairy-rich diet, lean meat as well, very very minimal sweets and energy drinks if any at all on most days. Also many of my teeth are rather loose or at least feel that way according to my latest dentist. Please, any input, thoughts, recommendations would be GREATLY appreciated, thank you very much in advance, heartfelt.

Am I candidate for all-on-4 at 25?

Emma B: Hi my top left incisor has been taken out and I'm trying to weigh up my options. My dentist suggested a traditional bridge as the two supporting teeth have fillings and could be improved by crowns. I have been researching on the internet before making a decision and I'm finding some places say the two supporting teeth have to be healthy to give enough support but then others say if they need crowns due to being filled then would be a good idea to have a bridge. I also was wondering if a Cantilever bridge would be possible as don't like the idea of three teeth being affected if something goes wrong. Thanks in advance for any advice ​ MattKW: When you say, "top left incisor", do you mean the large one next to the midline (central incisor) or the smaller ones 2nd from midline (lateral incisor)? A photo would be helpful, and Xrays of adjacent teeth too, pls.

Bridge when neighbouring teeth have fillings

Kels_: I recently had several fillings done. however, I am thinking of a back molar (back left) the filling is slightly too low. Suddenly I am feeling like my front right upper tooth and one of the front bottom right teeth are hitting and it hurts but NO work was done around there. I also feel a little edge where the filling is not flush with my tooth on the back left the tooth is higher its slight but I can feel it with my fingernail. definitely is not high on the back two molars there had fillings. a week prior to the back molar fillings the same dentist replaced two fillings in my upper molars one on each side of my jaw. that had caused bite issues as well, I had one adjustment the next day it felt high and the following adjustment the day he did the lower molars. he had to adjust my right premolar to stop them from hitting a new spot. It's been now nearly 2 solid weeks since my bite is wrong (and seems to change to some extent) and I am not sure what it should feel like anymore but I know it didn't hurt anywhere at all before. I did say I was concerned about doing more work before my bit was good. and now so many things have changed I'm just confused. I also now have a mild dull ache on my upper right molars one of them had a filling replaced 2 weeks ago but I had no dull ache that I am aware of until this week after he did the lower left back molars. (Perhaps the area he adjusted was caused more discomfort I didn't notice the ache but I think I would have) So my un-education theory is that the lower left molar filling or fillings are slightly too low causing extra pressure on my right upper jaw as well the front right teeth. It is extremely hard to find any information on a bite being off because of a low filling... Is this a thing? What does this sound like? The fillings are composite, if the filling is low can it be added too? what should happen if it's low? I am supposed to go in on Monday morning. If he wants to adjust the high teeth that had no work to them and just smooth the edge of the back tooth is that something that is ok? I am worried that at this rate every tooth is going to be slightly ground down to make my bite good. I had braces as a kid and prior to this work, I had no complaints of pain or toothaches. I don't wanna cause more harm. Kels_: MattKW: You wouldn't notice it if a standard filling as you show was too low. A high filling is immediately noticeable because the tooth will take more force than expected, but is easily adjusted and will provide immediate relief. There is likely to be some mild discomfort for up to 2 weeks after a fresh filling. Composite fillings are much more technique-sensitive and likely to cause post-op sensitivity than amalgams, and continued sensitivity after a composite may require redoing the filling, or replacing with an amalgam. I've seen many patients where they have had multiple useless "adjustments" after composites rather than having it redone. Kels_: It must be a high spot but they did so much work it got very confusing, it almost feels like a marble in that tooth and is creating soreness as my teeth just don't fit right and slide weirdly or something there's just too much tension I guess. like a tiny marble is in that tooth somehow I already had adjustments and it's still there I am not sure how he can't find the high spot or the cusp ridge that is running wrong. he cleaned up some margins he said and to try that but it's still not right. it the second molar on the right top.

What happens when a filling is too low?

Elle: Hi, I hope you are well! I had a teeth clean last week where the hygienist was rough and ripped a glove. After the cleaning, I experience extreme pain. At first, I thought it was just aggravated TMJ. I now need a root canal on a tooth that doesn’t have a cavity. Could the cleaning have caused this issue? Do I have alternatives to the root canal? Should I go to another dentist? Thank you for your time and insights! Dr M: Good day How do you know the tooth does not have a cavity? Did they take any x-rays that you could share? A lot of times a cavity can be in between teeth, which is not visible to the eye. This is why x-rays are taken.

Teeth Cleaning and now a Root Canal!

KV2: Hi everyone. I've recently had a crown and post fitted to replace an old crown. As you can see from the picture, the crown looks crooked and is longer than the other front tooth. There is also a large gap between the top of the crown and the gumline. Aside from looking awful, I'm concerned it could cause problems for the gum My question is does this pose a risk to the gum, and it is even possible for a crown and post to be adjusted or replaced without damage to the original tooth structure? Dr M: Good day I would go back to the dentist. This is not an acceptable result. I would suggest having at the very least a new crown made, if the post and core can be kept intact, keeping in mind that the post was also acceptable. I would need an x-ray to confirm this.

Ill fitting crown

cd96: Hello, I've just had a porcelain, metal fused Bridge fitted today, I'm really not happy with it.. it has a huge gap at the top (margin) I can actually breathe through it. I can't talk properly & when I talk the saliva just comes over the top of it. . It also feels like it moves when i eat/talk as it doesn't touch the gum. Please give me your opinions as to if this has been fitted right. Dr M: Good day When was the missing tooth extracted? cd96: About 5/6 months ago. Dr M: Usually I would first try in the bridge without cementing it, in order to see if there are any gaps. If there were indeed gaps, you can add pink porcelain onto the bridge, in order to cover up these "gaps". Remember, when a tooth is extracted, there will be some bone loss in that area. Sometimes for up until a year after the extraction. As the bone resorbs, the soft tissue goes with it, so there is a chance that the gaps that you see, could enlarge. I would go back to the dentist to voice your concerns. cd96: I'm back to the dentist tomorrow! Thank you so much!

Just had a porcelain, metal fused bridge.

