Problem getting crown to fit
 

Hi Bryanna,

Another dental ordeal that has been going on longer than my sinus perf. The two teeth next to the extracted wisdom teeth have temp crowns. For over a year, the crowns and temp crowns they placed on #15 have caused irritation and painful inflamed areas on the tongue. Removing #16 was part of the solution to see if there would be improvement, but there wasn't. Once the inflammation started on the tongue from #15, it seems nothing will fit without tongue pain. It started because a dentist placed a huge oversized crown that was also too short. This caused a sore on the tongue.

I just had a temp put on that is the worst ever. He actually put little feet on the temp and round bumps. (not the best shape for someone who already has tongue irritation!) He refused to change the temp. I will see a different dentist on Monday to make a new temp. I'm so exasperated now that I'm thinking I need to try to get a decent fitting temp on 14 and then if I can get a permanent crown on that.....I might need to extract #15. It's been over a year, and I'm sick of all the pain, and concerned if I keep this it could turn into cancer.

The dentist who put this last painful temp on is a prosthodontist. In your opinion, are prosthodontists usually any better with crowns than regular dentists? In this case, absolutely not.


Have you seen many instances where crowns cause tongue sores and can't find a proper fit for a crown after that?

Hope you're having a good holiday season so far. Carol

Hi Carol,

I am so sorry that you are dealing with this nonsense! Fabricating and fitting a temp crown should not be a big deal providing that the tooth/gum is healthy and there is adequate tooth structure above the gumline to put the crown onto. If alot of tooth structure is missing due to fracture or decay, then a core buildup is done..... which is simply a large resin filling that is added/bonded layer by layer onto the existing tooth that is sticking out of the gum. Then the temp crown is fitted and cemented over this bonded filling. The permanent crown would also be cemented over this filling.

The temporary crown material can sometimes be a little rough, but it can generally be smoothed out with a polishing bur or disk. The permanent crown is naturally smoother because it is porcelain.... or gold. I cannot think of any reason why there would be any bumps or feet!! put on a temp crown, especially it they are irritating to your tongue. What was the purpose of doing that, did the dentist say??

With regard to a prosthodontist vs a general dentist....... here's the dental version of the differences. ALL dentists are in the general category.... prosthodontists complete their general studies and then take additional studies/cases to learn how to restore "difficult cases" or those out of the ordinary. You may sometimes read on here that I suggest someone see a prosthodontist... depending on the situation. HOWEVER, any general dentist can at any time take those same courses or more extensive courses if they choose to do so. Also like anything else.... some people are just good at what they do and it's not necessarily the schooling that makes them that way, it's their natural ability to work well with their hands and their willingness to learn from their professional experiences. Sometimes, the "title" puffs up the ego so much that the person gets lost in all the puffs.........!!

You mentioned that you've had several temps or crowns on these two teeth... what was wrong with the teeth in the first place? Are they root canaled.... or periodontally involved?

Bryanna

Hi Bryanna,

Big laugh about the puffs! I think this prosthodontist drowned in the puffs many years ago. I came in to have him just do the crown on #15 that had been attempted by several dentists, and at this point had a temp on it. He kept having me come back for several months just to see how things were going. After several months he started insisting we have to also do a crown on #14 because the outcome of the bite would be better. I hated to involve another tooth, but I know #14 had a very large filling, and quite a few dentists over the last several years had mentioned it would or could use a crown at any time, so I decided to have him prepare a crown for that one also. #14 needs to fit the opposing tooth just right or it causes throbbing and aching in the opposing tooth. When he put the temp on#14, the throbbing came back which had been under control for the last year. I had it checked out by an endodontist before, and the tooth is fine. When the dentist added the feet and bumps, it held the tooth stable and sits on top of the opposing tooth, so it wouldn't slide or hit the opposing tooth inside of the tooth. The throbbing then stopped immediately. He didn't explain this to me, but I figured it out. But if feels like a porcupine. He also added porcupine to #15 which makes it too big. Would it work to have a crown that sort of sits on top of #14, but have #15 with a shape that is smaller and curved inwards. #15 does not need to sit on top to be comfortable, but don't know if that type of shape works being a different style between the two teeth. So the bite feels right, but the feet and bumps are extremely painful causing tongue irritation. I'm not sure if I should have the new dentist that I'm seeing Monday modify this temp or start over. The bite seems right which is hard to achieve.

