problem crown/tooth, what's my next move?
 

Last Nov. my dentist wanted to place a crown of a non-painful tooth because it had a crack that went below the gum line. Had alot of pain with the temporary that spread to other teeth despite the bite being adjusted a couple of times.

Went to another dentist to try and get it resolved who stated something about the margins on both the temp(and the permanent, I brought it with me)New dentist asked old dentist to replace the crown, he refused said he'd fix it. New dentist placed a new temp on and took a mold for the old dentist to "fix" the perm crown. New temp was less nerve painful but still didn't like much pressure. Asked new dentist if I would just be better off having a new crown made and she said no.

Had new dentist place the perm crown last week. She said the margins were still too big, even tried to take pics but camera wasn't working. So she tried to fill in margins with composite. Now I'm having worse pain from that 2nd to the last molar to the front tooth on that side. Sensitive to hot/cold(didn't have that before) and still problems with pressure. Also, she took a
the perm crown on /off several times while adjusting it, and that didn't hurt(was numbed), but when the cement was placed I could feel it in several teeth.

As mentioned in a previous post had a tooth extraction on the other side 3 weeks ago, so can't really chew on either side now. Was getting by on soups and smoothies but now with the sensitivity to temperature my options are even more limited.

Should I wait and see if it calms down?, should I try to get more composite added? Should I just start over? Not my primary concern, but it is getting expensive, and I just want the pain to stop and be able to eat normally again. I can't believe this has been going on for almost a year now.

Sorry it's so long.

Diana

Hi Diana,

Is this the same tooth that the oral surgeon recently said had an infection but your dentist didn't agree with that diagnosis?

When a dentist starts putting composite material on a new crown, there is a problem right there with the fit of the crown. Anytime the dentist remarks "the margins are still to big" on the crown they just made.... there is a problem with the fit of the crown.

Sounds to me like the dentist that did this new crown, has not treated you fairly in that if the new crown does not fit properly, he has to do a new one, no questions asked!

You have been through the wringer with your recent dental problems. How is the extraction site feeling and healing these days!

Bryanna

Yes, the same tooth. She said she really doesn't think it's an infection and wanted to place the crown. Shen told me before if the crown wasn't right, she wouldn't put it on, but she did it anyway. And didn't even return my call from yesterday telling her about the pain and new sensitivity to hot/cold. Not getting good care here, but not sure what to do now.

The extraction site is still sore, but compared to the other side it it doing fine. At least I can lay on that side at night.

diana

Hi Diana,

I agree, you are not getting the proper care from her. I know you don't want that tooth to be infected, but if the surgeon said it was, I would take his word over hers. Especially since she's treating you so lackadaisically, I just wouldn't trust her at this point.

Can you consult with another general dentist... perhaps the oral surgeon can refer you to someone else?

Bryanna

I've had enough, I am looking for another dentist. I've been unhappy with other things that have occured, but not calling me back after placing an inadequate crown which is causing new pain is unacceptable. What do they think I'm eating, or how I'm sleeping. Had to actually take pain pills from the oral surgeon from the extraction. Not sure what I would have done without those.

thanks again for your support. I'll keep you posted...

Wish I had better news. Put my head in the sand about this tooth til the temp cemented perm crown fell off. Dentist actaully declines to get me in to replace it, claiming I now need a root canal.

New biodentist does me a favor and gets me in. Said I need a new crown(no surprise there) Places a new temp and uses muscle testing to test a material(don't remember what is was)for the new crown.

Last Wens new crown placed, pain much reduced. But I can't relax at all, I have increased heart rate, shallower breathing, and my ears are ringing like crazy. Got a migraine last night. Have to take lots of meds to get any sleep.

I can't imagine having to get a third crown, but no way can I exist like this. What should I do? Why do I feel like he's going to be upset with me because I can't tolerate whatever this is made of? I have other crowns and have never had any reaction like this.

Any guidance you can give me would greatly appreciated.

thanks...

Hi diaba,

Your symptoms could be related to your migraine headache rather than the material of the new crown. If the physical symptoms do not subside once the migraine has passed, then call the dentist and explain what you are experiencing.

Bryanna

Hi Bryanna, the symptoms started within 1/2 hour of the permanent being placed. No injection were necessary to place it. The migraine was 2 days later. I think it was from the stress of not being able to rest or sleep much.

I guess I'll call my dentist tomorow and explain what's going on. It's a perfect fit, and the pain that was there for so long is gone, I sure wish I could keep it. But it seems unlikely.

I know there is a dental materials compatability blood test. Are you familiar with it and do you think it's accurate? If I have to get another crown I'd like to increase my odds of tolerating it, as the muscle testing method doesn't seem to work on me.

thanks

Hi diaba,

There are two biocompatible tests that I know of for dental materials. One is the Clifford Materials Reactivity Test by Clifford Consulting and Research and the other is the Peak Performance Test. There is some validity to them, but the values may be time sensitive meaning, the results may change from one test time to another as anyone can become sensitive to a material at any time.