Clacker: Dear Sir / Madam I’m currently on disability benefit for arthritis conditions, I also have non epileptic seizures on a weekly basis, I’m also on Income-related Support Allowance due to my arthritis in my joints (Legs and Hip) . I have a lot of missing teeth including a front tooth, I have a denture that I don’t use as there has been a lot of times where I’ve almost swallowed and choked to death on my denture when I had a seizure which my father had to lean my head forward to prevent it going further down my throat I also have psoriasis which I’ve been told can effect the teeth, I also have psoriatic arthritis. I have been told this from a dentist that couldn’t help me... ............................ There is a system within the NHS that allows dentists to refer patients to certain hospitals and apply for certain patients . They have to fit a criteria for funding , there is a list which the dentist follows and refers you to the hospital . I have looked at the list and it covers a few medical conditions including seizures which I know you have, this doesn’t matter if it’s epileptic seizures or none epileptic seizures you should still be able to get free implants regarding this and your dentist needs to refer you to the Birmingham dental hospital. ............................. I’m on benefits so I can’t afford the high cost of implants though I can manage monthly payments, I have a denture plate as some of my teeth have come out but because every so often I have a seizure (not epilepsy) like I said it’s caused me to almost swallow my denture as it came loose and fell to the back of my throat, luckily my father quickly got it out of my mouth by leaning me forward to prevent it from choking me, plus I also have psoriasis which doctors have said psoriasis can in some cases effect the teeth which is happening to me, it’s also extremely painful when eating. I’m scared of putting my denture in just in case I do swallow it and choke to death so I’m unable to wear my denture, I’ve been told that dentists can refer a patient for free implants on the NHS which my dentist has referred me to Birmingham dental hospital due to my condition, I just wanted to get more advice here as I’m worried that they won’t be able to do implants for me and I only have a few teeth left and I’m only 45 years old. I’m missing teeth on both sides upper and lower jaw and missing one at the front so you can imagine how it’s getting me down, I have a few teeth left. I have emailed so many places and had zero luck so far and it’s really getting me down and losing hope there’s nothing worse losing your smile and sometimes makes me feel suicidal as I hate looking in the mirror at my teeth but I’m hoping some good will come from Birmingham dental hospital, it’s also making my depression worsen to the point I’m having suicidal thoughts. I’ve put some links in regards to psoriasis causing dental issues. Psoriasis and Your Teeth: Problems, Tips, and More An increasing body of evidence suggests that psoriasis may be closely related to dental health. Learn more here. www.healthline.com All about dental health Arthritis can make it hard to care for your teeth, and those with psoriatic arthritis are more prone to tooth and gum conditions. Read on for some handy tips. www.versusarthritis.org The Link between Psoriatic Arthritis and Periodontal Disease The chronic inflammation experienced with psoriatic arthritis may be the reason why periodontal disease or periodontitis is often diagnosed in PsA patients. psoriatic-arthritis.com Thank you so much for taking the time to read my email I really appreciate it. Best wishes, Karl.

Please help advice needed.

Jacob _70: Hello everybody My dentist made a PFM full crown for my upper canine 3 months ago and used temporary cement to retain it. He's going to use a permanent cement 3 months later. Crown is well-retained now is it normal or should I worry about the temporary cement? Thisbites: Im guessing this is old news, but i can attest for myself anyhow that if all is well with your crown and the fit etc. and no pain or discomfort you can have temp cement on your crown no problem for 3 months. I have a lot stress around my teeth, and had the same concern. I still am ok with my crown having temporary cement and have not seated it w permanent yet. i dont even want to as it rattles me, and do not want to open up another pandoras box. I personally wouldnt worry about it as long as it feels ok. Scorp: I'm having a bit of an issue at the moment. I've been running with a permanent crown for 7 days, uncemented. We agreed with the dentist to leave it uncemented for 2-3 days, to see how I feel. I'm so glad I did, because the crown gave me huge headaches and earaches Since I already paid for the stupid crown, I can't go to get one done to my old dentist in a different city (I never had problems when he did my crowns). My old dentist took the print for the crown digitally and made it on the same day, and it was always a perfect fit. My current dentist did the traditional "paste in your mouth" to take the print for the crown, and it's just not as good of a fit. In any case, I'm probably going to have this new dentist shorten the crown a bit more, in case my problem comes from the crown and the tooth above it touching too much. And then I'm gonna have him do a temporary cement of the crown. If the crown continues to cause pressure in my head, in the end, I'm gonna throw it away and go get a new crown made where they do it digitally. So yeah, temporary cementation is good for some cases in my opinion

Temporary cementation of definitive crown

Patientseekinghelp: So, I visited a public dentist using benefits insurance. She told me I had three cavities, and one of them could have become a root canal. I used to buy private insurance, but my family decided I should stop paying for it because they said I couldn't afford it. So, two and a half years went by, and then this. But after the first filling, a big chunk of one of my teeth fell out, and a few days later, and even bigger chunk fell out. I might be able to pay for premium insurance as long as I pay close attention to my budget, so the obvious answer is that I need to stop going to her, even though I think she is a nice person, if two teeth cracked in half, it is too much to ask of me to place my trust in her again. I can only sue them what I pay out of pocket to my other dentist, which will be 50% of each crown, because I have a feeling they're both going to need crowns. Before I decide to go to small claims court, tell me something, do you think she did it intentionally? honestdoc: Do you have x-rays on the teeth in question? It is hard for us to guess the conditions. Patientseekinghelp: Ok, thank you for your time.

Two cracked teeth

Susan Blackwood: I’ve had a crown fitted today. I accepted the risks of being able to see the metal in time if my gums receeded etc, however I am disappointed that this is already the case from the beginning and not just at the top as picture shows. I did query this and was told the only way around it was to pay for a full porcelain crown. I was just wondering if this looks normal or whether the crown is not fitted properly. Thanks

New crown with metal showing

Anna1910: I want to put a zirconia crowns! ( Prettau zirconia) What are your thoughts about this crowns? I will put them only in upper teeth, will they wear out my lower natural teeth enamel? Are they good option for me, i want them to last long time. Thank you for answer and advise! Dr M: Good day Modern Zirconia crowns have a good combination of strength and aesthetics and can be a good choice for anterior teeth. Usually when the crowns are designed, they are designed in such a way to prevent them from " biting" too hard on the opposing teeth. Your bite is also checked by your dentist, once the final crowns are cemented. Over time, there can be some wear on the opposing dentition, depending on the condition of the opposing teeth as well as the movement of your jaw and teeth during function.

Zirconia crowns

ExtremeRemorse: I feel like very naive and just not smart because I didn’t realize I was getting a full mouth of crowns. I am now in my temporary set. I’m not really happy with them but not sure how to proceed. But since I can’t go back, I have a few questions. 1. Is there a certain material or anything else I should request for my permanent crowns? We planned for porcelain. Is zirconia better? I clench and grind my teeth. I have issues with crowns in the past. They tend to be a bit sensitive and my gums around them recede. 2. How long will these last before I need to replace? 3. Is there anything I can do to make them last longer? 4. Are there any diet restrictions or things I should avoid? 5. Anything else I should know or expect? Thank you in advance! MattKW: Feldspathic porcelains were the mainstay of crown for many years along with metal-fused-to-metal ("VMKs"). Nowadays there is a much greater variety of ceramics available. Yes, zirconia is very strong, but requires more tooth removal and is damnably hard to adjust or remove if the need arises - I avoid using zirconia. If you ask most older dentists which material they'd prefer, you'll find we often have a penchant for gold crowns on molar teeth. They can be made very thin with fine margins, and have excellent wear and strength characteristics. We've seen them last a very long time (up to a lifetime) with the usual maintenance.

