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#1 of 23 Chris Huber

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Posted March 20 2007 - 07:16 AM

Ok, anyone have a crown done to one of your back teeth? I had to get a root canal and now it needs a crown to finish it off.

I've got 2 dentists I could go to. One I know does really good work, but it $200 more for the procedure.

Is a crown pretty routine, or could there be fitment issues and complications that a good dentist would handle better?

Have you guys had any problems that you felt a better dentist could have fixed in the 1st place?

#2 of 23 mylan

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Posted March 20 2007 - 08:23 AM

I've had four crowns but no root canals. They are pretty routine by this point. The worst part is when they drill off the old tooth (sorry!) and then you get sent home with a temporary crown. The dental lab your dentist uses is more important I.M.O. because they are ultimately responsible to make a reasonable facsimile of your old tooth, provided your dentist makes a good impression of the old one. If there are fitment problems your dentist can always reshape it. If the more expensive dentist does better work it might cut down on return trips.
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#3 of 23 Chu Gai

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Posted March 20 2007 - 09:39 AM

Shop it around and ask how they deal with any issues that may crop up.

#4 of 23 Mort Corey

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Posted March 20 2007 - 10:39 AM

I've felt your pain. If you know a dentist that does "really good work".....then price should be of a secondary concern IMO. The hack that put a crown over one of my root canal jobs must have used dirty pliers because I ended up with repeated infections and had to have the tooth pulled eventually.

I've still got the crown though (gold) and can make you a good deal.

Mort

#5 of 23 Bob Graz

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Posted March 20 2007 - 10:42 AM

I have an excellent dentist, but I pay for his expertise. It's worth it not to have problems and to have dental procedures done the proper way.

#6 of 23 KurtEP

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Posted March 20 2007 - 10:47 AM

I've had a lot of trouble with my only crown, which is on a rear molar. It tends to loosen every eight months or so. Unfortunately for me, I broke a large piece of the tooth off (for no apparent reason). Now, it's half plastic or something with a crown over it. My dentist assures me I'll lose it eventually, but it's apparently in one of the worst available spots, and the surrounding teeth are nearly perfect, compounding the problem.

I don't know if this is the fault of my original dentist, who retired, but I know I wouldn't take something like this lightly after the problems I've experienced with it.

Edit: I also got a root canal on the same tooth. I paid $1k at a specialist for the procedure. Best money I've spent in years. I felt absolutely no pain, and only required aspirin afterward. The shots didn't even hurt. The guy was a magician.
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#7 of 23 Stan

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Posted March 20 2007 - 10:57 AM

Similar to Mylan, I've had three onlays (not as much tooth removal as a full crown), but thankfully no root canals.

Worst part is definitely the temporary while the lab makes the real one. First one I had ended up cutting into my gums and was extremely painful. My dentist actually opened up his office on a Saturday, just for me, to replace the temporary. I'd suggest not chewing on the side of your mouth with the temporary until the permanent crown is in place.

You also need to consider whether you want porcelain or gold. I believe the porcelain is harder, but can be more brittle and not last as long as gold. I've had a few tiny chips in mine, but they can be easily smoothed down, my first one is about 15 years old now and still in good shape. Going with porcelain was strictly vanity, even though they were all rear molars, but I just didn't want the metallic look.

Definitely go for the "better" dentist, may not necessarily be the more expensive one. If the fitting is wrong, just the tiniest gap between teeth will end up being very annoying in the future.
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#8 of 23 Al.Anderson

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Posted March 20 2007 - 11:03 AM

I've have numerous crowns on all different kinds of teeth. Even a bridge thrown in for good measure. (Definitely should have worn the mask playing hockey.)

I agree with the concensus a good dentist will do a better job taking the mold and handling problems, if they occur. If there are no problems it's pretty routine to put the thing on after the mold is taken.

I also agree that the choice of lab for the crown is as important as the dentist. If they screw it up either by it not fitting or worse, poor materials, it's hard to fix.

