Crowns and braces

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#16 Post by **rsprouse** » Tue May 29, 2007 1:14 pm

Dimples,

Are you missing any of your 1st or 2nd molars? It is not standard practice to use 3rd molars in anchoring for orthodontics, unless there are no other molars. 3rd molars are a major PITA to restore due to access. The human anatomy does not allow most people to open their mouth enough to get a drill back there along with everything else needed to restore the tooth. I do not envy your dentist, but applaud him/her for being so eager

My personal standard of care is to typically use minimally invasive restorations, especially on a 3rd molar. If the tooth is badly broken down then you obviously cannot keep it clean. What is the perio health like back there? It is possible that if you cannot keep your 3rd molars clean you can put the teeth adjacent to them at risk as well. Are they even in occlusion? My experience is that most people with decayed 3rd molars will have recurrent problems even with a restoration. I would explore having them extracted before your treatment, unless your ortho has treatment planned a use for them.

Good Luck,
Rory

#17 Post by **Dimples** » Tue May 29, 2007 4:48 pm

no i'm not missing my 1 or 2 molar. The tooth is chipped, it isn't worn down. It has a very large feeling that I have had since october or 2000. It isn't painful, and my gums are in good health.

If I can wait or opt out for an onlay or temp crown, then fine. But I don't have money to keep throwing out of the woodwork for dental procedures. The braces + the consultation fee is costing me enough.
Point blank, I don't have any extra funds to throw at the dentist for a full crown right now. So even if the dentist or ortho tells me that I can't get an onlay or temp crown, it'll have to wait anyway, because I am spending enough already, and don't plan on shelling out anything extra. But i don't see why an onlay would be out of the question, because the tooth is chipped. anyway, I am going to another dentist this week to see what he has to say about all of this. He is the one that put the feeling in my 3 molar.

My ortho told me that I have an excellent bite. I am getting braces for 1 tooth that is out of place . He also said that my bottom arch is good, except for the two teeth in the middle that turn inward a little bit.
My treatment time is 16-18 months.

Now the question remains, is there hope for my wisdom tooth??? How can it be fixed if it isn't fully erupted???

#18 Post by **Kbraced** » Tue May 29, 2007 5:11 pm

Hello All,

For those of you with crowns and braces, how is that going for you? I just got braces on April 19th. I have a front tooth that has been covered with a procelain crown (with a metal post) for the past 7-8 years. The tooth underneath was completely shattered as a kid, I ended up with a root canal and a crown to cover it. Now I'm an adult in braces.

Okay, so finally the point: The gum area around my crown has been swelling pretty bad over the past 3-4 days and I am worried. It's uncomfortable, although not particularly painful, and doesn't look good. I called my ortho and couldn't speak with him directly, was told by his assistant that I should see my dentist in this particular case.

Any thoughts/suggestions?

#19 Post by **Carolinahigh12** » Wed May 30, 2007 6:13 am

I can only speak on the wisdom teeth situation. All of my wisdom teeth errupted with no problem and I never had any issues with my teeth until about 1 yr ago. Before March, the last time I went to a dentist for a cleaning was when I was 5 ( I am 27 yrs old now).. I know, a long time. I didnt have any cavities or any issues with my teeth that I knew of until March. My wisdom tooth had chipped for some weird reason. The dentist suggested a root canal, but because of the position of my wisdom teeth in relation to my cheek, a root canal would be impossible. Because it was so difficult for me to properly clean those two teeth, we opted for full removal. My ortho felt that it would be better to have my wisdom teeth removed prior to doing impressions and records so that my x-rays would be up-to-date when he plans out my treatment. That is what delayed my brace day ( and the fact that the dentist office was over-booked and my appts for debridement and cleaning were placed 5 weeks apart).

So I guess when it comes to wisdom teeth removal a) it depends on your ability to clean and maintain that area including floss b) if or when a root canal is needed, would the dentist be able to reach that area and c) if you have a history of infections in that tooth or in the gum that is surrounding that tooth.

Me personally I was glad to get them taking out. I got both uppers taking out and at the same time I have no more cavities. But I dont believe that you would need to have them taking out prior to starting treatment. That could be done during or after treatment as long as the tooth doesnt cause serious gum issues ( infections, cavities etc)

#20 Post by **Kbraced** » Wed May 30, 2007 7:58 pm

Meryaten wrote:The only issues I had with my crowns braces combo were:
1. when some crud got up under the band and the gum got a bit infected, and
2. when one poor molar finally gave up the ghost and (due to me grinding the poor sod to death) needed a root canal.

But I don't think either of those applies (don't imagine your tooth is banded, being up front). Not sure what to suggest. Best to get in to the dentist and see what (s)he thinks.