Accidentally got full mouth crowns

YSI: My experience for what it's worth. I did not know I would be shown a large color chart on the spot while in the chair and asked to pick the color of my upcoming crown. I remember the dental tech disagreed with the dentist over which color. I remember I was not wearing my glasses and up close small squares of color were a blur to me. Today, I hate the color of my crown. I also suspect the tech went with her own opinion and who would know, since they handle the paperwork. My question is why isn't there more art involved in this? Ppictures of our teeth next to the tooth to be crowned should be used by the factory to create the crown, similar to how you take a swatch of color to the paint supply store and their computer analyzes and mixes up the perfect matching paint? Dr M: Good day I personally follow the advice of my dental tech, since he is the one that designs and makes the crown. It is important to note that there are other factors that influence the shade, such as the shade of the underlying tooth structure, or the light in which the shade was chosen. If you were unsure, it was important to speak up during the initial visit.

The color of the porcelain crown.

Michelle521: My tooth next to my 4 tooth front bridge needs to come out. My dentist said we can put a bridge. How are we going to connect the new bridge to the one in the front? Dr M: Good day Not sure exactly what he means. You can't add to an existing bridge. An entire new bridge will be made to include this tooth, but then the length or span of the bridge might be an issue. I would ask him for more detail on the procedure before anything is done,if you are unsure. This is part of the informed consent process. Michelle521: My bridge covers 6,7,8,9,10,11. 8&9 are the missing teeth. Been told for 17 years from many dentists it's a beautiful bridge. Number 12 is the tooth coming out. He wants to pull and put 2 pontics, 1 crown on 11, 12, 13. Can he separate number 12 from existing crown to do this? Michelle521: Dr M said: Good day Not sure exactly what he means. You can't add to an existing bridge. An entire new bridge will be made to include this tooth, but then the length or span of the bridge might be an issue. I would ask him for more detail on the procedure before anything is done,if you are unsure. This is part of the informed consent process. Click to expand... My bridge covers 6,7,8,9,10,11. 8&9 are the missing teeth. Been told for 17 years from many dentists it's a beautiful bridge. Number 12 is the tooth coming out. He wants to pull and put 2 pontics, 1 crown on 11, 12, 13. Can he separate number 12 from existing crown to do this? Michelle521: Michelle521 said: My bridge covers 6,7,8,9,10,11. 8&9 are the missing teeth. Been told for 17 years from many dentists it's a beautiful bridge. Number 12 is the tooth coming out. He wants to pull and put 2 pontics, 1 crown on 11, 12, 13. Can he separate number 12 from existing crown to do this? Click to expand... I'm sorry I meant separate number 11 from existing bridge

A bridge next to an existing bridge

DecoDiva: I have had a bridge fitted and have had it now for one week. I am aware that I need to get used to it but there are certain aspects that bother me. Let me say it does not hurt at all but it feels enormous in my mouth. I thought that this would improve over days but it still seems like a huge alien object in my mouth. The tooth it replaces was lost about 10 years ago so I do understand that I need to get used to have a tooth there again. However, the teeth seem so big - I keep biting my tongue when I eat and sometimes when I speak. There seems to be “pressure” in the bridge which I can feel if I push it with my tongue or try to chew anything harder than cake or vegetables and also when I use Tepe brushes on teeth near it. (The bridge is the last 3 teeth on top right). I cannot chew meat at all. I can’t say it hurts but it does cause an uncomfortable sensitive feeling. As I said I knew I would have to get used to it but I did think they would feel like my own teeth but they do not, they feel like large lumps of plastic in my mouth which get in the way when I try to eat and I am constantly trying to move them out of the way. Logic tells me that an impression was taken of the teeth that were there previously so the crowns should be exactly the same size and shape. My dentist says that the bite is perfect and I can close them together without any problem but if I chew anything substantial there is discomfort. I am waiting until two weeks have passed before I return to the dentist but in the meantime would be interested to hear others experiences as at present I am not sure whether it is me and a settling in period or not. I did have an orthodontic plate when younger and I couldn’t get on with it at all, there was a similar feeling of it ring huge in my mouth so I wonder if it is just me.

New Bridge Problems

markowich: Dear dentists of this community, My dentist installed a crown (PFZ) on my 3-6 tooth. I do not know if this is improtant info for my question, but crown was quite high at first so it needed to be lowered about a week after instalment. The top of the crown needed to be honed. I had a feeling that not the best material was used - because if I compared it with my older crown (installed 12 years ago on 4-6) porcelain had no translucent properties and it felt very opaque. Anyway this week, which is about a month after installment, another medical center did some orthopan X-ray regarding some unrealted issues and they informed me, that there is something wrong at the root of the crown and that it would be impossible to fix it without removing the crown and if I do not attend to this problem - tooth decay will occur and eventually tooth will break. They suggested I should talk to the original dentist first, since it is only a month from installment. What do you think I should do? Thank you for your expert opinion. IMAGE LINK - https://ibb.co/T15KpPm Best regards

Problems at the root of crown [X-Ray] - need a dentist advice

Godschild: My dentist is recommending a Cerec crown. They offer two types. Cerec fired vs. regular Cerec crown. Why choose one over the other?

Cerec fired vs regular Cerec crown

Gental: I had a filling placed and it is still sensitive to cold after getting the bite adjusted once. I feel that the bite is still high. The cavity was on the side of the tooth but the top was drilled a bit and I think the filling there may be high. I had a cavity on a top molar on the other side of my mouth in a similar location but the filling was just placed on the side so the bite was fine. I also circled an area in green on one of the pictures. Do I maybe need the filing done again, if I look at the before and after x rays, it seems like maybe they did not take out the entire cavity area and fill it. Also if you look at before and after, it looks like the filing covers the top of the tooth higher than the original tooth sat. I had my bite readjusted once, should I go back to have it adjusted again? The dentist that did the filling said that the part that I circled was nothing. Is it worth asking to see a different dentist to get their opinion? Thanks