I think the question should become $200 more than what? If the cheaper guy is $19.95; go with the more expensive guy.

#9 of 23 Chris Huber

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Posted March 20 2007 - 11:23 AM

Well,
dentist A, 50% coverage = $477 (with build-up if needed)
dentist B, 40% coverage = $646 (with build-up if needed)

Is the build-up or post really needed? Most of my tooth is still there... I don't want them cashing in on an extra 100 bucks if I don't need it.

#10 of 23 Patrick Sun

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Posted March 20 2007 - 11:41 AM

Did y'all know your temp crowns are edible? I found that out the hard way when I chewed on some cheese squares after getting the temp crown put in place.
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#11 of 23 Henry Gale

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Posted March 20 2007 - 01:29 PM

Quote:
Originally Posted by Chris Huber
One [dentist] does really good work....

Is the build-up or post really needed? I don't want them cashing in on an extra 100 bucks if I don't need it.

I thought I was back in bobby's speaker building thread!

You know a "really good dentist" and you f$c@ing asked US if a procedure is needed?
Wait a minute, OPEN WIDE! Oh hell no, the guys a charlatan.

Sorry Chris, I shouldn't post while I'm still waking up. Posted Image
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#12 of 23 Elizabeth S

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Posted March 20 2007 - 02:03 PM

I swallowed my gold crown. One moment I realized the tooth felt rough on my tongue, checked and the crown was gone. The dentist made me go get an x-ray to make sure it didn't go down anywhere strange -- though in hindsight -- where could it go? It was in my stomach, anyway. The crown had been put on over a root canal about 12 - 15 years ago. I can't remember if there were any warning signs before it popped off.

#13 of 23 John Alvarez

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Posted March 20 2007 - 09:43 PM

I had no warning when a front crown popped off. I was in a resturant out of town when it happened too...... the thing was 20 years old so........

#14 of 23 Eric Samonte

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Posted March 20 2007 - 11:46 PM

Dentists usually have a lab that he sends his impressions to on a regular basis trusting the work of said lab. Any problems that come up with the crown is ultimately his fault, ie., bad impression, ll fitting crowns, etc. The lab only does what its told to do with the impresson it gets. At times, things will look bad already upon creation of a casting from the impression and usually a call to the dentist would solve this.
Remember too that he does most of the work, impresson, fitting ,etc., that's why he charges up the wazoo over the actual crown cost. So it takes a good dentist to make a great crown as he also chooses what material to use and which lab to send it to.
How do I know this? I run a dental lab on the side....pays for most of my toys...Posted Image

#15 of 23 KurtEP

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Posted March 20 2007 - 11:54 PM

Quote:
Originally Posted by John Alvarez
I had no warning when a front crown popped off. I was in a resturant out of town when it happened too...... the thing was 20 years old so........

Mine comes loose gradually, accompanied by a strange taste in my mouth. A loose crown also seems to give some people really bad breath. I worked around a guy for a while who developed breath so bad you could almost taste it. Posted Image He got his crown fixed and it was gone.
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#16 of 23 Chris Huber

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Posted March 21 2007 - 01:01 AM

Thats alright Henry, it's good post like Erics above are what I was after...

#17 of 23 Michael Reuben

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Posted March 21 2007 - 01:53 AM

Chris --

Further to Eric Samonte's post: If you have a dentist whom you know to be good, use him and pay the extra freight. Let him determine whether any post or buildup is needed, because each situation is different, and the person in the best position to judge is the guy who has to do the restoration. Dentistry is as much an art as a science, and it involves a lot of judgment calls. If you have someone you trust, use him.

My qualifications? I am confident that I've spent more time in dentists' chairs than anyone else in this thread and probably than anyone else on HTF. All of my back teeth have crowns, two of which are implant crowns (this after the failure of several bridges). The rest of my mouth is a patchwork of crowns, onlays, fillings, implants and root canals. I've had good dentistry, and I've had so-so dentistry, and you can feel the difference every time you take a bite of food.