The dentist that is caught in the puffs...after 5 months of seeing him , then preparing #14 for a crown like he insisted, adds a new idea to treatment plan of making a $975 bite guard. He now insists that I do this before he will make permanent crowns. He also added that he wants to do a hour and a half appointment of bite equilibrium before he will send for perm crown. They would charge extra for this at a rate of $375 per half hour. They said he might need 3 or 4 appt. like this before he is ready for a perm crown. I could see his reasoning for crowning #14, but not this additional treatment.
A part of #15 broke off. This was the reason to need a crown. It is very flat now because of several attempts by dentists that couldn't eliminate the biting of the tongue and inflammation that resulted from original ill fitting crown attempt. It had no root canal or other dental problems. #14 also had no root canal or periodontal disease. I can feel that he left a decent portion of #14 there after crown prep. I already paid half of the fee for those 2 crowns. The other half would be paid at time of delivery. He didn't need to prep #14 because it already was so flat. I like to stay away from any gold because I have silver fillings....because of the battery effect that could ensue.

Because of all the additional treatment/charges he keeps adding as we go along, I can't have puffy dentist complete the work. Also, he refuses to make changes to his porcupine temps. I said I would pay for a new smooth temp, but he won't do that. He wants it to stay just like it is because he is puffy (lol)......what with all his treatment plans sounds like 2 to 4 months. It takes a month to get a crown in his office once he tells the lab to go ahead. Seems a little too long for me. So I'm trying to figure out what to have the dentist that I'm seeing Monday do for starters.

Carol

Hi Carol,

It sounds like you have had alot of issues with #15 and I'm not sure why. If this were me, I would go to the new dentist and not give him any history on it... just the xrays. Just ask for his opinion as to what he sees and what his treatment options would be. Sometimes a new dentist will get caught up in the "baggage" of the dental history and be reluctant to treat the pt. If he asks you why there is a temp on it, you could say.... I'm not sure. And then tell him you have a problem with the "bumps" on the temp and again say, you're not sure why they are there. Allow him to give you an unbiased opinion of what he sees.

I see that you were going to see someone today.... hope this message isn't too late!

Let me know what happens.
Bryanna

Hi Bryanna,

Thanks, I got your message before my appointment. Great idea to not tell the dentist about the nonsense and baggage. I had seen this dentist one time for a consult, so he knew some of the history. I didn't choose him to do the crown at the time because he thought he might HAVE to do gold for the back tooth, but it depended on seeing the tooth.

Today he made a new temp out of new material, but he used the old temp as a starting point by making an impression of it, and made changes to it that he thought would be better. It feels like a big improvement in shape....like a tooth actually. He said I show try it out for few weeks or month, and come back for changes if something isn't right. He said one guy needed 4 changes before they got it right. Whereas the other dentist did not want to make changes. He had that long expensive treatment plan instead. Today this new dentist said that after seeing the teeth, both crowns need to be all porcelain. That was good to hear since I have a lot of allergies, and did not want to go with a new material that I never tried. I always have heard about the galvanic response, so prefer to stay away from gold.

Hi Carol,

Well that sounds like it was a positive visit! I could not understand why your temp crown was so uncomfortable..... never should it be that way!

The galvanic response is an interesting topic and I'm surprised to hear that you know about it! How did you come upon that? Most people are totally unaware of it because it is one of those issues that is not disclosed by a dentist to their patient....... unless the patient brings it up! I believe that the galvanic response that occurs from the various metals used in dental fillings and crowns has negative effects on the persons health in some way or another.... the problem just may show up as something totally unrelated and therefore be overlooked in their diagnosis.

High Noble Gold crowns are actually bio-compatible an can be tolerated by most people really well.........but put them in someones mouth who has mercury fillings and the gold becomes contaminated by the mercury setting off that galvanic response. Even porcelain fused to gold crowns become contaminated by mercury fillings because the mercury vapors work their way into the slighted openings. Fortunately, steps are being taken to outlaw the use of mercury in dental fillings across the US... hopefully it will happen soon!

With your new dentist, make sure he means all porcelain crowns on those teeth. Ask him if they will be zirconium (lava) or procera.

