Yikes, I might need a crown! Need some advice!

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#1 Post by **bbsadmin** » Wed Apr 04, 2007 10:58 pm

For once, I'm the one asking for advice! Good thing I run a dental message board, LOL!

For the past 3 or 4 months, my right bottom molar has been inexplicably sensitive. At first the sensitivity came and went. I kept forgetting about it, and then it would surface again. I noticed that it got better after I wore my retainer the previous night. Then, it was sensitive all the time. Even just touching the side of the tooth with my finger is extremely uncomfortable.

I saw my dentist last month to determine what is going on. He took x-rays and found nothing wrong. We decided to re-do the composite filling on the tooth. He put extra sealant on it. It feels a speck better now, but is still very sensitive. Basically I find myself not chewing anything hard on that side of my mouth.

Today I saw my orthodontist for a "retainer check." I described the situation to him, and he said it sounds like I might have a cracked tooth. He said that "cracked tooth syndrome" often will not show a crack in an x-ray. When I got home, I Googled "cracked tooth syndrome" and from what I read, I think he may be on to something.

So tomorrow I'm going to call my dentist and discuss this with him. He may want me to see an endodontist. I hope I don't need a root canal. That tooth seems healthy and the gum around it is fine. I don't suspect any sort of infection or periodontal problem. I have a feeling that I may need to get a crown on that tooth. Worst case might be that I would have the tooth extracted and have an implant put there -- which I REALLY DON'T want to do. I already had 4 teeth extracted for my braces and I certainly don't want to lose any more!

I'll keep you folks posted on the outcome of all this.

And here's the kicker (can you believe this?) My husband is between jobs at the moment and right now we have no dental insurance. So I may have to pay for all this totally out of pocket. I could go on some dental discount plan, but my regular dentist doesn't take any of those (and I certainly would only want to see my regular dentist for this -- unless there is an endodontist on the supposed plan which he would recommend).

I do have one piece of good news, however. I just saved a ton of money on car insurance by switching to Gieco. OK, no (LOL).....seriously, the good news is that my daugther (who was treated for a crossbite with an expander a couple of years ago) may not need braces. The ortho said that if Mother Nature continues to be good to her, and her teeth continue to grow in straight, she may not need braces at all, or only need them for a very short time. He joked and said, "Well Lynn, she didn't get YOUR teeth!" (in other words, my natural "open bite" and crooked teeth before I got braces)!

So I was wondering...has anyone else had anything like this happen to them? Are root canals as bad as they sound? What do crowns feel like in your mouth? I guess my two big fears are: 1) That this stupid tooth will feel sensitive from now on, even with a crown. 2) I may need to have the tooth extracted for some reason and need an implant.

#2 Post by **Zondrae** » Thu Apr 05, 2007 3:42 am

well I haven't had a cracked tooth but have had 3 root canals & have one crown. The crown doesn't feel any different to a natural tooth. Root canal isn't fun, but once the nerve is dead it isn't painful at all. The tooth is no longer "active" & unless the gum gets in the way, the tooth doesn't hurt at all.

I had my root canals because of abscesses (caused by my impacted wisdom teeth), so it was a blessed relief to get the root canal I can tell you. The pressure/pain is unbelievable. I always joke it's worse than childbirth!

So root canal is really no big deal when you've had that excruciating pain in your mouth.

Good luck & let us know what happens at your appointment.

#3 Post by **loulou123** » Thu Apr 05, 2007 5:50 am

Hi

Ive had three root canals and 2 crowns and there really not so bad, the root canal is not really any worse than a filling except it takes abit longer and as soon as the nerve is dead there is no pain at all

Crowns are ok, intially you notice it abit cos its something differnet in your mouth, but you get used to it in no time and it just becomes a normal tooth then.

Im sure itll all be just fine, and anythings gotta be better than getting toothache.

One note, its a good thing you know youve properly got a cracked tooth as i didnt realise i had one and was having a routine filling and the pressure made the tooth crack in half, so this is definately worth getting sorted out. Good luck.

#4 Post by **becks** » Thu Apr 05, 2007 5:55 am

I've had just one root canal & crown. The root canal wasn't HORRIBLE but it wasn't fun either. It wasn't that bad but I guess it all depends on your pain tolerance. The crown feels just like a regular tooth, as said above. I would definetely go the root canal/crown route over the extraction and implant

Great news about your daughter. I always so HOPE my kids don't get my teeth!!

