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My New Crown Doesn’t Fit Right

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Hi,

I recently got a porcelain crown on my upper back tooth, but it feels out of alignment with the teeth below it. If my dentist shaves the crown down, will it damage my tooth? I want my dentist to do something about it, but he keeps telling me to wait so my mouth gets used to it. However, it’s been a few weeks and it’s not getting any better.

Thanks,

Takao, from Alice Springs, Australia

 

Hi Takao,

Your dentist’s reluctance to fix the crown sounds like inexperience. Unless your case is rather difficult, your dentist should know how to make the crown fit better, and make your discomfort go away.

A new crown should not be noticeable when biting or chewing. It should fit perfectly in your jawline, and feel like a natural tooth. Over time, you will get used to the crown, and it may not cause any further problems. However, the science behind jaw alignment is a difficult art, and having a crown out of place for so long can cause problems down the line, such as bone loss, stress on surrounding teeth, or even TMJ disorder.

To prevent TMJ or other issues, I would get your crown adjusted. This is not a difficult task, and if your dentist knows what is wrong, he or she can easily fix it. Shaving down the crown is not going to damage your tooth. If your dentist doesn’t know what is wrong, you should go see a different one; however, this may incur additional fees.

One way for your dentist to adjust your crown would be to have you bite down on a bite registration paper. If your teeth hit high on the paper, then your dentist will know where to grind down the crown. You can go to your dentist for this adjustment, but if you need another crown later on, I would suggest you go see a different dentist.

For a dentist to have skill in fixing your bite, you will need to see a dentist that has skill in full mouth restoration and post-graduate education in occlusion and TMJ.

This blog post is brought to you by Colorado Springs TMJ dentist, Dr. Joseph Rota. Please note that TMJ is not a specialty recognized by the ADA, but dentists like Dr. Rota have over 30 years of experience treating TMJ patients and their pain.

 

 

Emergency dentist or urgent care for toothache, headache, facial pain?

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Photo of a dark-haired man with a shadow beard, smiling, perhaps after treatment from an emergency dentist, similar to Colorado Springs emergency dentist Dr. Joseph Rota.

An emergency dentist will relieve your pain and help you smile again

Should I see an emergency dentist or go to urgent care? I am not sure if I can make it through the weekend with a horrible toothache. It is making me nauseous. It started last month and I should have done something about it. Work has been so busy that I just kept putting it off.  Now I’m beginning to think it is serious. I am scheduled to take a flight to NE on Monday afternoon. Should I go to urgent care if I can’t find an emergency dentist to see me? Thanks, Kelvin

Kelvin – It’s good that you’re asking for help now. You need dental care as soon as possible.

Why Choose an Emergency Dentist Instead of Urgent Care?

  • Urgent care may give you something for pain, but they are not equipped to examine and x-ray teeth to find the cause of your pain.
  • There are many dentists who take patients on an emergency basis. Some have evening or weekend hours to accommodate patients with a busy schedule or who have dental emergencies.
  • You don’t have to be a current patient of a practice to see an emergency dentist.
  • The pain and other problems you describe indicate that you have a serious tooth infection. It will continue to spread until you get treatment. A root canal treatment will clear the infection. The tooth will be protected with a dental crown. Antibiotics may be prescribed also.
  • When the pulp of a tooth is infected, cells rush to the site to fight the infection. There is no room in your tooth for the infection-fighting activity, so the result is swelling and pain. Eventually, the pulp in your tooth will die, and the pain will decrease. This does not mean that the infection is gone. Your tooth still needs to be treated.
  • Beware of a dentist who simply wants to sedate you and extract your tooth. It’s best to preserve your natural tooth whenever possible. If it is unnecessarily removed, the dentist will likely recommend that you receive a dental implant and crown, which will cost you $2000 or more.

Do an online search for an emergency dentist, and they will have you come to the office during normal business hours or after hours.

This post is sponsored by Colorado Springs dentist Dr. Joseph Rota.

I don’t have TMJ, so what’s wrong with my jaw?

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I don’t have TMJ but my jaw does pop. Sometimes it pops on its own or I can make it pop. Also for the past few weeks, when I wake up in the morning, my teeth feel sore, and my bite feels a little off. What could be the real problem? – Dustyn

Dustyn – We would be interested in knowing why you say that you do not have TMJ (temporomandibular joint) disorder. Some of the symptoms are popping or clicking in the jaw, jaw stiffness, jaw locking, a change in your bite, or radiating pain in your jaw.

The symptoms you describe are similar to those of TMJ. If you have not had an examination by a dentist who is trained in the diagnosis and treatment of the disorder, we suggest that you do. If you have already received an examination, we recommend that you seek a second opinion.

Diagnosing and Treating TMJ Disorder

Diagram of a human skull, with focus on the temporomandibular joint.

The temporomandibular joint and related parts

The only way to identify the source of your symptoms is to receive an exam and diagnostic studies. If you are suffering with the disorder, a TMJ dentist will recommend a customized night guard. Night guards relieve your symptoms in several ways, including:

  • Raise your bite and reposition your jaw
  • Relax your jaw muscles
  • Reduce the impact of teeth grinding

In addition to a night guard, you can get additional relief from the following:

  • Jaw joint exercises
  • Physical therapy
  • Applying warm compresses on the sides of your cheeks
  • Avoiding gum chewing
  • Adjusting your bite, perhaps with dental crowns, or by ensuring any existing crowns fit correctly.

Look for a dentist with extensive training in TMJ. He or she is better equipped to accurately diagnose and treat your symptoms. Don’t delay scheduling an appointment for an exam. It’s best to rule out the disorder rather than to assume you don’t have it.

This post is sponsored by Colorado Springs dentist Dr. Joseph Rota.