Glad your feeling better...... Keep us posted........
Bryanna

Hi Bryanna,

I'm at a loss what to do next. The new dentist made a new temp, then made one change to the temp. The temp still is causing biting pain and irritation of the tongue on #15. He told me to come back when the sore is there so he can see where it is. He did mention he might want to grind down one of the other teeth, and added it could make things worse. I don't want to take a chance on things getting worse than they already are. It sounds too risky to me to grind other teeth. It seems it would be better to work with the temp. What are your thoughts?

The first dentist who made the painful temp, wanted to do equilibration before he would order the final crowns. It sounds to me like equilibration is grinding the teeth also. I thought I'd never go back to him, but his office called and wanted me to make an appt. for equilibration. I was thinking of telling them I would only come in for crowns if they will do that, but no equilibration. What do you think of that? I have a feeling they are stubborn, and will not agree to that.

Maybe it would be best to go to a different dentist altogether and follow your advice of not give them any history. If the biting pain and sores on tongue can't be improved, I'm thinking I might ultimately have to extract some teeth. I can't eat without getting painful sores on my tongue. I can feel that this temp is pulling my bite too far to the left and also probably too short. The dentist who made the initial temp never measured my bite on the opposite side to make the temp. I think he just made it from models of my teeth that he had. The second dentist used the first dentists basic shape for the temp and didn't start from scratch.

I had read about the galvanic response some time ago. I remember reading about someone who had their gold crowns and metals removed because they were having problems with the galvanic response and electrical sensitivity. Removing the metals improved their situation dramatically. It seems that if someone gets pretty definite symptoms as shocks, buzzing and odd electrical sensations in their body, they may more easily attribute it to the galvanic response. (but they would also need some knowledge of that in the first place) I'm sure there are so many other conditions and illnesses that may start or become exacerbated by mixing mercury and gold. Most people probably never attribute it to the galvanic response, and probably continue to worsen as long as the mixed metals remain in their mouth.

I heard there is an instrument that can test the voltage in your mouth. Do you think that is accurate? It's not something I'm needing, thank goodness.

Appreciate any direction you can provide. Bryanna, you are the best!

Hi Silky,

Ok, so the new temp felt ok initially....... and then you went back for an adjustment, correct? At that appt the dentist discussed reducing the occlusion of another tooth, I assume that was to reduce the biting pressure off of the new temped tooth. He is right in that too much adjusting of other teeth can throw your entire bite off. However, it sounds to me like your bite is not occluded (lined up) properly to begin with... is that correct?

Having a full mouth occlusal equillibration done can be very hard to do because the bite changes according to the position of the head in relation to the rest of the body. So when you're laying down the bite is in one position, when you sit it's in another and when you stand it's yet another. Usually the dentist performs the procedure while the person is laying down. Once it is done, it is done forever.... there is no turning back. In some people in general, their bite is so off that no matter what type of filling or crown you put in there, the bite will not be right. A filling or crown can only be adjusted so much before it becomes totally dysfunctional... the same goes for an actual tooth too.

It is hard for me to say what should be done here. It sounds like your bite is unstable for issues other than just this tooth. Are you missing teeth and for a long time? Do you have old fillings and/or old crowns on other teeth? Do you have periodontal disease? All of these things can cause the bite to become misaligned.

With regard to the tongue becoming sore from the temps..... if no sore is visible, then it is a sensation that you are having to an irritant. What type of toothbrush, paste and floss do you use..... any mouthwash? Do you eat hard candy or lifesavors or mints.... things like that?

The test for elevated mercury or oral galvanic response is called Electrodermal Screening test. Here is an informational page explaining that..
http://www.naturallyhealthy.ws/eds.htm

Bryanna

Hi Bryanna,

I have old fillings but not old crowns on other teeth. I do not have periodontal disease. I have one tooth missing for several years. The missing tooth is on the opposite side from the problem temps. The missing tooth side has a very stable and good bite, according to a dentist who made molds of the teeth to look at the bite. I can feel that it is a very good bite. The problem temps are on the opposite side, and are the two back teeth. They feel too short, and feel like they are pulling my bite too far to the left. So I mostly eat on one side now. If they can't make a better fit for crowns, I guess I could get by with eating only on one side. The dentist who prepared the second crown, said that by doing the second crown he could have more control and get a better bite, rather than just working with one crown. So far that hasn't happened. Do you think getting a good fit with two crowns instead of one crown actually makes it harder to get a good bite?

