crown replacement - does this make any sense??????
in [Dentistry]
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From: bytor on 29 Nov 2005 23:46 i recently broke an old crown on a molar, and am in the process of getting it fixed i liked and trusted my old dentist but because of insurance reasons i had to get a new dentist and i'm not sure this new dentist has my best interests at heart - i think he may be cutting corners on me to save himself costs, but i'm not sure and am curious what people up here think as per usual crown proceudres he drilled down the existing tooth to prep it for the new crown, took impressions etc but instead of then fitting me with a temporary crown for the interim 2 weeks while the new crown is being made, he said "this will be easier for you than a temporary crown" and simply filled in the remaining stump of my tooth with white dental cement stuff so what i have now is my stump of a tooth, the hollowed center with some cement in it, my gums very raw around the outside of the tooth, pain while chewing both occasionally from the tooth itself and even more so from food that keeps hitting the gum area around my tooth which is already mashed up somewhat from the procedure chewing is difficult and i am having trouble eating, the tooth is sensitive to hot/cold & sometimes pressure while eating food keeps getting stuck in the gap between the crownless tooth and the tooth in front of it, making the area more & more sore shouldn't i have a temporary crown protecting all that? protecting the tooth itself??? giving me something to chew on? protecting the already super sensitive and cut gums next to the tooth? and isn't a purpose of a temporary crown also to keep the gumline down until the actual crown is ready????? are there any circumstances where NOT putting on a temporary crown makes sense?? if in my place, what would you do in this circumstance? grin and bear it? go back & ask that a temp crown be put in, but in doing so risk alienating the dentist & having him treat you with disdain & not really care about doing a good job from then on, or even worse, perhaps HURT YOU ON PURPOSE in order to make the point of "i told you it would be better to not have a temporary crown put in!!!" i'd like to trust this dentist and give him the benefit of the doubt but this is all weighing heavily on my mind thanks for any opinions
From: Amatus Cremona on 30 Nov 2005 07:16 > > I liked and trusted my old dentist but because of insurance reasons I > had to get a new dentist > This is what happens when you go to the office "preferred" by the insurance carrier. Why do you think the insurance plan prefers this office ? -- / Amatus / "bytor" <bytors_snowdog(a)yahoo.com> wrote in message news:1133325984.191055.185620(a)g49g2000cwa.googlegroups.com... >i recently broke an old crown on a molar, and am in the process of > getting it fixed > > i liked and trusted my old dentist but because of insurance reasons i > had to get a new dentist > > and i'm not sure this new dentist has my best interests at heart - i > think he may be cutting corners on me to save himself costs, but i'm > not sure and am curious what people up here think > > as per usual crown proceudres he drilled down the existing tooth to > prep it for the new crown, took impressions etc > > but instead of then fitting me with a temporary crown for the interim 2 > weeks while the new crown is being made, he said "this will be easier > for you than a temporary crown" and simply filled in the remaining > stump of my tooth with white dental cement stuff > > so what i have now is my stump of a tooth, the hollowed center with > some cement in it, my gums very raw around the outside of the tooth, > pain while chewing both occasionally from the tooth itself and even > more so from food that keeps hitting the gum area around my tooth which > is already mashed up somewhat from the procedure > > chewing is difficult and i am having trouble eating, the tooth is > sensitive to hot/cold & sometimes pressure while eating > > food keeps getting stuck in the gap between the crownless tooth and the > tooth in front of it, making the area more & more sore > > shouldn't i have a temporary crown protecting all that? protecting the > tooth itself??? giving me something to chew on? protecting the > already super sensitive and cut gums next to the tooth? > > and isn't a purpose of a temporary crown also to keep the gumline down > until the actual crown is ready????? > > are there any circumstances where NOT putting on a temporary crown > makes sense?? > > if in my place, what would you do in this circumstance? grin and bear > it? go back & ask that a temp crown be put in, but in doing so risk > alienating the dentist & having him treat you with disdain & not really > care about doing a good job from then on, or even worse, perhaps HURT > YOU ON PURPOSE in order to make the point of "i told you it would be > better to not have a temporary crown put in!!!" > > i'd like to trust this dentist and give him the benefit of the doubt > but this is all weighing heavily on my mind > > thanks for any opinions >