If you were going to get another crown done, it would probably be best to have the crown done immediately after the compatibility test results.

Are you still having the same symptoms that you were having when it was first put in?

Bryanna

yes, I just left a message for my dentist.

diaba,

Please keep us posted on everything....... thanks!

Bryanna

I went back in today. They gave me a homeopathic to try to calm my autonomic nervous systen down, seemed like it might have been helping. But then they added prolotherapy which was an injection of procaine and that made things worse(plus cost me $150!)

Supposed to go see someone tomorrow who will make another homeopatic remedy to counteract the energy of the material(emax porcelin)It all sounds a little woo-woo, but what choice do I have.

I did get the Clifford test kit so I'll get that done. I wish I could have this material removed and get one that I won't react to, but I don't know what that would be yet. Are you familiar with the emax porcelin?, it's composed of dilitium silicate. i couldn't find any info on potential side effects. My dentist hasn't had other patients that reacted like this.

probably going to spend more $ trying to keep this crown,i swear i'd just get the darn tooth removed but it's such a large molar, I had to have the one on the other side removed and it's really hard to chew without it.

Hi diaba,

I am a proponent of homeopathic remedies and have had good results using them myself. Sometimes you have to try different ones or different combinations until you achieve the best results. I have also seen prolotherapy work well in some patients but not so good in others. I think the timing of that therapy is crucial and perhaps it works best at the onset of the initial problem.

I am familiar with e.max material. It is a porcelain that is layered or pressed onto a firm material like lithium disilicate or zirconium. It is also the material that is used when making in office crowns with a CAD/CAM system. I have had patients complain about a chalky after taste which subsided after a few days. Sometimes people have some side effects from the cements that are used to adhere the crown. But they seem to diminish also. Have you looked up the MSDS form on e.max?

I wouldn't remove the tooth if it is healthy. If a reasonable solution can not be obtained with this crown, then the dentist may have other material options. Don't loose hope .......... !

Bryanna

funy i did have the taste of baking soda in my mouth for a few days after, and actually can't tolerate baking soda. So had initially wondered if there was any in the crown, but i guess not.

I had a different perm crown of porcelin(not sure which type) with a temp cement and had no reaction to that. So maybe it is the perm cement. Can it travel via the tooth to the boday/brain?

Anyway to get the crown off without destroying it and trying a different cement? Found out the cement is relay x 2 with clear fill primer, do you know anything about these?

thanks for your help with all this. nice to have someone to talk to who doesn't think this is all craziness.

Diaba,

Dental cements are applied to the inside of the crown and then the crown is placed over the tooth. Some cement can squish out of the crown as it is pushed down and end up in the gum tissue around the margin of the crown or in the mouth. When this happens, it is generally in a very, very small amount and whatever can be seen is immediately removed. However, some people can be sensitive to the cement even in small doses, but it's usually a temporary side effect.

There are several types of RelyX cements. Each dentists has there preference as to which one they like to use the best. Generally these cements are tolerated pretty well but of course that doesn't necessarily apply to every person.

There really is no good way to remove this crown without ruining the integrity of it... because it is cemented on :) So the only way option would be to have it tapped or cut off and then have a new one made.

I think more people than is realized have some degree of <temporary> side effects to their dental work. Afterall, most dental procedures are in some way traumatizing to the teeth and gums... and the medicament's used in dentistry are never benign because they are all derived from chemicals. I think many people just assume they will have some discomfort in some way which usually seems to subside after a little while. Others can be hypersensitive, for whatever reason, to certain things and their discomfort is not tolerable.

I hope the homeopathics are helping.... if not, then they may need to be changed a bit. Do you see a homeopathic physician?

Bryanna

found out it is the cement and the primer too. I had them tested using a vega test machine. The crown material is okay. This nd, who has a dds education too, said it has to come off. It has a post and permanent cement , they'd have to destroy it to get it off wouldn't they?

Not sure what to do next, left a message with this info for my dentist yesterday, he sent me to get this stuff tested. My health is definately taking a hit dealing with tnis, still not able to rest.HR and Bp are getting higher.

Not sure if I should call back and insist they remove it and place a temp so I don't go any further downhill. And then wait for the clifford test results to come in and then test those to be sure.

Hard to believe he hasn't even called back. This is a biodentist who is supposed to understand the relationship between teeth, dental materials and overall health.

The homeopathic relax milieu that my dentist gave me flared up my lyme symptoms so i had to stop taking it.

Hi diaba,

You mentioned that this tooth has a post in it.... that means the tooth has been root canaled. Perhaps this tooth isn't so healthy after-all?