Advice on tooth #2 filling

Gental: Hello. I went to the dentist for a regular check up and they told me I have a cavity that needs filling for tooth number 2 (I believe). There was no pain or discomfort before the filling. You can see the cavity on the x ray (see attached 'Pre-Filling'). I got the filling about 1 month ago and the first couple days I did not feel sensitive to hot or cold but chewing on it felt a bit tender. Oddly enough, after a few days it felt better to chew on but started sensitivity to cold but very slight. The cold sensitivity slowly grew until it was pretty sensitive a couple weeks after the filling. If something cold hit it, it would feel very sensitive but as soon as the cold was moved away, it felt almost immediately fine. However by about 3 weeks after filling, once the cold was removed it immediately felt a lot better, but it would have a dull ache for a couple minutes and then feel fine. About 4 days ago hot tea started to have the same effect as the cold (but not as bad), so yesterday I went back to the dentist. They did the paper test and slightly adjusted my filling because it was a little high and marked the paper blue. They said the filling was fine and that maybe I would need a root canal because it was a big filling. I do not want to rush into a root canal and wanted extra eyes on the before and after for others to hear the situation. Seeing if maybe it is worth waiting awhile and if it stays sensitive to try to get the filling re-done? If you look at the before and after (see attached 'Post-Filling_circled'), I notice an area below the filing where it looks to me is the edge of the cavity, could some of the cavity have been missed? I pointed it out to the dentist but they said that was nothing. I had never gone to this dentist before and they had a very hard time at certain stages of the filling and reaching the spot. At some point I think they got their glove stuck while trying to position the (Matrix?). It seemed like the glove was stuck there for awhile and I could see the dentist looking at the assistant and vice versa with an 'aw crap' look on both of their faces. Anyway, this did make me feel less confident and wonder if maybe bacteria could have gotten under the filling or the dentist could not adequately access the area to get the entire cavity? Your advice would be appreciated to guide me on next steps and if it is worth avoiding a root canal more. I have a bad experience with root canals because my 4 front bottom teeth were knocked back in a sports injury and needed root canal. Many years later they got infected and I was told by a clinic to do apicoectomies which were done very aggressively and did not work and also made my gums feel weird and scar tissue feels stiff. That same clinic wanted to pull them and give me partial dentures. I went to a very reputable endodontist that said it was a shame that I didn't see him first and that he could see a missed canal that probably caused the problem for all 4 of the teeth and if treated would have remedied the area, but that now since the other place took over half of the below tooth structure of all those teeth, I cannot keep any of them. I am actually just healing from a special bone graft with special bone protein just for hopes that enough bone can grow for getting an implant supported bridge instead of dentures. So I am extra bummed about this cavity because I feel like one very long tooth saga was about to come to an end as I am hoping to get the 2 implants for the bridge soon. Now I only have one section of my mouth that I can comfortably eat with. So even though normally a cavity is not so big of a deal, this is just kind of feeling extra depressing for me. I also looked back on older x rays and I can see this cavity, only smaller. I always went to the dentists that took my not so great insurance and now I wonder if they told me the treatment best for me or just ones that they would cover or something. I do not know why no one saw the cavity for years. I also was told apicoectomies were a minor tiny procedure and was told it was better than re-treatments, which is what I originally came to them asking about. They wound up taking half of my teeth and leaving a defect in my jaw bone which another endodontist said was not even necessary. Sorry I kind of went off topic. I guess while typing this is my entire mouth situation is getting to me. Anyway for the main cavity issue, just a couple last notes that are maybe helpful: -My bite never felt very off but I do remember touching the surface of the filling with my tongue and it felt kind of flat. A few days in, about the same time sensitivity came, it felt a bit more concave. -Only one specific area is very sensitive. I tested it with a frozen corn. I could place the corn all around the tooth and nothing, but if I placed it at this one spot on the side looking out of my mouth down by the gums t would be pretty intensely sensitive. -The sensitivity is sometimes worse after I wake up which makes me feel like maybe the filling is high and while I am sleeping I am bothering it more than when I am awake and actively trying to be careful with it. Thanks a lot for your time p.s. This dentist also said that I needed scaling, which I was warned about by the dental clinic who did my apicoectomies. I was on Chlorhexidine for like 2 months which is way longer than you are supposed to from what I've read. They said it is fine but I may need special cleaning due to the long use Chlorhexidine causing tartar build up, or something like that. Is that something that can be seen in an x-ray to confirm that I need? If it can be seen in an x-ray I can post it in a different topic if it does not count as this topic, thanks.

Tooth #2 sensitive one month post filling - advice appreciated, thanks

Dondinger: Hi. I hope you can help me. I'm due to have my front tooth removed due to untreatable abscess. My dentist has said I need to pay for a denture on NHS and wait 10 weeks then pay over £100 for a bridge. Does this sound correct. My friend had the same thing happen but had a temporary play dough bridge fitted while waiting to heal. I'm so confused Dondinger: Sorry. £1000 for bridge.

Paying for NHS band 3 and private for bridge.

Owl333: I had perfect teeth my whole life: strong, no cavities. My dentist retired and another one took over. I pointed out a tooth where there was a gap between it and the next tooth, and she looked at it and pronounced it severely decayed. No ex-ray or anything. Being an idiot, I let her drill into my tooth. Her filling increased the gap between my two teeth. It was also slightly too high, meaning that my tooth squidged into my gum every time I ate. The next dentist I went to tried to replace the filling, but I reacted too sensitively to the drilling. He asked me if I felt air blowing on my gum, and I did, so I said Yes. He then told me that I needed a root canal, even though my tooth didn't hurt at all (but did feel as if it were on an unstable surface due to the squidging). I went to an endodontist who, when I said my tooth didn't get numb during the drilling, decided that I didn't need whatever tests she was going to perform and that she needed to conduct the root canal right away. Now, I have a crowned tooth after two procedures I think were unnecessary. And my current dentist is telling me the tooth will not last through another crowning should this one go bad. I'm absolutely terrified. Is it true that a root-canaled tooth can be too whittled down and fragile for re-crowning? If I have to get an implant, how risky and awful will this be? I'm a 45-year old female and have a family history of osteoporosis. I'm in a frenzy thinking of how stupid I was to not do more due diligence, and how much I stand to lose in money, health, and peace of mind. honestdoc: Once the tooth gets a root canal, the strength of the tooth and root greatly diminishes. It is unpredictable how much damage will be underneath the crown should you need to replace it. You can still get a cavity under your crown so be very thorough with brushing and flossing and avoid sugary/acidic/creamy beverages.