From: Steven Bornfeld on 30 Nov 2005 09:26 bytor wrote: > i recently broke an old crown on a molar, and am in the process of > getting it fixed > > i liked and trusted my old dentist but because of insurance reasons i > had to get a new dentist > > and i'm not sure this new dentist has my best interests at heart - i > think he may be cutting corners on me to save himself costs, but i'm > not sure and am curious what people up here think > > as per usual crown proceudres he drilled down the existing tooth to > prep it for the new crown, took impressions etc > > but instead of then fitting me with a temporary crown for the interim 2 > weeks while the new crown is being made, he said "this will be easier > for you than a temporary crown" and simply filled in the remaining > stump of my tooth with white dental cement stuff > > so what i have now is my stump of a tooth, the hollowed center with > some cement in it, my gums very raw around the outside of the tooth, > pain while chewing both occasionally from the tooth itself and even > more so from food that keeps hitting the gum area around my tooth which > is already mashed up somewhat from the procedure > > chewing is difficult and i am having trouble eating, the tooth is > sensitive to hot/cold & sometimes pressure while eating > > food keeps getting stuck in the gap between the crownless tooth and the > tooth in front of it, making the area more & more sore > > shouldn't i have a temporary crown protecting all that? protecting the > tooth itself??? giving me something to chew on? protecting the > already super sensitive and cut gums next to the tooth? > > and isn't a purpose of a temporary crown also to keep the gumline down > until the actual crown is ready????? > > are there any circumstances where NOT putting on a temporary crown > makes sense?? > > if in my place, what would you do in this circumstance? grin and bear > it? go back & ask that a temp crown be put in, but in doing so risk > alienating the dentist & having him treat you with disdain & not really > care about doing a good job from then on, or even worse, perhaps HURT > YOU ON PURPOSE in order to make the point of "i told you it would be > better to not have a temporary crown put in!!!" > > i'd like to trust this dentist and give him the benefit of the doubt > but this is all weighing heavily on my mind > > thanks for any opinions I'm surprised Amatus didn't say "What's a Temporary?" (he generally prepares and delivers Cerec-restorations same day. If this is a tooth that has a vital pulp, a temporary crown definitely should be placed. While a temporary can be made to prevent the gum from creeping up the root surface, ideally the tooth shouldn't be prepared more than maybe 1/2 mm under the gum anyway, so preventing reattachment is not a primary reason for a temporary. Sometimes a tooth prepared for a crown will actually drift significantly between visits, esp. if there is a lapse in treatment, and a temporary crown will prevent or minimize this. However, in a back tooth that has had root canal and where cosmetics is not an issue, I occasionally will dispense with a temporary. It is difficult to make the edges of a temporary crown as smooth as the permanent crown anyway, and esp. if the gum is in poor shape the rough edge sometimes slows down the healing. I would want to know why the gum is so cut up. It is sometimes necessary to work under the gum somewhat and the gum can get inflamed during the preparation and impression phase, but it really shouldn't be severely traumatized, or something is wrong. If you are in discomfort, you should tell the dentist of your concerns. His response will be telling. If you get the sense that he is retalliating for some slight, RUN--do not walk to another dentist. Not to lecture, but I always shake my head when a patient has a good dentist and HAS to change because of insurance. If the second guy is a bum (not saying he is) you know what you should do. Steve >
From: Amatus Cremona on 30 Nov 2005 09:48 > > I'm surprised Amatus didn't say "What's a Temporary?" > I did not think the temporary was a big of an issue as was the potential crappy care form a "preferred" office. -- / Amatus / "Steven Bornfeld" <dentaltwinmung(a)earthlink.net> wrote in message news:438DB6A0.6040708(a)earthlink.net... > > > bytor wrote: >> i recently broke an old crown on a molar, and am in the process of >> getting it fixed >> >> i liked and trusted my old dentist but because of insurance reasons i >> had to get a new dentist >> >> and i'm not sure this new dentist has my best interests at heart - i >> think he may be cutting corners on me to save himself costs, but i'm >> not sure and am curious what people up here think >> >> as per usual crown proceudres he drilled down the existing tooth to >> prep it for the new crown, took impressions etc >> >> but instead of then fitting me with a temporary crown for the interim 2 >> weeks while the new crown is being made, he said "this will be easier >> for you than a temporary crown" and simply filled in the remaining >> stump of my tooth with white dental cement stuff >> >> so what i have now is my stump of a tooth, the hollowed center with >> some cement in it, my gums very raw around the outside of the tooth, >> pain while chewing both occasionally from the tooth itself and even >> more so from food that keeps hitting