Just to inform you.... all teeth have roots with a few large canals and many thousands of smaller canals. Contained in those smaller canals are miles of nerves. When a tooth is root canaled, various amounts of nerve material are removed from the large canals. But the microscopic smaller ones cannot be accessed, so dead nerves are left behind in those tiny spaces. Anaerobic bacteria requires no oxygen so it thrives in these small canals and continually absorbs the necrotic nerve material. Eventually the bacteria becomes toxic and leads to chronic inflammation and infection. The blood vessels and lymphatic channels that surround root canaled/non-vital teeth carry these toxins to the blood supply throughout the body which can compromise all organ systems leading to a slue of diseases. The longer root canal treated teeth remain in the mouth, the more the immune system becomes compromised.

Most people do not associate the health of their teeth with their "common" medical conditions (heart disease, diabetes, kidney disease, auto immune disorders) or "common" viral/bacterial infections such as lymes disease. But any irritant or toxin in the body that compromises the immune system on a continual basis most definitely contributes to the ill effects of every other health condition.

The cement and primer may be irritants to your fragile system, but they may not be the true culprit. The tooth (if it is in fact root canaled) could be the source of the problem and it's just showing itself in a different way than it did with the first crown. I am familiar with muscle testing called kinesiology, the vega test which tests for various irritants/sensitivities, etc. and the cavitat test which tests for cavitations in the jawbone. All of them in my opinion, are not reliable diagnostic sources as they are very technician sensitive and results can vary widely from one clinician to another. I wouldn't let any of them guide my course of dental treatment.

It is important not to overlook the bacterial issues associated with this tooth because other than removing it, irrelevant of what you do to it, the toxic bacteria will still be present.

I'm sorry to tell you these things, but I didn't know the tooth had been root canaled as I don't recall you mentioning that in your previous post.

Your feedback on this .... comments ...are very welcome... please offer them freely.

Bryanna

maybe I'm calling it the wrong name, it is something they applied around the tooth because there wasn't enough surface area to place the crown. It does not have a root canal.

I did hear back today. the plan is to put a new temp on next week. Then use the clifford test reauls to guide to a beter cement option. I'll also ask if I can have a sample of the cement to try holding it in my mouth for a couple hours to see how I do.

Diaba,

When there is inadequate tooth structure remaining above the gum line to place a crown, they do what is called a core buildup. The material used to make this buildup is usually a composite material similar to what is used for white fillings. Different dentists use different brands of composite materials.

The primer and cement used to adhere the crown is used in a very minute amount. The primer is equivalent to less than a nail polish brush with a tiny bead of nail polish on it and whatever does not dry onto the tooth is rinsed off with the suction tip over it. The cement is about the same equivalency and it is predominantly inside of the crown itself. It is possible to have a reaction to this tiny amount of either chemical, but the length and varying symptoms you are experiencing sound a bit exaggerated for this type of thing which makes me wonder if there isn't something else going on.

I don't doubt that you are feeling these things.... I just wonder if it's something that will subside in time or if it's something else altogether.

I would hate for you to go through the crown process again only to have something similar happen. Anything else you could possibly associate your recent symptoms with?

Bryanna

Yeah, i'd hate to go thru it all again just to end up no better as well. I thiunk they used more than a swipe of it because there was enough that some broke off and I swallowed it.

The reaction is clearly extreme, but considering I get heart rhythm changes with .5 L supplemental oxygen and have been unable to tolerate any meds for lyme or ms over the past several years, and have cardiac/breathing changes around baking soda, it seems possible that I might react this way. I can't think of anything else that has changed, and the symptoms started about 1/2 hr after I had it placed.

diaba,

There truly is only a tiny amount of cement used to adhere a crown. The inside walls of the crown get lightly lined with the cement allowing enough room for the crown to fit over the core build up without jeopardizing the fit. I'm stressing the amount to you because hopefully your exposure to it was minimal enough to avoid a permanent problem. Of course your concerns about continuing to wear this crown are warranted based on your history of extreme reactions to minimal exposures of other things.

I wish there was an easy solution to this problem... or at least a reasonable one!

I'm hopeful that your physical reaction will lessen and dissipate altogether and you won't have to deal with this any further.....

Keep us posted.....
Bryanna

Hi diaba
 

I have been listening to the posts. You definately need someone new to treat you. what you have experienced isn't good dentistry. Wish you were in my neck of the woods, as after 60 years, I found a gem. Hope you find the quality of care you very much need. Brayanna is right about that! Wish you all the best, ginnie:hug::eek:

not sure how I can find a safe cement for me at this point. The clifford test said that this relyx2 is compatable for me, the vega test said no. So as i read about online, i tried to place a small sample of it in my mouth and got an increase in my heart rate after about 5 min.

So it seems like the blood test is not accurate for me. seems like a gamble to try another cement and hope it is okay. I guess I could get many samples and try placing them in my mouth and see what happens but not sure that much experimenting would be good for my body either.

just updating, not sure there's anything anyone else can do, except remove the tooth.