#5 Post by **rsprouse** » Thu Apr 05, 2007 6:02 am

What kind of symptoms are you having? Pain only on function for that particular tooth? Does it go away instantly when you stop chewing on that tooth? Did the ortho make you bite only on that tooth on certain cusps? Cracked teeth are common enough for teeth that have large fillings in them. But I am trying to remember if I have ever seen one from a tooth with a large composite. Ever have a large silver filling in this one? Yes, it is nearly impossible to see a cracked tooth radiographically. And if it is a cracked tooth the prognosis will be determined by where the crack stops. The only way to figure that out is to do some exploratory drilling. Just so you know I have seen patients with similar symptoms to a cracked tooth that simply needed a little localized deep cleaning. As always, YMMV.

Good Luck,
Rory

#6 Post by **Rickysa** » Thu Apr 05, 2007 6:34 am

Hi Lynn,

When you bite down, do you feel like you are hitting harder on that tooth, or it hits before your other teeth do?

Hot/cold sensitive or just when pressing on it?

Is the composite filling fairly large?

If the tooth does have a crack (that doesn't go to far down the tooth) a crown will take care of it, and the crown won't feel any different than any other tooth (maybe smoother!).

Best of luck!

Dr. S

#7 Post by **gunter8888** » Thu Apr 05, 2007 6:38 am

Sorry to hear that Lynn. Not fun! But, your Geico joke cracked me up.

I have had 2 crowns (w/ out root canals) and 1 root canal. My experience is that if the dentist/endodontist knows what they are doing they are not a big deal.

In my experience, the part to watch closely is the fit of the crown itself. My first one, the root canal, the crown has never quite fit right. When my dentist placed it the fit was way off and he tried grinding it down inside to fit better, but it was never right. I was too eager to get out of the chair and didn't push enough to either make some more adjustments or to have the crown re-cast entirely. I really wish I had.

The other two crowns were a breeze.

The worst part of all three for me was the temporary crowns. I know some offices no longer use them and that is great. Take a wad of chewing gum and stick it to the top of a molar. Now wander around for a week like that. They are bulky, ill-fitting and awkward. They also have a tendency to crack or break. Fortunately, you usually only have to have them for 3-7 days.

Once the final crowns are on (and fitting correctly) you quickly forget you have crowns. They feel a little different than real teeth (not quite as smooth and fewer dimples and ridges), but they quickly blend in. You do need to be dilligent about cleaning around the gumline where the crown ends and the real tooth begins. Easy spot for crud to gather and create problems.

Best of luck!

#8 Post by **bbsadmin** » Thu Apr 05, 2007 9:05 am

Thanks guys for all your replies!

Rickysa and Rsprouse, I will answer some of your questions. I appreciate your opinions on this! It's quite a mystery.

I tend to totally forget about the tooth until I try to bite something (for example, a hard cracker or pizza crust). Then I get a zing that is very unpleasant. I can chew a lot of other foods with that tooth just fine, but if something hard hits it "just the right way" I feel the sensitivity. For example, if I'm eating pizza crust, I initially bite on the other side. Then when the food in my mouth is softened up a speck, I can bite it on that side. Before I had the filling replaced a few weeks ago, it had even become sensitive to my hot drink in the morning.

At first I wasn't sure exactly which tooth it was. Then it became clear that it was the last molar.

The most curious thing is that it feels sensitive when I push on it from the labial side (but not from the other sides). Before re-doing the fillling, my dentist tried grinding down the top of filling in some places, thinking that maybe there was a high contact point. It didn't make much of a difference.

Originally, I'm sure I did have an amalgam filling in that tooth. It was replaced with composite about 3 years ago. Before this eposide, I never had any problems with that tooth. It is a fairly large filling. When the dentist re-did the filling recently, he said he saw no signs of decay in the hole. There are no periodontal issues as far as either of us can tell.

I am wondering if my retainer is playing some part in all of this. I have been wearing the same Hawley retainer on the bottom since my braces came off. I wear my retainer several nights per week. Lately I have been wearing it every night. Last night I didn't wear it and this morning the tooth seems less sensitive. But I don't think that the retainer is causing this problem, because at first the retainer seemed to make the problem better.

I wish there was a way to know for sure if the tooth is cracked. I don't have a problem with getting a crown or even a root canal, but I would rather not do anything invasive unless it is absolutely necessary.

I have been living with this sensitivity for several months and I have adapted. I'm not in pain or anything. I don't even feel it unless I chew. I can even chew gum, as long as the initial "bite" isn't on that side. It's just not "normal" for me to have this sensitivity and I would like to get it resolved so that I don't have to think about it anymore. From what I've read on the subject, there is a danger that the tooth could crack badly if I don't get something done (if indeed a crack is my problem).