Upset and scared about possible implant

Will2022: Hi everyone, I would really appreciate a second opinion on the following: I have a clear visible crack on the second premolar on the upper right jaw. I've been experiencing constant pain and discomfort, enough to keep me up for the last three nights in a row. For the last 3 days when I put any pressure on the tooth even very light pressure I feel intense pain, on a scale from 1 to 10 I would say a definite 10/10. However today the pain is less intense, I would say 7/10 when I put pressure on the tooth and just slight discomfort when no pressure is on the tooth, I feel like it is improving. I am currently 33 years of age, no known medial issues in the past or present though my mother has Diabetes. What would you recommend as the best course of action? I would like preventative measures to be taken ASAP on the crack to prevent it getting worse. Many thanks in advance! Dr M: Good day The most important factor is to determine how deep the crack goes. If the pain is subsiding, it might be a good sign, but it could also be a bad sign, since the nerve might actually be dying. In such a case, the pain will first go away, and then gradually come back as an abscess is formed. The best option would be to go see a dentist. He will have to follow the crack and restore it with a normal filling if possible. If the crack extends into the nerve, a root canal is indicated. In severe cracks, the tooth will need to be extracted. Will2022: Thank you so much for the advise. Very informative. Does the level of pain indicate the deepness of the crack? The pain was unbearable with even the slightest pressure on the tooth. Do the two xrays show if any of my teeth need a root canal? Is it possible to see this from just the X-rays alone? Would a filling help at all or will it just make the crack worse? Would you suggest a crown or just doing nothing for now? Really appreciate your response and also interested in other opinions! Dr M said: Good day The most important factor is to determine how deep the crack goes. If the pain is subsiding, it might be a good sign, but it could also be a bad sign, since the nerve might actually be dying. In such a case, the pain will first go away, and then gradually come back as an abscess is formed. The best option would be to go see a dentist. He will have to follow the crack and restore it with a normal filling if possible. If the crack extends into the nerve, a root canal is indicated. In severe cracks, the tooth will need to be extracted. Click to expand... Will2022: Thank you so much for the advise. Very informative. Does the level of pain indicate the deepness of the crack? The pain was unbearable with even the slightest pressure on the tooth. Do the two xrays show if any of my teeth need a root canal? Is it possible to see this from just the X-rays alone? Would a filling help at all or will it just make the crack worse? Would you suggest a crown or just doing nothing for now? Really appreciate your response and also interested in other opinions! Dr M said: Good day The most important factor is to determine how deep the crack goes. If the pain is subsiding, it might be a good sign, but it could also be a bad sign, since the nerve might actually be dying. In such a case, the pain will first go away, and then gradually come back as an abscess is formed. The best option would be to go see a dentist. He will have to follow the crack and restore it with a normal filling if possible. If the crack extends into the nerve, a root canal is indicated. In severe cracks, the tooth will need to be extracted. Click to expand...

Chipped and cracked tooth

DaveDogge: I've Just received a dental restoration quote for 31.5K euros, (see photos) is suggested work appropriate ? £27,000 is a lot of money to me and the dentist I saw gave me no alternative to the option I describe below, note that I am in my late 40s: If you look at the photos posted, my lower four front incisors are worn down like tiny stumps almost at the gum line, I have no enamel on them above the gum line and it's just detina that is exposed, the upper incisors look chipped and worn but at least they have vertical length. I've obviously suffered from teeth gnashing (bruxism) and foolishly have not been to see a dentist in decades. The dentist I saw suggested that he does root canals on the lower front 4 incisors, increases the exposed crown length of these by cutting away the gum and then creating a bridge for all 4 (after I did look at the pros and cons of bridges), that's all fair and good and I thought that was probably all that was required. BUT after second consultation with the dentist he showed me a physical model of my teeth and told me that if he were to install the bridge for the front bottom 4 incisors then he would have to put metal crowns on ALL my back molars BECAUSE the introduction of the bridge would lift the back molars 2-3mm (thus creating a 2-3mm gap for all the back teeth) and when I eat my food using the back molars the food would somehow go from the back of the mouth to the front of my mouth (or something along those lines) and wear down the front incisors in no time as they would be doing the lion's share of the tearing of food. So he proposed metal crowns for practically all my back molars (he surprisingly suggested gold, which I know is the best but still - high cost) with porcelain 'side' crowns to hide the metal crowns on the molars. He also suggested porcelain veneers for some of the front teeth and I asked him on the spot that these were a cosmetic addition only aren't they ? and he said in my case 'not just cosmetic', right now I am assuming he wants them for the front top chipped teeth. What caused me to go to the dentist in the first place is that I ate a corn on the cob and one of my lower incisors started to hurt constantly and it then went away after 2 days, I was told only via the 2nd consultation that it was a minor infection when I saw them the 1st time (although the first time they told me it wasn't an infection). Also note that I had the same pain in the same tooth 19 months before - again after eating a corn on the cob, which only lasted 3 days. Question: I am assuming that for the amount of work (a full overhaul of the teeth in my mouth and 6 months work it's about the right price but is so much work necessary for the back molars, he claims that these are worn down also (hence the 2-3mm gap he was talking about) but I have no problem using them; could he not just make the lower bridge height for the 4 front lower incisors 2-3mm lower so that they are more level with the molars at the back as they are ????? After my first consultation I thought it would be 4 lower incisor root canals, crowns for all of them and maybe some repair work on the two principal upper incisors ... Anyone have any thoughts on this ??? I include the work required / cost break down in Euros below if anyone is interested: UPPER JAW (Euros) ------------------ crown lengthening ~(gum reduction) 12 to 22 453.00 porcelain veneer 13,12,11,21,22,23 6,120.00 back crown porcelain 14,15,16,17,24, 25,26,27 5,760.00 pale gold laboratory 2,300.00 LOWER JAW crown lengthening ~(gum reduction) 32 to 42) (lower jaw) 453.00 root canal 31,32,41,42 1,628.00 Fiberglass posts Whitepost FGM is a brand for example I think) 31,32,41,42 420 00 Front porcelain Crowns 37,36, 35,34,47,46,45,44 5,760.00 Back porcelain Crowns 33,32,31,41,42,43 5,700.00 Pale gold at laboratory 2,300.00 Bite plate to prevent night teeth nashing 660.00 ------------------ 31, 544.00 ------------------

I've Just received a dental restoration quote for 31.5K euros, (see photos) is suggested work appropriate ?

i500: Hello, I have been having a lot of issues ever since I got a crown earlier this year. I think the crown was too big and tall and that caused me to crunch my teeth while I sleep at night. The crown is on upper back tooth on the right. I also had pain on the crowned tooth from the day I got the crown prep done and the pain never went away to this day. The pain was focused around the crown at first, but then it spreaded to the entire upper teeth, then to the lower teeth (more like lower jaw bone). I went to many dentists/dental specialists (general, periodontist, orthodontist) but they all told me that it is probably due to the uneven bite. I had my crown adjusted and my dentist says it is not touching anymore when I bite down, but the bite still feels off. It seems like teeth on both sides of the crown are touching the lower teeth, but it does not feel like pre-crown bite. And I still crunch my teeth during sleep (I can feel pain/soreness when I wake up). Also, those two teeth do not hurt, but the crown does hurt. Could you please let me know what it can be that is causing the pain? Is it possible that the crown is too wide/tight and it is causing the pain? I noticed that sometimes flossing gets really tight there. Additional info: The crowned tooth had root canal done by a specialist before the crown was cemented and my dentist says x-ray shows no issue. Any help is greatly appreciated. Thank you.

