Crown than root canal???

[Allie101]

I had a large filling and my dentist said it was cracked, so my dentist suggested a crown.
He did the prep, and set a temporary crown until the permanent was being made.  While with the temporary crown I complained about pain on the tooth when biting down..The dentist response, the temporary crown is just too high! He went on with the positioning the permanent crown on, ajust the bite and send me home…
I came back complaining that I still have the pain on the same tooth. OH! Then you need a root canal!! He said.
My question is: Shouldn’t he figure that out before putting the permanent crown in?
Is this lack of experience on his part? After that I found out that he graduate in 2005...
So now he went on and performed the root canal over the crown, leaving the filling seeing on the crown… I did not know that was the way to do things and when I asked on my next visit if the dark spot on the crown would even out, since I thought the purpose of the crown is to cover the filling…his response was, the purpose of the crown is because you had a very large filling!!!

Ok, now more than a month past and I started having pain on the same crown, and the crown have a very tiny wiggle if I try to move it... Went back to him and he said that this tiny movement is normal with the ligament, his proposition to my problem is take the RX antibiotic for 7 days and wait a month to see if, the antibiotic take care of the infection that he sees on the x-ray, “small gray area" if stop the pain we are done; but if the pain continues, he will go back in and thru the same hole and re-do the root canal. Wouldn’t that week the crown and give me less life on the crown and making it prone to crack?
Can I request that he do-over of the crown? Do I have the right giving the whole scenario? And what is the standard of care?
Please advice, this doctor did one previous root canal and then a crown on another teeth and I did not had a problem with it.
At the same time health come first and I honestly I want to see what another dentist thoughts are.
I appreciate your response.
Allie101

[Hamidreza Nassery , DMD, FICOI]

If any dentist ever tell you that this same scenario has not happened to them, they are not being truthful. We always try to be as conservative as we can and sometimes to a fault. I have a few years over this denist and I don't quite fall into it as many times.
I, however, usually replaced the crown if it was done just recently. By recently I mean less tha six months.. unless I warned the patient about the possibility and they chose to take that chance. I which case I document in chart.
However, I don't like the rest of the story as you have said, if the tooth is still throbbing then the Root canal was not successful, and if the crown is moving the seal of the cement is broken and that is not good either. Not acceptable on both counts. I would have an endodontist check the root canal and then redo the crown.
Hope this helps.

[lynn117]

i cant answer all your questions but it is normal when a crowned tooth needs a root canal to jusy drill thru the top of the crown. you would chance damaging the tooth more by removing the crown first. many teeth with deep filling dont end up needing a root canal but dental work close to the nerve can cause trauma. after the crown is place sometimes the trauma calms down and sometimes it doesnt. if it doesnt a root canal is necessary. the crown keeps teeth with large fillings from breaking and cracking. i always get gold crowns for back teeth since they dont crack , chip, or break and tend to be more durable.

[StratRebel]

Dr. Nassery is correct, this does happen from time to time that after finishing a crown the nerve just does not recover and needs a root canal.  However, my problem with this scenario is that the dentist permanently seated your crown while the tooth was still in pain.  If one of my patients ever comes back with pain while wearing a temporary, I will adjust the temporary and wait on the crown.  Cementing a final crown on a symptomatic tooth is not such a good idea.

If the tooth is still throbbing after the root canal, it may be an unsuccessful root canal, or the final crown may still be too high and its putting too much pressure on the bone and causing the throbbing (basically like a bone bruise).  I would try to get him to recheck the bite again and see if your crown needs adjustment before redoing the root canal.  The crown being loose leads me to think your bite is high in eccentric (side movements), although a lack of initial cement seal is also a possibility.

If the crown needs to be redone this quickly, you should not have to pay for a second one.

[kayla276]

Don't forget to notify your stated dental board of your happenings, just for your own piece of mind.    Oh and don't forget to see a Prosthodontist if your General Dentist doesn't know how to put crowns on right or do occlusal.  

I got a 2 crowns on that a dentist did not do right and the crowns were to high, i ended up with 2 root canals and one of my crowns are still moving that he stated was not, now I have to see an orthodontist.

It cost me 2560  for two crowns

for a specialist to replace the crowns, it is going to be 3488.00  not to mention the two root canals 2040.00

Add it up and it gets pretty expensive.  Lucky you have just one.

[Allie101]

Dear Dr. Nassery,
Yes the crown was done about 2 months ago...
Since I agree with some of the impute I got from you guys, thst it was reasonable on my part to ask for another crown since it was done recently, this Dentist didn’t take it very well, and now he changed his approach and instead of go back and re-do the root canal like he said he would, now he said that I have high expectations and sincerely he doesn’t want to treat me anymore and he wants to send me to  root canal specialist. And the costs are mine to incur since nobody can guarantee a root canal…
I appreciate your thoughts on this scenario.

[Hamidreza Nassery , DMD, FICOI]

Well the sort of it is that there is no written rule saying that he should.. first of all I would recommend that you get the re-traetment of the root canal with an endodontist. He didn't do it right the first time , what makes you think he would retreat it right. remember retreatments are more difficult.
As per him not standing behind his work, it will only come back to huant him down the line.. we live in an increasingly informed society and not only people talk but they also read and research the net extensively.. negative comments can really hamper ones business.. he still young and has not figured that out. Unfortunately, this hurts you , and him ( weather he realizes it or not) and the profession.
Find yourself another dentist that has more respect for his craft and profession and his patients.