#9 Post by **bbsadmin** » Thu Apr 05, 2007 9:13 am

Sorry to hear that Lynn. Not fun! But, your Geico joke cracked me up.

I appreciate everyone telling me that you can't even feel a crown in your mouth -- that it feels no different from other teeth. That makes me feel a lot better.

Regarding the Geico joke...I just couldn't resist. I was sitting there writing my story and it fit so well, I just HAD to put it in!

#10 Post by **fins** » Thu Apr 05, 2007 9:26 am

You won't notice the crown after about a week. It will feel just like your other teeth. I think they have made great improvements in root canals from many years ago. I am sure they can be done in only a couple vists and with minimal discomfort. Do you think the hawley might irritate the amalgam? Is the hawley have any metal over the amalgam part of the tooth?

#11 Post by **becks** » Thu Apr 05, 2007 9:41 am

Forgot to mention in my post above, but that Gieco joke had me cracking up! Hope you can get this tooth issue resolved soon.

#12 Post by **bbsadmin** » Thu Apr 05, 2007 10:51 am

Geico is a car insurance company here in America.

A while back, their ad campaign went something like this:

A woman is sitting in the waiting room of a hospital. A doctor comes out in scrubs to talk to her.

Doctor: "Mrs. Smith, it's more serious than we thought. Looks like Jimmy will need an operation."

Jane: "Oh no, doctor!"

Doctor: "Yes, but I do have some great news!

Jane: "Oh doctor, what is it?"

Doctor: "I just saved a ton of money on my car insurace by switching to Geico!"

I tried to find an example on YouTube, but all they have are the new caveman commercials!

#13 Post by **Clairey Fairey** » Thu Apr 05, 2007 3:36 pm

If you've had extractions - A crown is nothing!! You'll be fine

#14 Post by **bbsadmin** » Thu Apr 05, 2007 10:05 pm

After speaking with my dentist today, we decided to do a temporary crown. It will be done at the end of the month. It is the most conservative approach. If the temporary relieves the sensitivity, then I can get a permanent crown placed later.

But, if the tooth is still sensitive with the temp crown, then I may need a root canal done by an endodontist. Then the permanant crown would be placed.

There is always the unpleasant chance that the tooth could be cracked down too far (to the root), in which case it might not be possible to save it. In that case, I would need to get it extracted and have an implant placed. But I won't even "go there." I'm keeping my fingers crossed that a crown will take care of the situation. I would feel kinda sick about losing that molar after having 4 second bicuspids extracted a few years ago for my braces.

You know, it's funny -- I've never needed any sort of dental work like this before. I remember when I was little, all the adults would talk about root canals and crowns and bridges. So I thought, "That's what adults have done to their teeth when they get old." So I guess now at the age of 46 I am officially an adult!

Well, I'm not happy about any of this, because that tooth will be changed permanantly. But I realize that there really is no other option. I have given it many months to feel better....re-did the filling in hopes that it would solve the problem....really, I guess this is the only option if I want the tooth to feel normal again. Darn!

If I do need to see an endodontist, I will try to do that AFTER I get new dental coverage, which will probably be in late summer. I asked my dentist how expensive this stuff could be, and overall it would cost almost as much as braces! Yowza! The permanent crown is almost $1,000 alone. I wish I'd have realized all this before my dental coverage ended...I would have had it done a couple of months ago. You know they say that hindsight is always 20/20.

I'm also thinking about looking into dentalplans.com. IF they have a good endodontist in my area (one that my own dentist or orthodontist recommends), then it may be worth it to join, as long as there isn't a long waiting period to do a procedure like this or some pre-existing condition clause.

#15 Post by **rsprouse** » Fri Apr 06, 2007 6:55 am

Unfortunately there is no real way to find a crack without exploratory drilling. This is assuming it is an internal fracture. Sometimes you can see craze lines or a piece of the tooth moving, but not always. The symptoms you describe do mostly sound like a cracked tooth, but not entirely. I have seen some crazy symptoms from a little errant plaque hanging out in a pocket. Clean it out well and you'll be surprised at the results. But, this is usually in a case without functional pain. Doing a temporary crown is the proper standard of care if a crack is suspected. I hope it works out for you.

$1000 is not a bad fee for a crown, especially in Cali. It could be much worse, wanna fly out and see me?

Remember that "Dental Insurance" is more of a discount. Most plans will only pay about 50% of major services and max out around $1500/year. So yes it would help offset some of the cost, but it is not going to pay for it all.

Best,
Rory