Pain and bite issue after getting crown

Jono: Hi, Please provide your assessment of what might be causing ongoing sensitivity. Case: UR6 shallow occlusal composite filling (replacement for an amalgam). Intermittent sharp shooting pains upon chewing. Secondary caries identified underneath amalgam. No fractures were identified. Composite filling placed seven months ago. Since having the composite filling done, I have experienced pain only on biting something hard on the filling or when directly pushing against the filling and upon release with the fingernail. There’s no pain on touching the tooth itself with the finger. Initially for the first three months, the pain was a very acute, short lived, sharp and shooting type of pain, with no dull ache or throbbing and was most prevalent in the mornings. There is no discomfort with cold, hot or sweet things. However there was a brief period in which the tooth was sensitive to cold water which started two months ago and resolved by itself after a few weeks. I have used sensitivity toothpaste for the last several months which has alleviated the acute, sharp and shooting pain into a milder shooting soreness upon chewing. My dentist mentioned there is no obvious fracture line in the tooth. The filling is also not high, and has been adjusted out of the occlusion after I sought a review from my dentist one month after the procedure. The tooth is not tender to percussion and responds normally to cold test. There is no pocketing around it. Aside from a possible fractured tooth, I am thinking it could be polymerization shrinkage as my dentist placed the composite in bulk. My dentist also did not use any irrigation in drilling out the caries so may have irritated the nerve at the time. I have attached a copy of x-rays taken before the replacement (with amalgam) and one month after the composite filling. I have noticed a dark line from the tooth centre and was wondering if that is a sign of a poor bond or nothing at all? Thank you, Jono

Sensitivity after a filling

VallartaLad: Should I replace an old large filling on #18, or replace it with a crown? Have attached Xray images (along with neighbor #19, which had an AstraTech implant and zirconia crown put in this past winter and spring). The symptoms improved but didn't go away. I still get some occasional (and rarely severe/long-lasting) pain in my lower left when eating something chewy, cold or sweet. My newly acquired general dentist, who installed the #19 crown, thinks #18 could be at issue now. Its old filling may have a small leak or perhaps there is a small crack which isn't yet too significant. He says I could: a) Go to endodontist; have an eval and probably a root canal, and then come back for a crown. b) Skip (a) for now. Just have the general dentist put in a crown. That might trigger the need for a root canal but odds are it would not. It might stop the symptoms for good. If later it needs a root canal, just drill through the zirconia crown and patch it. (Is it that easy with solid zirconia, which I know can be quite hard?). He didn't mention a 3rd option of just replacing the old filling with a new one and I didn't think to ask. But I thought I'd ask on this forum as a possible 3rd option. That seems the most conservative route certainly. Any thoughts? Dr M: Good day Replacing the filling with another filling, or even perhaps an amalgam filling, might be a good option to consider as a first option. It does look like there might be some micro-leakage mesially, which could lead to sensitivity. Crown placement is more destructive, so I would consider this only after replacing the filling. I would not consider root canal treatment at this stage, unless you start experiencing more severe symptoms. Also make sure to check the occlusion on the tooth, after replacing the filling. VallartaLad: Thanks hugely! I guess this replacement filling would also be called an onlay filling then? (or inlay?). You mentioned amalgam. But is there any reason NOT to request composite material? I know it doesn't have the longevity of amalgam. I'm in my mid 60s if that helps answer this. Should I perhaps be concerned that my dentist may have a tougher time keeping the area dry so it can bond, and layering the composite in an ideal way? Dr M: Moisture contamination is one of the main risk factors, which influences the bonding of the resin composite to the underlying enamel and dentine. Any poor areas of bonding might lead to micro leakage and sensitivity. With any composite material, it is critical to keep the area dry, with a rubberdam and suction. Amalgam on the other hand is a lot less moisture sensitive. VallartaLad: Got it! Thanks! If I do go for a crown after chatting with the dentist, I think I'd choose a full cast gold alloy (highly noble). Since this needs less tooth reduction than other crown types, this should reduce the chances that I'd trigger a need for a root canal. Plus I suspect the crown's core integrity will stand up well, if I do ultimately need a root canal and the endodontist drills a hole thru the crown. And I don't mind the esthetics that far back in my mouth. So my last question: Are most dentists willing to provide a pretreatment estimate for the cost of a gold crown up front? Or does the variable price of gold and the inability to predict how much gold is needed until the impressions are taken, just make this simply impossible to estimate? Might PFM with metal (i.e. gold) occlusal be a good 2nd choice? Thanks!

Replace filling or just go with a crown?

Mamaj: My husband has had a porcelain crown fitted to his front tooth which is more yellow than his other teeth, the tooth underneath the crown is black the dentist says it has to be more yellow to cover the black tooth he also says the whiter the crown the weaker it is. Is this true? We understand the crown needs to be thicker but could it not be whiter and is he just saying that because he hasn’t matched it to his other teeth correctly? Dr M: Good day I have a very close relationship with my lab technician. In difficult cases like this, there are a lot of things to consider. If the tooth was root canal treated, non-vital bleaching could have been considered in order to whiten the tooth prior to the crown placement. If it was only black stains, this could have been polished away. In more severe cases, I send my patient to the lab in order to choose the shade. Sometimes they have to place a block out layer over the stains, whereafter they put the porcelain. This should have been part of the initial treatment planning, when taking on a case like this.

Dentist says he cant match crown to colour of teeth

VallartaLad: Do most general dentists today tend to default to Zirconia or to PFM when they put in crowns over natural posterior teeth? Would the answer change if these crowns were going to sit on top of a custom abutment and implant? We are a two dentist family. Mine leans toward Zirconia crowns (I think for both natural teeth and implants), and my spouse's seems to lean toward PFM. Sort of curious is this is just a personal preference by the dentist and the split is pretty even? Or is one of our dentists in a clear minority? Thanks! honestdoc: I find PFMs are not esthetic and the layered porcelain fractures or flakes off. I like full contour not layered zirconia. They can still fracture if prepped or milled incorrectly but they are fake diamond material designed for strength. Implant crowns should have foil relief occlusion so opposing wear should not be an issue.

PFM vs full contour Zirconia

Rue: My new dentist has recommended extraction of teeth 8 teeth leaving 2nd molars & pre-molars both sides top & bottom and all front teeth. (In prep 4 braces decades ago, 4 molars were pulled.) He is recommending partials. While I know it would be more expensive, would combination bridge, partial denture be better? Would you do bridge on bottom & partial on top? Remaining molars would be restored. Could that be done before extractions, or does it make sense to work on one section at a time. Really dreading extractions. New dentist experienced & seems competent, but he's NEW to me! Thanks honestdoc: You will always get different opinions. Some important considerations are which procedures are more traumatic (more drilling, more surgery, etc.), more costly vs benefit (value), and more functional vs esthetic. I always favor less traumatic. Partial dentures will be less traumatic than bridges. With bridges, the abutment teeth needs prepping (drilling). After drilling, those teeth can get more sensitive and painful. When the bridges get cemented and you don't clean them as recommended, you can get cavities under them and worst case lose the abutment teeth. Partials do not require a lot of drilling but they are not as functional and comfortable as bridges (minus any sensitivity) due to their removable (not cemented) nature. Many people do get accustomed to them so they are happy. I'm very big on prevention. I get disappointed with my colleagues when their patients continue to have deteriorating teeth with no discussions on home care and prevention. Bottom line, natural teeth will always trump any restoration. Rue: Thank you for your response. I hadn't factored the Trauma associated with bridges and that makes the decision somewhat easier. Age & aging crowns bring me here. I have always been meticulous about brushing & flossing.

