Consdering dental crowns (or other options)

[ayac]

My dentist replaced an amalgam filling today on #13 (I think it's a premolar on my left side) that had extensive decay underneath it. She recommended that I get a dental crown for it since the decay went so deep. I recall that they had to fill the amalgam-depositing device three times before they got the entire thing filled up. That's probably bad news...

I also have an incisor (the right one next to the two front teeth) that she also recommended getting a crown for, since it had 3 composite fillings in it. (Yeah, I'm starting to regret being lazy and not brushing my teeth, can you tell? :( )

The thing is, I'm graduating college soon and I don't think my parents' insurance will last me out until then. My mom quit her job and my dad's thinking about retirement. I've already gotten all of my fillings replaced by this dentist this year since apparently my previous one neglected to look for decay under them...

If I had a choice between getting a crown for the incisor or the pre-molar, which would be the best? I'm leaning toward pre-molar, since I don't bite into hard foods very often with my incisors, and I'm taking care not to because of the delicate state of that tooth.

Next week I'm getting an amalgam in #14 replaced and I'm hoping that it's in better shape than #13 but I'm not keeping my hopes up. :(

Thanks for any advice!

[funkynina]

I worked as a dental assistant for a prosthodontist for 2 years.  I agree with the dr. that you should definately not allow insurance to dictate your treatment needs. I do think though that you should have the premolar crowned maybe not asap, but think about it in the near future because the filling you had done was an amalgam and those do not bond to the tooth.  So this could cause the filling to come out and possibly break your tooth because amalgam is stronger than tooth structure.  The break could cause you to need a root canal and a build-up which would cost you more $.  Onlays and inlays can not be done on a front tooth.  Maybe a veneer.  Which would definately need to be decided by the dentist treating you.  A lot of things would determine the treatment needed for this tooth.  I do agree that the premolar should be crowned first because of it's over all function in your mouth.  It is a tooth that takes a lot more stress than an anterior tooth.  Try not to think too much about the $ part (with in reason of course), but think about how young you are and the importance of your dental health and of course appearance.  You should take good care of your teeth because it can affect your quality of life in so many ways.  Heck!! You can always get a second opinion.  Someone else may have a different treatment options with a clear look at the situation!  But, I think you refered to your dentist as a "she"?  And remember women are always right!!  Just kidding!  Best of luck with your dental health and your upcoming graduation and the start of your life!!

[ayac]

Thanks for the advice! I'm definitely going to ask my dentist what she thinks.

I've run across a treatment called dental inlays, that are more conservative than crowns but strengthen the tooth. Do you think that could be a possible option for me, instead of the crown? The incisor might have too much surface area covered by filling to make an inlay possible, but the premolar only has one (deep and large) filling in it, so I think an inlay could be done on it.

[Jerome Bogin, D.D.S.]

It is impossible for me to determine which tooth or both need crowns without seeing them. You seem to be pretty young so I would not suggest the crowns unless it is definitely necessary. Once you place a crown it will have to be redone in the future.These restorations like any restorations in your mouth will eventually have to be redone.Do yourself a favor and don't determine treatment by when and how much insurance you have. It may help you in the short term but may be detrimental to your dental health in the long run.