Went to the dentist today. He said that food is getting stuck b/t the tooth and the gums and causing the inflammation. Which I figured but thought it may have been infected. The gums around my crown are pretty loose and food gets caught deeper below the gumline than a normal tooth. He suggested a different way of brushing that particular area and a way of sort of squeezing the food outta there. It's really weird...I'm pretty sure some of the gum area surrounding my crown has dead nerve endings because he did lots of scraping and poking yet I barely felt it...then I looked in the mirror and it was bleeding quite a bit.

Anyway, he suggested trying the new cleaning method for a week, and if it doesnt get better he's gonna numb it and do a deep clean/scrape and give me something to clear up any infection that may come about. We'll see how it goes.

#21 Post by **Dimples** » Mon Jun 04, 2007 2:51 pm

Well, at my records appointment today, i got some good news. The dentist told me that he had spoken with the ortho, and I can wait until after my braces to get my molar crowned. He said that he can put a band around it to protect it. The dentist also told me that HE can put a filling in my wisdom tooth, (i'm really not a fan of extractions anyways) before or afer I get my braces on. I chose after of course. So i'm glad this isn't going to interfere with my brace day, which is only 4 days away!!!!

#22 Post by **Catmom** » Mon Jun 04, 2007 5:45 pm

I had a mouthful of crowns before being braced, so it was interesting finding solid teeth for the anchors. That being said, however, things have gone well and no problems with the crowns to date. I will probably have another root canal while braced as I had a filling done last week and the tooth is still quite sensitive - a feeling I know well from the other crowns.

I'm not sure if they can actually do the root canal while the braces are on as that molar just happens to be the anchor for my upper brace. Oh well, just one more thing to worry about, right?

#23 Post by **Kbraced** » Mon Jun 04, 2007 6:10 pm

Well, my gums are still giving me trouble. It looks like there is some sort of cyst above my crown rather than swelling. If I squeeze it white fluid oozes out (ew). It isn't painful but I'm going to call both my ortho & dentist tomorrow.

#24 Post by **Tin Indian** » Mon Jun 04, 2007 6:32 pm

I have a total of 16 crowns to date. They are a mixture of ceramic and gold. They have cost between $650-$800 a piece with insurance picking up 1/2 cost of each. Neither my regular dentist or ortho perceived any problems but we'll have to wait until treatment is over to tell.

#25 Post by **Kbraced** » Thu Jun 28, 2007 7:54 pm

Update: As it turns out, that issue with my gums was due to an abscess. I chipped my front tooth as a child and have had a series of crowns covering it since I was about 9. I had a root canal done on this tooth as a teen about ten years ago and now there's a new abscess. So, I'm going to have to have my wire taken off, crown removed (along with the post, etc. from my previous root canal), and a root canal do-over. I really wish this would've happened a few months ago before I got braces but it must be taken care of asap. So basically I'll be back at square one with my upper teeth as they are going to shift back to their original position until the root canal is done (over the course of 2-3 dental visits). *sigh* It's very frustrating but at least we found the problem relatively early into ortho treatment (less than months in). Dating is going to be really awkward for a while.

#26 Post by **Kbraced** » Thu Jun 28, 2007 7:58 pm

For some reason, I'm not sure if the crowns I had prior to the one I have now were porcelain...they were "temporary" as I understood it. Both the ortho & dentist have recommended getting a new crown at the end of ortho treatment. The newer crowns look better than the one I have so I'm looking forward to that.

#27 Post by **Kbraced** » Thu Jul 12, 2007 4:45 pm

Update: As it turns out, that issue with my gums was due to an abscess. I chipped my front tooth as a child and have had a series of crowns covering it since I was about 9. I had a root canal done on this tooth as a teen about ten years ago and now there's a new abscess. So, I'm going to have to have my wire taken off, crown removed (along with the post, etc. from my previous root canal), and a root canal do-over. I really wish this would've happened a few months ago before I got braces but it must be taken care of asap. So basically I'll be back at square one with my upper teeth as they are going to shift back to their original position until the root canal is done (over the course of 2-3 dental visits). *sigh* It's very frustrating but at least we found the problem relatively early into ortho treatment (less than months in). Dating is going to be really awkward for a while.

Well I had my root canal done yesterday. The dentist didn't have to disrupt my braces or anything as he was able to do it by putting a hole in the crown and doing what he needed to do through that hole, then resealing it. He told me that he gave me the spiel (above) so that I'd be prepared for the worst case scenario...what a slickster lol.

Not sure if I mentioned this, but it's a crowned upper front tooth I'm dealing with.

Thu Jul 12, 2007 5:42 pm

I agree, MissSmiley. I have 2 new crowns on my molars, and without them I wouldn't have been able to start my ortho treatment. More than anything I'm just glad to get rid of my mondo fillings, even if I had to trade them in for 2 fake teeth

My b-day is Monday (7/16) so we'll see how my crowns behave with the braces...Ortho assures me they'll be fine!

Kirsten

#29 Post by **Kbraced** » Thu Jul 12, 2007 6:48 pm

Fantastic that it's done K and all is good!

Here's to the remainder of your journey being smooth!

Thanks!