Bridge or partial?

Whatteeth: When there is a need for major, basically full mouth restoration, for implants, there are many service provider options. It's hard to pick. There are international providers; 'corporate' providers such as ClearChoise or 'dental implant centers; regional US providers, and local providers. There are also different types of dentists who might offer services, e.g., prosthodontists. My priorities would be one, quality, and two value. If only quality mattered, I'd probably go to a local specialist, but the price there seems it can approach $100,000, and that's quite a lot. 'Corporate' providers I haven't priced but ballpark sound like maybe $50,000. International less. It's a pretty important selection, and the choices have me not getting it performed. honestdoc: I would avoid chains/corporate settings (I worked at a few). They are more concerned with production than quality. If specialists fees are too high, try training facilities where they train prosthodontists to restore and surgeons to place implants. Whatteeth: Thanks for the suggestion. This would be 'place', not 'restore', so does that rule our prosthodontists? Is there a name for the specialist other than 'surgeons'? I'll have to look for training. Do you think the quality will still be there? The only one I've seen in the area was the state university UCSF, and they only have the faculty offer the service, and they don't offer bone grafts, that seem like a good idea. honestdoc: Usually you will go to the restoring dentist (general dentist, faculty, prosthodontist) for full consult and evaluation. That restoring dentist coordinates with the surgeon (periodontist or oral surgeon) to place implants, bone graft, etc. At a school/training facility, everything will be overseen by an experienced provider so the quality should not be a concern. Whatteeth: Thanks. I wouldn't mind going to a prosthodontist for advice where to get the service, but think it'd be awkward because they'd want to do it themself. I even had that with a general dentist who wanted to - her yelp reviews said 'she wants to do a lot more than she can'.

Suggestions for best resources for major implants?

Mdel205: During a recent dental visit all my teeth checked out healthy except #18, and two weeks ago I received a filling. Recently, #17 exhibits quick sharp burst of pain chewing hard foods like chips, but only if the food hits the tooth dead center, otherwise passive pressure while chewing does not elicit any reaction. I do not experience ongoing soreness or pain, and my tooth is not affected by changes in temperature. During my filling the dentist applied two shots of novacaine as well as a carbocaine injection to ensure complete numbness. I have read about rare circumstances where a nerve can be aggravated and take several weeks to heal, and I wonder if this is my issue considering #17 had good x-rays and no visible or physical signs of cavities. Are there any suggestions how to navigate this issue, even including ignoring it and seeing if it goes away. I already went back once to have my filling sanded down a little to adjust my bite, I don't want to go back again for another problem if it is truly minor and temporary. Thanks. Dr M: Good day Do you perhaps have x-rays that you could share? Mdel205: I am not in possession of my most recent x-rays, however at the time my dentist did not see anything of concern either in the image or examination. The sensation I feel is very specific when crunchy food hits my molar dead center, and my tooth won't even react if I poke that same area with a tooth pick. It still does not react to temperature changes either. I was thinking of giving it some time and see if the feeling goes away in case it is related to nerves, and if not call my dentist. Dr M: Difficult to give any advice without more information. I agree, that if the pain doesn't go away, go and see your dentist for another look.

Pain in tooth adjacent to tooth with filling

denthelp12: I'm having my front teeth crowns fitted in two days. I've had a test fitting a couple of days ago and I've noticed that my front teeth now have small black spaces between them. It's much more visible in person than it is in the photo. I've asked my dentist about it and he said that the gums will fill out these spaces. I really hate the way it looks and I'm worried that the spaces will always be there. Is it common for the gums to fill these spaces after crowns are fitted? Thanks! https://preview.redd.it/18xtij0ilkj71.png?width=1942&format=png&auto=webp&s=cb8c1756c90af9218ac8380c6f675f352f2917dc Dr M: Good day There are a lot of factors to consider when talking about these " black triangles ". Sometimes when the temp crowns were not well made and very rough, it can irritate the gums, which then tend to " pull away" . As soon as the temp crowns are replaced by the permanent crowns. these triangles tend to get smaller and disappear, since the gum tissue heals and adapts. If you had bone loss around your front teeth however, prior to the crown preps, these triangles might remain, since the interdental papillae ( gum in between teeth ) is influenced by the underlying bone.

Black holes after crowns

Mo24078: I had a deep cavity on tooth 18 that I posted about last year on this forum, Deep Cavity on Necrotic Molar, RCT Needed? Hello all, I had a deep cavity on my No.18 molar on the mesial-buccal surface. Two weeks ago, my dentist removed all the decay without administering any anesthetics; he could tell just by looking at the tooth that it was necrotic and I felt no pain during the procedure. In that process of decay... www.dentistry-forums.com Last year, the cavity was taken out and even though the tooth was necrotic, we didn't do an RCT. Mainly due to Covid concerns and my age, we decided to hold off on that and take bi-annual X-rays to monitor the situation. Now that we're able to go back to the dentist, a recent visit showed that there is a radiolucency at the apex and the infection is draining thru the side of the tooth, there is small abscess on the buccal side of the gum, and there is also a cavity adjacent and under the big amalgam restoration that's about 4mm under the gumline. The dentist said that because this new decay is on the root of the tooth and under the gumline, it is difficult to restore and therefore suggested extraction. I have attached the most recent periapical X-ray but it might be difficult to see the new decay. Is this 4mm subgingival restoration impossible to do? Does it definitely require a crown lengthening procedure or is there a way to do it without out that? This is my last functional tooth on the left side and I'm really hoping to save it. Thanks in advance. MattKW: 4mm subging might be possible in amalg only. Of course you also need to do the RCT to resolve the abscess. There's no need to do crown lengthening, and it might make the situation worse because you risk exposing the furcation of the roots. The only other option is to extract, and place an implant. Mo24078: Thanks so much for your reply. I have a few follow-up questions that I would very much appreciate your opinion, - For a subgingival amalgam restoration, do I have to look for a specialist? The dentist we saw said she wouldn't be able to do such a restoration. - Is a subgingival restoration doomed to fail quickly because the margin is under the gumline and since it's harder to clean, bacteria will eventually get in? - Is a crown an option her at all? MattKW: A specialist is not required. Maybe your dentist is not comfortable with subging amalgs? They can be fiddly to get enough retention ("grip"). Yes, more likely because of the chance of decay starting again, and because the gum doesn't react well to foreign substances. A crown would still be subgingival (unless you gum lengthen), and difficult to do. I suggest the subging amalg because it is the most cost-effective solution for this bad situation. Going to the expense of crown lengthening (and crowning) may only offer a slightly better chance of success for a lot more $$$.