Would it be best to start from scratch and make a new temp? When I see the dentist, I have a feeling he will want to modify this temp.

Thanks! Silky

Hi Silky,

Old fillings wear down over time which causes an unnatural and gradual shift in the bite. When the dentist tries to put in one or two new crowns, it can be difficult to get them to fit into the existing bite because the bite can literally be all over the place. The old fillings do not wear down evenly because some are newer or older than others. The teeth on your upper arch opposing these two temps may have worn down fillings which could make it very difficult if not impossible to get the bite correct.

The problem with doing an occlusal equalibration on teeth with old fillings or teeth that are mostly filling... not only will portions of the filling have to be shaved down but so will portions of the actual enamel of the tooth. Old fillings are already breaking down with micro fractures.... add to that the drilling for the bite adjustments and the filling breaks down even further. Sometimes it is better to have all of the fillings replaced (can be very costly) so that the bite can be aligned according to the new restorations. Doing one filling here and there does not solve the bite problem. Did I explain that ok??

Bryanna

Hi Bryanna,

Thanks, you explained that very well. The second dentist found a good fit for one of the temp crowns, but the other temp is still causing a sore on my tongue when I eat. I'd like to get one of the crowns, and just keep the other crown in a temp. He is planning on telling the lab to make the crowns exactly like the temps....without the labs deciding the shape of the crowns. Is this a good method? Or is it better for the lab to have some input?

The first dentist who prepared the crowns never provided delivery of the crowns. He insisted that I have equilibration before he orders crowns. It doesn't seem right to force someone to do a procedure with high risk in order to get crowns, when this was never discussed previously. I would not want to take that risk. I paid them half of the price of the two crowns. I'd like to ask for a refund since he never provided crowns. Do you think it's appropriate to ask for a refund since he never followed through with crowns?

Thanks! Silky

Hi Bryanna

Thanks, you explained that very well. The second dentist found a good fit for one of the temp crowns, but the other temp is still causing a sore on my tongue when I eat. I'd like to get one of the crowns, and just keep the other crown in a temp. The dentist decided it would be good to get the one crown. Then the second tooth will still have a temp. He might be able to get a better fit with a single temp, instead of the temp around the two teeth?

Another thing I was wondering. If a comfortable fit can't be found for the second temp, could a much smaller crown be made that might not be functional but would at least cover the tooth. It would at least stop the pain from irritating the tongue.

The first dentist who prepared the crowns never provided delivery of the crowns. He insisted that I have equilibration before he orders crowns. It doesn't seem right to force someone to do a procedure with high risk in order to get crowns, when this was never discussed previously. I would not want to take that risk. I paid them half of the price of the two crowns. I'd like to ask for a refund since he never provided crowns. Do you think it's appropriate to ask for a refund since he never followed through with crowns?

Thanks! Silky[/QUOTE]

Hi Silky,

I'm still confused as to why this temp crown is causing an irritation on your tongue? Can't he just smooth out that rough portion of the crown? Is the temp too large?

Yes, a dentist can tell the lab to duplicate the shape of the temps. However, I don't see how that would solve the problem if the temp does not fit properly on the one tooth. Dental technicians are like dental artists... for chewing and esthetic reasons, they make the crowns according to the natural anatomy of a tooth. Temp crowns do not have those qualities. Will the crown be functional irrelevant of how it is shaped... depends on the anatomy of the other teeth and the bite.

If your first dentist did not insert permanent crowns on those teeth because you refused the occlusal adjustment, then yes, you are entitled to a refund of any money that you paid him for them. He would not have sent your impressions to the lab to have crowns made until your bite adjustment was done...and since it wasn't done, he most likely has not incurred any lab expenses.

Bryanna

Silky,

Are the two temps connected to each other??

Making a smaller crown for that problem tooth may not necessarily be a good option. It could cause additional problems with your bite because the top tooth may then have nothing to bite against.

Bryanna


[/QUOTE]

Hi Bryanna,

Yes, right now the two temps are connected as one. The dentist will go ahead and put a permanent crown on #14 which is not a problem. That will leave #15 with a temp crown.

One thing that was mentioned was to round off the opposing tooth to #15 because the tooth is very sharp. Is working on the opposing tooth something to stay away from? He said it could make things worse, but he could add back what he rounded off.

