Worried about crown removal proceedure

[cnad]

I have a query regarding the process of crown removal. I have written to this forum earlier and I find it very helpful. In august I had 2 root canals done on my top right molars & crowns were put in. The wisdom tooth on that side has been extracted because it had grown into my cheek. The crowns did not set properly so a month later they had to be removed. They were removed by my new dentist. I was also told that the quality of my root canal treatment was not good & that both the root canal treatments had to be redone because only 2 canals had been filled. Anyhow, the RCT was repeated on both the molars and new crowns made. I was given no temporaries. Permanent crowns were directly placed. The problem is these crowns do not make any contact at all with my lower teeth. My dentist actually told me that this is how I get crowns made so that they wont cause wear on the opposing teeth. But I think this is wrong. I cant feel any teeth on my right side. Its been 2 month since i have done any chewing because it causes pain on my normal side since the teeth keep touching and there are no teeth on the opposite side to balance my jaw. Also a few times my jaw made a clicking sound which has never happend in my life before. I understand that if there is a problem with the occlusion it can cause TMJ problems. I went back to my dentist and he said he can cut the crowns off for me and re-pay me. My question is, is it safe to get them cut off since its the second time in 2 months? I am very worried. My jaw feels tired and tight since I have done no chewing in about 2 months! Please advise me

[Jon8]

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[Dan97408]

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[MikeOverseas]

Hi,

I would greatly appreciate it if a dentist could comment.

I made the mistake of walking around for two years with a "permanent" crown which was attached only with temporary seal.  (Due to frequent travel and change of continents, just never made it back to California for the follow up).  Number 14 tooth, I believe, upper left hand side.

Anyway, the crown fell out two weeks ago.  A dentist put it back in today.  But before placement, she observed (without taking any x-rays) a cary (around the top of the root canal).  Drilled into it (I could smell bacteria).  Then, place some white material in there for a few minutes, then glued the old crown back in.  The crown immediately felt wrong, and she did not believe me that my bite does not feel right, and said to come back in a few weeks -- if "I don't get used to it."

My bite is definitely off.  She did not use carbon paper or anything like that to assess the bite.  When I close my upper and lower jaws, the predominant feeling is pressure from the area of crown against the lower tooth (even though I can sort of clench down on the right side of the mouth if I try).

My concerns are the following:

1. Did she really take care of the infection that was in there?  The root canal was complex and took a long time on this.  (I have an excellent endodontist back in Maryland who has an excellent regional reputation (dentist's dentist; professor; etc.) and he said that my long roots / curves made for a very difficult root canal.

Since there was a nasty smell when she applied the drill, was this more than just a little pocket of bacteria?  Could this be in the root?  How could she know if she did not take an x-ray?

2. Is there something wrong with putting an old, dirty crown (which I brought in a plastic bag) back onto the stump without cleaning it (she used some swab/solution right at the chair-side)?  I would have expected a cleaning machine, autoclave, or something like that.

3. Is there something wrong with covering an infected tooth with a crown right away?  My common sense tells me that things should be allowed to drain or dry out or something like that.  Maybe she put in a filling, but it was not clear to me what the steps were during the procedure.

4. As far as the fitting goes, I almost would prefer that some other dentist remove this "porcelain on metal" crown and take a proper look / start over again.  I feel that this was a botched job.

I have a set another appointment with a very expensive clinic in the major city near here, and I'm hoping to get better service.

Any thoughts by professionals on the above will be GREATLY appreciated.

Thank you!

[mike1105]

it is safe to have them removed. usually, a slice is made throgh the crown and they pop right off. it is simple. However, I'd suggest you contact a new dentist (get a referral from a family member or friend) BEFORE you have these bad ones removed. let him or her examine you and give you a written treatment plan. you are right-- if they do not make contact they were done poorly (they should not have been cemented--- and his claim about wear on the other teeth is bogus). that being said, i would tell this dentist that you are going to have them re- made in another office, and if he wants them back you will give them to him when your NEW dentist removes them, at which time you expect a prompt refund. make sure your new dentist takes photographs and documents the case well in case your current dentist gives you a hard time. you may want to send your current dentist a certified letter BEFORE YOU DO ANYTHING, that: 1. explains what is wrong with the crowns 2. mentions that you now have TMJ symptoms that you never had before and 3. mentions that you expect (as agreed) a prompt refund once the crowns are returned to him. 4. includes a diagnosis as to why the crowns are no good FROM YOUR NEW DENTIST. btw-if insurance paid any money towards these crowns, you should call your insurance company now and inform them of your situation as they will be unwilling to pay for them again until THEIR money is refunded.
In your letter, you should also demand copies of your records, which by law in most states he must give you. if you are given a hard time from your current dentist when it comes to the refund, you can refer the case to your state's board of dentistry.

[Jerome Bogin, D.D.S.]

I have been in this profession for nearly 40 years and it never ceases to amaze me what I hear from patients. You are absolutely right that these crowns should be in contact with your other teeth.If the present dentist is not going to redo the crowns which is necessary why his he cutting them off? if you are going to a new dentist which might not be a bad idea then let the dentist who is going to do the crowns cut them off. As far as cutting them off I do not think that would propose a problem.