Subgingival restoration on molar, is it possible?

guts_feeling: First visit to a dentist for a new patient exam and regular cleaning. I think the doctor(they do not have a hygienist) chipped the enamel of the inside of the lower central incisor, the round part near the gum line. My tongue felt something strange. When I look at the mirror, the round part is gone for one incisor. It is been half an hour, so far, no hurt. Wondering what can be done to fix the chip? Dr M: Good day Sometimes if you had areas which were already demineralized, a cavity can form with pressure from the scaler during a cleaning. It then might be an indication that you need a filling in that area. MattKW: Most likely reason is that now that the calculus (tartar) has been removed. It feels different and gappy. If you're still unsure, go back to the dentist. Removing enamel with a scaler is very rare, and mostly in old people .

chipped enamel

D040821: I have to have one of my upper right premolars crowned. One problem here is that I suffer from Obsessive Compulsive Disorder, and one feature of this is that I'm extremely sensitive to anything 'feeling wrong' in my mouth: as soon as I have any restoration done, I feel around it with my tongue, and if it doesn't feel exactly the same as before I'd had the work done, I feel distress. My present dentist is very good, but he told me that to do the crown, he would only be making an impression of the tooth AFTER it had been ground down, plus an impression of the opposing (ie: lower) teeth. I asked him how a lab could possibly deliver a crown that was exactly the shape of my tooth if it did not have an impression of it, but all he said was "they're very experienced people". I know that the impression of the opposing teeth would be enough to make a crown that would occlude satisfactorily, but I need more than this: I need a crown where the shape of the whole tooth, not just the occlusal surface, is the same as the original tooth, because otherwise my tongue will feel the difference. I've had several CEREC crowns done, and they're fine, but with CEREC, an impression is made (via a camera) of both the unprepared tooth and the prepared tooth. The problem is, to get CEREC, I would have to go to another dentist in a distant town - a dentist who'd be an unknown quantity, whereas I know my own dentist is first rate. So I suppose my question is: can I rely on a lab-made crown being natural enough to satisfy my OCD? Thanks. honestdoc: No, handmade lab crowns will never be exactly like your original contours. A possibility is your dentist will need to provide an impression of the tooth before it gets prepped. The technician can then survey the contours to match as close as possible (analog way). If you had CEREC (digital) crowns and your fine with them, then that may be the option. I find CEREC crown margins not as well-sealed in the margins as the handmade ones.

How accurate can a ceramic crown be if it isn't CEREC?

Kingsley2019: Hi, Please give your thoughts on what may be causing pain. Case: UL7 shallow occlusal composite filling, first done 6 years ago. Since having the filling done, patient has pain only on biting something hard on the filling or when directly pushing against the filling with her finger, though no pain on touching the tooth itself with the finger. The pain is very acute, sharp and shooting type pain, but short lived, with no dull ache or throbbing. There is no discomfort with cold, hot or sweet things. It has been like this for the last 6 years. The filling has been redone by 3 different dentists approximately 4 times, there is no obvious fracture line in the tooth , and this has been checked with a microscope once the filling is removed. The filling is also not high, and has been adjusted out of the occlusion. The composite filling was replaced with a temporary zinc oxide eugenol filling and the pain went completely. After 4 months, a permanent composite was again placed, and the pain symptoms returned. The tooth is not tender to percussion and responds perfectly normally to cold test. There is no pocketing around it. Aside from a possible fractured tooth (which seems unlikely given the very small size of the filling), I cannot think what may be causing the pain. Any thoughts on possible reasons for the pain? I have attached a copy of a recent bitewing I took. Thank you, Kingsley honestdoc: Unfortunately all composite materials shrink about 1 to 1.5% during light curing. This can cause micro stresses between the bonding and tooth structure. Have your dentist use Fuji Equia final glass ionomer restorative material or better yet (more expensive to the dentist) Activa bioactive restorative material from Pulpdent. MattKW: Sometimes the smaller composites can be more troublesome than incrementally filled larger composites. The fact that you got relief using a temp ZnO is a good sign. Also consider a amalgam with a Dycal or GIC lining. Butterfly5: Dear Kingsley Were you able to solve your problem? If so, how? Thank you very much

Pain after filling

joss: I needed repair work done to some crowns close to the gum line. [ along the pallet/roof of my mouth, and after a few days, the gum has become very irritated. [ sore, burning, and sensitive] I noticed the same reaction when he placed a temp crown while I waited for the finished crown to get done. When that crown was placed, by THE NEXT DAY the skin on the inside of my mouth that was in contact with the temp was almost 100% better. Those crowns are less than two years old, and I can't afford new at this point. Anyone have this issue? My dentist of 30+ years doesn't offer an alternative to this material he is using. Is there one, [ it has to adhere, as a part of it came out, he said due to not being able to get the area dry enough before putting it in] Any help would be appreciated. Dr M: Good day, Although rare, certain patients has shown to be allergic to the crown cement that has been used. Sometimes even the temporary cement underneath temporary crowns. Especially if they contain Eugenol. I would suggest a new dentist if your regular dentists doesn't have alternative materials and won't at least try and accommodate you. There are a lot of modern crown cements to use. To determine the exact type of allergy, specific allergen testing should be done. That being said, it is is possible that the gum was also just irritated by irregular margins on the temporary crown and then when this was replaced with the smooth margins of the permanent crown, the irritant was removed and everything returned to normal. If you have no symptoms anymore, I would mention this reaction the next time any crown work is done. joss: Well, there wasn't a problem with the permanent crown, once it replaced the temporary, NO irritation, so I believe it is the material used in the temporary. Now, the material my dentist used to fill the hole he drilled in my permanent crown is bothering my mouth just like that "temp" crown. There has to be a correlation between those two materials. This is my issue. Never had this problem before, and I'm wondering if there are more choices for other types of resin [?] materials. He passed a message through his secretary that the temp crown material is different than the material he just used for the filling. So I am at a loss. Dr M: Do you perhaps have a photo of the affected area? joss: Sorry, I do not. Very difficult to take a pic of the Roof of my mouth. MattKW: Sometimes damage to the gums during crown preparation because we have to push them aside with a retraction cord. Could also be the metal alloy used in the crown if it's a porcelain-fused-to-metal (PFM) - non-precious or semi-precious react with some people; always best to use precious in PFMs. Another remote possibility is that it's set off a palatal herpes outbreak. Kate 44: I would get the data safety sheet for the materials the dentist used and have an allergist test me for those chemicals in a scratch test Maybe you have an allergy to one particular ingredient. I once had a reaction to a crown, it turned out I have an allergy to palladium. Plus I think I react to the Eugenol. I know its 2021 now, but this is in case you have not solved the problem, or for those with similar problems.

I think I have developed an allergy to the filling material my dentist uses.