Thanks. Silky


[/QUOTE]

Hi Bryanna,

The temp causes irritation and a round like sore on the tongue when eating. The temp is not too large. Right now the temp is kind of sharp along the tongue edge, but I don't think he can smooth it any more.

I've left messages for the dentist for a refund because he did not deliver permanent crowns, and he's ignoring it. The occlusal adjustments would have cost maybe $3000 or more because his staff said he would probably want 3 or 4 of them. The dentist never talked to me about occlusal adjustments. He just had the staff give me that info. I've read where occlusal adjustments aren't done much any more because they found they cause more problems than they solved. I did the second crown because he insisted on doing that before he would get a permanent crown for the first tooth. I didn't want to do that because that tooth was fine, but then went ahead with that. I saw it as the only way to get permanent crowns. As soon as he prepared the second tooth for the crown, he said he was putting the permanent crowns on hold. That's when he threw up the roadblock of "occlusal adjustments are required now before I'll order permanent crowns". I'm just exasperated with that kind of treatment.

Thanks. Silky

I'm still confused as to why this temp crown is causing an irritation on your tongue? Can't he just smooth out that rough portion of the crown? Is the temp too large?

Yes, a dentist can tell the lab to duplicate the shape of the temps. However, I don't see how that would solve the problem if the temp does not fit properly on the one tooth. Dental technicians are like dental artists... for chewing and esthetic reasons, they make the crowns according to the natural anatomy of a tooth. Temp crowns do not have those qualities. Will the crown be functional irrelevant of how it is shaped... depends on the anatomy of the other teeth and the bite.

If your first dentist did not insert permanent crowns on those teeth because you refused the occlusal adjustment, then yes, you are entitled to a refund of any money that you paid him for them. He would not have sent your impressions to the lab to have crowns made until your bite adjustment was done...and since it wasn't done, he most likely has not incurred any lab expenses.

Bryanna[/QUOTE]

Silky....

Firstly, how are you?

Secondly, if the dentist has not inserted the permanent crowns... you are not responsible to pay for them. Sometimes in situations like yours, a letter from an attorney or a complaint to the state dental board will get you a refund.

Please check with us when you can :)

Bryanna



[/QUOTE]

[QUOTE=Bryanna;749512]Silky....

Firstly, how are you?

Secondly, if the dentist has not inserted the permanent crowns... you are not responsible to pay for them. Sometimes in situations like yours, a letter from an attorney or a complaint to the state dental board will get you a refund.

Please check with us when you can :)

Bryanna


Hi Bryanna,

There is some progress. I had a permanent crown put on #14 with temp cement and it seems it will be fine. Do crowns usually remove with temp cement okay? The temp on #15 is still a problem with irritation to the tongue, so not sure what to try next.

I did start a complaint with the local dental society because the dentist never provided permanent crowns. They may be able to help get money refunded, but maybe not. After that is completed, one can still file a complaint with the state dental board. The dentist is going to try to say that I discontinued treatment, but that is not the case. He never answered his emergency phone number when the temp was causing extreme pain. He wouldn't even order a crown from the lab because he insisted
I complete treatment of 4 equilibration treatments and a $1000 bite guard first.

Thanks for your comments! Silky

Hi Silky,

Temporary cement is just that.. temporary. Unless the crown fits very tightly on the tooth, then yes, the crown will remove fairly easily if it is temporarily cemented.

With regard to your $$$ situation... If the dentist did not have the crowns made by the lab, but you or your insurance already paid for them...he cannot legally keep that money. If the dentist had the crowns made by the lab but never inserted them in your mouth... he can charge you the lab costs to have the crowns made. However, when he gets notice that you filed a complaint, he will most likely want to resolve this matter quickly.

Every dental office has reimbursed a patient from time to time for various reasons so it's not uncommon.

Keep us posted!

Bryanna




Hi Bryanna,

There is some progress. I had a permanent crown put on #14 with temp cement and it seems it will be fine. Do crowns usually remove with temp cement okay? The temp on #15 is still a problem with irritation to the tongue, so not sure what to try next.

