About crowning a fractured tooth
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Brux
#1 / 5
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 About crowning a fractured tooth I am a serious bruxer, and this has caused me no end of problems. I have lost several teeth due to below-gum fractures, which have been or will be replaced by implants. And before long almost all the remaining teeth will have been crowned, as a protective measure. I only have so much money, and I'm trying to spend it in such a way as to save as many teeth as possible. I have a particular situation I'd like to ask advice about, though it is also a
general question. (My dentist is great, by the way--and if anyone in the
Wheaton, IL needs a referral, please email me--but I am looking for additional
imput from those who might have more experience with people like me.) I have
no wisdom teeth, and the farthest-back upper molar on the right hand side is
missing (from below-gum fracture, of course). The intention is to get an
implant there, but for the moment my dentist and I thought it would be best to
spend the money on other areas. When I bite, the molar below it--the tooth I
want to talk about here--contacts a little bit of the upper molar next to the
missing one, but not much. For some time the lower tooth has been hurting on
and off, sometimes just when my tongue pushes against it, though there was no
great pain from chewing. Since it flared up when another tooth was troubling
me, I thought it might be a referred pain situation. But even though it looked
okay it was obviously fractured. Recently I started to worry about losing it,
and my dentist said it could be protected by crowning. So he replaced the
filling with composite, did the prep for the crown (said he couldn't see any
obvious horrific fractures), and now I have the temporary crown on there. The
good news is that pushing my tongue up against it doesn't hurt anymore, and
there is no pain when not chewing. I'm sure the nerve's okay. And there
doesn't seem to be any pain coming from below the gum. The bad news is that now
chewing anything harder than pudding on that side gives some pretty intense
sharp pains. My dentist says that the permanent crowns fit better and the
cement holds tighter, but it's hard to imagine that the pain will ever be low
enough to chew on that side.
So... any advice? Give up on the tooth? In particular, would it be worth
trying to take that composite out and replace it with those adhesive fillings I
see mentioned in this group? (Or would the trauma from that likely make it
worse? Or is that kind of material unsuitable for under a crown?) And in
general, when *do* you give up on a tooth in a situation like this? I would be
*very* grateful for any advice--this is a very depressing situation for me.
- Tom
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| Sun, 29 Jul 2001 03:00:00 GMT |
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James P. Boyd, DD
#2 / 5
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About crowning a fractured tooth
This is an easy one.
Consider the "definition" of dentistry:
*The art and science of healthy teetn, and how they come together*
You and your dentist are knocking yourselves out trying to create healthy
teeth, but aren't doing anything about how/why they needed
attention...the "how they come together" part.
But it's not just "how they come together", for you it's how HARD they
come together. Given you'd probably snap a traditional protectice splint
in half, you and your dentist could consider another option.
This slide presentation will explain another option...
-Dr. Boyd
Quote:
> I am a serious bruxer, and this has caused me no end of problems. I have lost
> several teeth due to below-gum fractures, which have been or will be replaced
> by implants. And before long almost all the remaining teeth will have been
> crowned, as a protective measure. I only have so much money, and I'm trying to
> spend it in such a way as to save as many teeth as possible.
> I have a particular situation I'd like to ask advice about, though it is also a
> general question. (My dentist is great, by the way--and if anyone in the
> Wheaton, IL needs a referral, please email me--but I am looking for additional
> imput from those who might have more experience with people like me.) I have
> no wisdom teeth, and the farthest-back upper molar on the right hand side is
> missing (from below-gum fracture, of course). The intention is to get an
> implant there, but for the moment my dentist and I thought it would be best to
> spend the money on other areas. When I bite, the molar below it--the tooth I
> want to talk about here--contacts a little bit of the upper molar next to the
> missing one, but not much. For some time the lower tooth has been hurting on
> and off, sometimes just when my tongue pushes against it, though there was no
> great pain from chewing. Since it flared up when another tooth was troubling
> me, I thought it might be a referred pain situation. But even though it looked
> okay it was obviously fractured. Recently I started to worry about losing it,
> and my dentist said it could be protected by crowning. So he replaced the
> filling with composite, did the prep for the crown (said he couldn't see any
> obvious horrific fractures), and now I have the temporary crown on there. The
> good news is that pushing my tongue up against it doesn't hurt anymore, and
> there is no pain when not chewing. I'm sure the nerve's okay. And there
> doesn't seem to be any pain coming from below the gum. The bad news is that now
> chewing anything harder than pudding on that side gives some pretty intense
> sharp pains. My dentist says that the permanent crowns fit better and the
> cement holds tighter, but it's hard to imagine that the pain will ever be low
> enough to chew on that side.
> So... any advice? Give up on the tooth? In particular, would it be worth
> trying to take that composite out and replace it with those adhesive fillings I
> see mentioned in this group? (Or would the trauma from that likely make it
> worse? Or is that kind of material unsuitable for under a crown?) And in
> general, when *do* you give up on a tooth in a situation like this? I would be
> *very* grateful for any advice--this is a very depressing situation for me.
> - Tom
[
NTI_Tutorial.html 2K ]
This 19-slide presentation identifies the causitive and perpetuating muscular elements of TMD,
and introduces the new "NTI Clenching Suppression System".
To review the related accompanying article, go to:
Identifying the {*filter*} Force of Bruxism: Treatment and Prevention of TMD and Chronic Headache Using a New Clenching Suppression Device
Next Slide****Slide Navigatior
Questions or comments can be directed to James P. Boyd, DDS, director of the
Headache Prevention Institute, and developer of the "NTI Clenching Suppression System".