BTW, the extent of work I've had done has very little to do with the quality of any particular job. It's just the (bad) luck of the genetic draw. My father's had even more than me.

M.
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#18 of 23 KurtEP

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Posted March 21 2007 - 03:05 AM

Quote:
Originally Posted by Michael Reuben
All of my back teeth have crowns, two of which are implant crowns (this after the failure of several bridges).

Michael,

How has your experience with implant crowns been? My one crown is on an upper rear molar (second from the rear, no wisdom teeth). My dentist told me that this would be the preferred option since anything else would ultimately involve drilling into teeth that are pretty much perfect (unusually so, according to him). He said that this is bad in that there are often problems with the patient not having sufficient bone in this area due to the sinuses. If this is the case, it would apparently require something like a bone graft, which he described as very painful. This is not what I was hoping to hear.

Do you have any experience with this?

KEP
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#19 of 23 Michael Reuben

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Posted March 21 2007 - 03:50 AM

Quote:
Originally Posted by KurtEP
Do you have any experience with this?
Unfortunately, I do. Much more than I'd like.

I assume your dentist is talking about extracting the crowned molar and replacing it with an implant? If so, there must be a problem with that molar that requires it to be replaced. (The most common problem would be a crack below the gum surface.)

Your dentist is correct that the other option -- a bridge -- would require significantly cutting into the teeth on either side of the molar, and if they're still good, it would be better to avoid that. But implants are not a simple business.

First they need to do a CAT scan of your jaw so that they can see it in three dimensions and evaluate whether its shape and size are suitable for the implant procedure. It is indeed common for implants in the upper jaw to require a "sinus lift" (a/k/a "sinus graft"). I needed it on one side, but got away without it on the other. The procedure is unpleasant, but only for the short time that it lasts. The pain from an implant procedure typically lasts a day (with proper aftercare), and it was the same for me with and without the sinus graft.

Note that all implant procedures require some sort of bone grafting. If you know you're getting an implant, you'll need bone grafting when the molar is extracted to ensure that the bone fills in properly. You wait anywhere from 4-8 months after the extraction; then you get the implant and wait another 4-6 months for the bone to grow in around it; then the implant is "activated" (basically, a five-minute procedure that involves a small incision in the gum) and you wait another two weeks; then the dentist makes an implant crown.

Expect to pay a lot for this, and most insurance doesn't cover it. The extraction procedure is one charge; grafting is another; the implant procedure is still another; the sinus lift, if needed, is a separate charge; and an implant crown can cost twice as much as a regular crown, depending on materials and design.

NOW the kicker, which they frequently neglect to tell you at the outset: Implants can fail, for no particular reason and with no particular warning. You can go through all of the above, get the crown installed, and suddenly it hurts like hell and everything has to come out. The failure rate is about 20% on the upper jaw, 10% on the lower (because the bone in the lower jaw is harder). A good conversation to have at the outset with whoever's doing your implants is what they do -- and what they charge -- in case of implant failure.

To date, I've had three implants, two molars and a bicuspid, all in the upper jaw. The bicuspid succeeded, one molar failed, and the other is still a question mark. Implants are great when they work, but IMO they're currently very much in vogue, and that sometimes leads dentists to undervalue and understate the risks. I'm not saying you shouldn't try it, but do it knowing the pros and cons. And insist on disclosure in advance of all the costs.

M.
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#20 of 23 JonZ

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Posted March 21 2007 - 04:01 AM

"The hack that put a crown over one of my root canal jobs must have used dirty pliers because I ended up with repeated infections and had to have the tooth pulled eventually"

I lost 2 back teeth because of recurring infections. Had them eventually pulled and never went back to that dentist.

Ive much happier with the guy Ive been going to since. He actually had to do a root canal and crown on another tooth about 2 years ago. No problems since and to me its worth it to pay extra and know the person doing it will do a great job(and I had to pay for 1/2 the work since my medical only covers 1/2 dental surgery).

I used to have great teeth. I went 10 years without a cavity, but once I hit my mid 30s, they started falling out of my head Posted Image


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