I did start a complaint with the local dental society because the dentist never provided permanent crowns. They may be able to help get money refunded, but maybe not. After that is completed, one can still file a complaint with the state dental board. The dentist is going to try to say that I discontinued treatment, but that is not the case. He never answered his emergency phone number when the temp was causing extreme pain. He wouldn't even order a crown from the lab because he insisted
I complete treatment of 4 equilibration treatments and a $1000 bite guard first.

Thanks for your comments! Silky[/QUOTE]

Hi Bryanna,

I still have a problem with a crown on #15 causing irritation on the tongue. The dentist isn't sure if it is the crown or the wisdom tooth #17. The wisdom tooth has a flattened out cusp of mercury on the part of the tooth closest to #18. The tongue gets sore after eating. Could the #17 tooth even be affecting the tongue when chewing. The opposing wisdom tooth #16 was extracted, so there is no tooth to chew against. I hate to get #17 extracted if it is not the problem. The roots are close to the nerve on that tooth.

The crown is in temp cement. I was wondering if it was possible to make a very small temp crown (maybe something the shape of a bottle cap....the prepared tooth does not have much height to it) to put in there to relieve the irriation for a while and try to determine which tooth is the problem. Appreciate any helpful insight you might have. Thanks. Silky

Hi Silky,

The dentist could make a new temp with a different shape and also remove the mercury filling in #17 and replace it with a composite one (non mercury). I would not extract #17 unless it was infected, a collector of plaque and/or served no chewing purpose. Just changing that filling may solve the problem.

Bryanna

Tongue irritation and biting after new crowns
 

Hi Bryanna. I was unable to find a way to post a question addressed directory to you, so I'm just replying. Please forgive me for that.
I read your posts and I have a question. About a a year and a half ago I had 2 crowns replaced, bottom moLars on opposite sides. My previous crowns didn't bother me at all. My dentist told that they were old and leaking. They were kind of old. It's true. So I replaced both. After they were replaced i started experiencing severe burning on my toungue and sometimes even my mouth is very irritated. Also the gum I kind on receded in one side. I first called the dentist and he said that everything is right in my mouth and he never had a patient with this problem. RE the gum he said it's because he had to make a crown taller going into the gum more and my body doesn't like it. He said it will adjust with time. It's still the same issue. I also told him that I time to time bite my tongue. He said that it may be because the crowns are new. I went to numerous MDs with my toungue issue. I had upper GI scope done and it's all negative. At first I thought may be I have an allergy to some materials in the crown. I now think after reading this forum that may be the crowns are wrongfitted??? My teeth are naturallying very short and every dentist I see says that it may be a problem. But I had crown there before and there was no issues. What do you think about it?is this a crown issue?

Hi Spiro,

Welcome to neurotalk! If you ever want to address a thread to me directly, you can just start a new topic :)

In the meantime, I found you........... :)

Having short teeth is a problem when trying to fit a crow properly because there just isn't much to work with. If your original crowns had fit well with no problems and there was no decay underneath them that needed to be removed when he prepped for the new crowns, then the new crowns should fit just as well as the old because he would not have had to do much drilling.

Yes, crowns need to be replaced as the cement eventually gives out and bacteria is able to seep in underneath the crown.

Regarding the possibility of being sensitive or reactive to the crown material... that is always possible. It is also possible to be sensitive or reactive to the cements used to cement the crown. All it takes is one smidgen of cement to be caught below the gum line and a reaction can happen. Especially if the person is sensitive to the chemicals in that cement. The reaction usually consists of an irritation sensation, burning, itching, inflammation, etc. The gum tissue will tend to pull away from the tooth in the area of the irritation. The symptoms of that could transfer to the tongue or other area of the mouth as it travels along a nerve path.

Perhaps it would behoove you to have a consultation with another dentist, not associated with this one, and bring your pre and post op xrays to that appointment. Ask them to check the gingival (gum) margin, check the bite, and check to see if there are any pieces of cement caught between the gum and tooth. it's probably not best to wait as your reaction to these crowns indicates not right.

You can also be tested to see if you are reactive to dental materials. It is a blood test called a biocompatibility test. Here is a link that talks about that:
http://iaomt.org/practical-guide-com...tal-materials/

Some holistic dentists use another test called Kinesiology which is a form of muscle testing. This type of testing is usually pretty accurate.
Here is a link that talks about that:
http://www.drwolfe.com/dentistry/dental_materials

Hope this info is helpful to you. Keep in touch.
Bryanna