To request a copy of these slides, or to arrange for Dr. Boyd to present a continuing education seminar,
contact Bob Weber, marketing director for the "NTI Clenching Suppression System" in the United States for Heraeus Kulzer
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| Sun, 29 Jul 2001 03:00:00 GMT |
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Brux
#3 / 5
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About crowning a fractured tooth
Quote: >Given you'd probably snap a traditional protectice splint
>in half, you and your dentist could consider another option.
Perhaps surprisingly, my nightguard seems to be holding up pretty well. Quote: >This slide presentation will explain another option...
Thanks, I'll show it to my dentist and see what he has to say. In the meantime, do you or anyone else have any ideas what I should do about this particular tooth? Give up, ask about replacing the built-up part with something else before permanent cementing, etc? - Tom
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| Sun, 29 Jul 2001 03:00:00 GMT |
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Dr. Stev
#4 / 5
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About crowning a fractured tooth Tom, Something else is going on that you are not able to convey to the group or
are unaware of. If the temporary hurts while chewing (and was not left
higher than the adjacent teeth) the permanent crown will hurt, also.
A lot of dentists like composite cores under crowns. I see too many that
lead directly to a painful tooth. The composite does not seal well when it
is over a certain size. Most teeth which need crowns have huge fillings in
them. The composite leaks, the tooth hurts or new decay starts.
The composite core may have failed, the tooth may be too "high", the cement
may have "washed" out from under the temporary, the temporary may have a
piece chipped off it, your tooth may be beginning to "die" or something else
may be going on.
I would suggest a new temporary crown with fresh cement, re-evaluating the
"bite" then going home for a few days to see how it feels. If it hurts,
correct the pain before you "permanently" cement anything. Alternately, you
could have the final crown cemented with weak temporary cement to evaluate
your pain.
Talk to your dentist some more. He is going to be very caring and
considerate once he knows you problems. There is a good way out of
everything, but it requires communication.
Best wishes,
Dr. Steve
Quote:
>>Given you'd probably snap a traditional protectice splint
>>in half, you and your dentist could consider another option.
>Perhaps surprisingly, my nightguard seems to be holding up pretty well.
>>This slide presentation will explain another option...
>Thanks, I'll show it to my dentist and see what he has to say. In the
>meantime, do you or anyone else have any ideas what I should do about this
>particular tooth? Give up, ask about replacing the built-up part with
>something else before permanent cementing, etc?
>- Tom
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| Mon, 30 Jul 2001 03:00:00 GMT |
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Neildd
#5 / 5
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About crowning a fractured tooth You said your lower tooth only occludes with a part of the upper tooth. I think that your lower tooth is being occlusally traumatised i.e.there is a heavy bite on that portion of the lower tooth, which could be causing inflammation of the supporting structures of the lower tooth. The area on which the lower tooth meets the upper tooth, is there an adjacent lower tooth on that side, or is there a space between the lower tooth and the adjacent tooth? Adjustment of the bite may solve the problem.
I would be interested in knowing how things work out for you.
Best of luck.
Quote:
>I am a serious bruxer, and this has caused me no end of problems. I have lost >several teeth due to below-gum fractures, which have been or will be replaced >by implants. And before long almost all the remaining teeth will have been >crowned, as a protective measure. I only have so much money, and I'm trying to >spend it in such a way as to save as many teeth as possible. >I have a particular situation I'd like to ask advice about, though it is
also a
>general question. (My dentist is great, by the way--and if anyone in the
>Wheaton, IL needs a referral, please email me--but I am looking for
additional
>imput from those who might have more experience with people like me.) I
have
>no wisdom teeth, and the farthest-back upper molar on the right hand side
is
>missing (from below-gum fracture, of course). The intention is to get an
>implant there, but for the moment my dentist and I thought it would be best
to
>spend the money on other areas. When I bite, the molar below it--the tooth
I
>want to talk about here--contacts a little bit of the upper molar next to
the
>missing one, but not much. For some time the lower tooth has been hurting
on
>and off, sometimes just when my tongue pushes against it, though there was
no
>great pain from chewing. Since it flared up when another tooth was
troubling
>me, I thought it might be a referred pain situation. But even though it
looked
>okay it was obviously fractured. Recently I started to worry about losing
it,
>and my dentist said it could be protected by crowning. So he replaced the
>filling with composite, did the prep for the crown (said he couldn't see
any
>obvious horrific fractures), and now I have the temporary crown on there.
The
>good news is that pushing my tongue up against it doesn't hurt anymore, and
>there is no pain when not chewing. I'm sure the nerve's okay. And there
>doesn't seem to be any pain coming from below the gum. The bad news is that
now
>chewing anything harder than pudding on that side gives some pretty intense
>sharp pains. My dentist says that the permanent crowns fit better and the
>cement holds tighter, but it's hard to imagine that the pain will ever be
low
>enough to chew on that side.
>So... any advice? Give up on the tooth? In particular, would it be worth
>trying to take that composite out and replace it with those adhesive
fillings I
>see mentioned in this group? (Or would the trauma from that likely make
it
>worse? Or is that kind of material unsuitable for under a crown?) And in
>general, when *do* you give up on a tooth in a situation like this? I would
be
>*very* grateful for any advice--this is a very depressing situation for me.
>- Tom
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| Tue, 31 Jul 2001 03:00:00 GMT |
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