Which is best – a dental implant crown that is screwed on or cemented on?

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Dental implant fixtures are the first step in replacing a missing tooth. But they are just that—a fixture that replaces tooth roots. A restoration (to replace the upper white part of your tooth that shows when you smile) must be secured to the root form. Only then is your smile complete.

A restoration, or implant crown, can be made to screw onto the implant fixture, or to be cemented onto it. Which should you ask for? Rather than insist on a particular type of crown, ask your implant dentist which type he or she prefers. Some implant dentists use both types, and make a selection on a case-by-case basis.

Dental implant crowns – What do the facts show?

The Journal of Prosthetic Dentistry reveals that published studies from January 1995 to March 2015 show that implant crowns that are cemented have higher implant-survival rates, result in less bone loss, and have fewer complications than screwed-in implants.

If you are considering dental implants, we recommend that you have consultations with two to three implants dentists. Ask what method the dentist uses to secure crowns to the implant. But don’t base your decision on that alone. Choose an experienced dentist who has completed many cases similar to your own. Ask to see pictures of restored teeth, and ask what is done to ensure successful implant placement and longevity.

Your goal is to receive healthy tooth replacement—from fixture to crown. The foundation of the implants must be sound to receive truly successful results.

Be certain to follow after-care instructions for best results, some of which are:

  • Floss around and brush the implant as you would a natural tooth.
  • Avoid smoking, because it can interfere with the healing process.
  • Avoid foods or drinks that can harm the surgical site.
  • Keep your regularly schedule follow-up appointments to ensure that the healing process is going well.

This post is sponsored by Colorado Springs dentist Dr. Joseph Rota.

My implant crown broke twice

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I received a dental implant in August 2014 and since then the crown on the implant has broken twice. My dentist replaced it at no charge, but I am not getting a good explanation as to why this is happening. Can you give me an idea of why this might be happening? Thanks. Yvonne

Yvonne – When an implant crown breaks there are several possible causes:

  • Bruxism (teeth grinding) – If you grind your teeth while you sleep, it puts extra force on them. Teeth and crowns can weaken or break from the force.
  • The crown itself – When a crown is made from substandard materials, it can break easily. Even a crown made of quality materials, if incorrectly formed, can easily become weak and break.
  • Crown placement – Proper positioning and securing of the crown is required to help it withstand the force of biting and chewing. It must be ensured that your bite (the way your teeth fit together) is properly aligned. When any these factors are off, a crown can easily break.

It is good that your dentist willingly replaces your broken crowns, but if the problem persists, you can consider getting a second opinion from a dentist who is experienced with both dental implants and crown placement.

This post is sponsored by Colorado Springs dentist Dr. Joseph Rota.

Emergency dentists recommended a crown but my insurance is limited

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My front tooth and it needs a dental crown. I paid out of pocket to see two different emergency dentists. They both told me the same thing. I need a crown. The problem is that I have very limited dental insurance and it will only pay $600, nowhere near the total cost  of work that I need. I have asked friends and family to loan me money, but no one seems to be interested in my problem. Is there a dentist that will do this work free? Al

Al – Although your friends and family are not able to loan you money, you will be able to find a dentist you can provide you with the porcelain crown that the emergency dentists recommended.

Look for a cosmetic dentist who offers payment plans or financing. Financing is a loan, so it will provide you with the assistance you need.

It is important to protect your broken tooth with a crown as soon as possible to prevent pain and further problems with it.

This post is sponsored by Colorado Springs dentist Dr. Joseph Rota.

 

All-porcelain crowns

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Can you tell me why my dentist wants to put an all-porcelain crown on a lateral incisor, but insists on putting a porcelain-fused to metal crown on my molar? I’ve been told the all-porcelain look more natural.

Nesibe A.- Austin, TX

Nesibe,

It is true that all-porcelain crowns look more natural, but the porcelain-fused-to-metal crowns are stronger. Your dentist is putting the all-porcelain crown on the tooth that is very visible when you smile, but doesn’t have a lot of bite pressure put on it.

He may be afraid  that the crown on your molar will crack if doesn’t use the metal foundation on it to give it strength that it would not otherwise have. I know they are more opaque, but back in your mouth no one will be able to tell the difference, so your smile will still be beautiful.

This blog is brought to you by Colorado Cosmetic Dentist Dr. Joseph Rota.

 

My front teeth decayed from the inside. What now?

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My 2 front teeth decayed on the inside and I was not aware of it until my teeth broke away.I have about 1/2 of the teeth still remaining and although the are stained and possibly decayed some can the decay that exists be removed and lumineers installed.The teeth are still firmly attached.Just look terrible.

Thanks.
– Thomas from Virginia

Thomas,
That’s how decay progresses. It starts by making the surface of the tooth porous, and then it actually decays from the inside out. So those cavities have been there probably for years and you didn’t know it. The decay undermines the enamel, and then one day the enamel starts chipping away and you see how big the cavity really is.

I’m guessing it’s been a while since you’ve had a checkup, or those would have been caught a long time ago. Now, if half the tooth is missing, you’re going to need at least porcelain crowns covering each tooth entirely. It’s very possible the teeth also need root canal treatments. With decay that large there’s a good chance that it has infected the pulp of the tooth.

Lumineers cover only the front of the tooth, so that won’t be adequate for these teeth.

There’s a strong possibility you have a number of other cavities that are smaller. I’d get a checkup and get all of those fixed. Right now, you’re going to be paying in the neighborhood of $1000 to $2000 to fix each tooth. If you catch these cavities while they’re small, they only cost maybe $75 to $200 apiece.

This blog sponsored by Colorado Springs dentist Dr. Joseph Rota