the gum area around my tooth which >> is already mashed up somewhat from the procedure >> >> chewing is difficult and i am having trouble eating, the tooth is >> sensitive to hot/cold & sometimes pressure while eating >> >> food keeps getting stuck in the gap between the crownless tooth and the >> tooth in front of it, making the area more & more sore >> >> shouldn't i have a temporary crown protecting all that? protecting the >> tooth itself??? giving me something to chew on? protecting the >> already super sensitive and cut gums next to the tooth? >> >> and isn't a purpose of a temporary crown also to keep the gumline down >> until the actual crown is ready????? >> >> are there any circumstances where NOT putting on a temporary crown >> makes sense?? >> >> if in my place, what would you do in this circumstance? grin and bear >> it? go back & ask that a temp crown be put in, but in doing so risk >> alienating the dentist & having him treat you with disdain & not really >> care about doing a good job from then on, or even worse, perhaps HURT >> YOU ON PURPOSE in order to make the point of "i told you it would be >> better to not have a temporary crown put in!!!" >> >> i'd like to trust this dentist and give him the benefit of the doubt >> but this is all weighing heavily on my mind >> >> thanks for any opinions > > I'm surprised Amatus didn't say "What's a Temporary?" > (he generally prepares and delivers Cerec-restorations same day. > If this is a tooth that has a vital pulp, a temporary crown definitely > should be placed. While a temporary can be made to prevent the gum from > creeping up the root surface, ideally the tooth shouldn't be prepared more > than maybe 1/2 mm under the gum anyway, so preventing reattachment is not > a primary reason for a temporary. Sometimes a tooth prepared for a crown > will actually drift significantly between visits, esp. if there is a lapse > in treatment, and a temporary crown will prevent or minimize this. > However, in a back tooth that has had root canal and where cosmetics is > not an issue, I occasionally will dispense with a temporary. It is > difficult to make the edges of a temporary crown as smooth as the > permanent crown anyway, and esp. if the gum is in poor shape the rough > edge sometimes slows down the healing. > I would want to know why the gum is so cut up. It is sometimes necessary > to work under the gum somewhat and the gum can get inflamed during the > preparation and impression phase, but it really shouldn't be severely > traumatized, or something is wrong. > If you are in discomfort, you should tell the dentist of your concerns. > His response will be telling. If you get the sense that he is > retalliating for some slight, RUN--do not walk to another dentist. > Not to lecture, but I always shake my head when a patient has a good > dentist and HAS to change because of insurance. If the second guy is a > bum (not saying he is) you know what you should do. > > Steve > >> >
From: bytor on 30 Nov 2005 12:22
Amatus Cremona wrote: > > > > I liked and trusted my old dentist but because of insurance reasons I > > had to get a new dentist > > > > This is what happens when you go to the office "preferred" by the insurance > carrier. Why do you think the insurance plan prefers this office ? > Sorry i wasn't clear on this point, but actually it is a little more complicated than just the insurance reasons, but it isn't simply a case of an insurance plan telling me to go to this guy instead of my previous dentist. - I am not currently working and lost my group dental coverage which my old dentist participated in - My crown broke 2 days b4 thanksgiving and i was in agony with eating problems, my tongue was getting cutup by the rough surface of the crown, the tooth itself was extremely sensitive to hot/cold etc etc etc - I actually tried to get an appointment with my old dentist but he could not see me for over a week!!! So i decided to try to find a new dentist, one that could hopefully see me last week. And at the same time also decided to get new dental coverage to help me defray the costs that i would be incurring . So i joined a discount dental plan in my area, and went to a dentist nearby who could see me the quickest, who was a member of the plan. I am still not sure what to do about my existing situation but i am not particularly happy with this dentist & will try a different dentist in the plan next, as i need other dental work done as well. Not having dental coverage I have neglected my teeth (bad move). This all leads into the topic of "how to choose a new dentist?", and i do have recommendations for others that are actually in the plan, and i did try them first last week, but again, because of the holidays all were either closed or backed up!!! So i went with this guy simply because he was available, and in general I assumed that most dentists are honest, competent, trustworthy, etc. Which leads me to ask - Amatus' comment of " Why do you think the insurance plan prefers this office?" suggests that insurance plans will steer you towards substandard dentists!! Ones that cost less, work less thoroughly, cut corners, or something of that nature - am i naive in thinking that that should not be the case? |