• Welcome! This is a forum for anyone who is affected by a fear of the dentist, dental phobia, or specific dental fears.

    We are lucky to count a number of dentists among our members and moderators. Look out for the "Verified dentist" badges. If you are a dental professional who likes to help, please join our community!

    Register now to access many more features and forums!

All journeys start with the first step

B

blackhound

Well-known member
Joined
Jun 23, 2012
Messages
247
Location
Pennsylvania, USA
On dental crowns. My 2 cents. Feel free to ask for change.

I have a crown on tooth #4 that is a CEREC milled crown. Put in place 8 years ago. Nearly fell off this week. From what I have read they also require more tooth structure to be removed for placement. That could be a lie because I read it on the internet.

Sitting right next to it on #3 is a lab created crown of porcelain over metal. Cemented in place 35 years ago. Yep. Put on in 1985. Hasn't budged an inch. Hasn't caused one issue to date.

So.

I really don't care that the CEREC crowns can be done in one day in one appointment. If I have to go back twice for a lab crown and the damn thing holds on for 35 years? I've already wasted more time with this failed CEREC crown than I did with the original placement of any lab crown in my mouth.

I'm thinking I want a lab crown from here on in.
 
krlovesherkids777

krlovesherkids777

Super Moderator
Staff member
Joined
Jul 26, 2017
Messages
2,768
Location
Minneapolis, MN
Blackhound,

This is very interesting , thank you, I always wondered about Cerec myself, sounds like frustration at best. Do you have to go and get it replaced ? did they cement back on, that is one of my major fears, crowns randomly coming off. Amazing that other crown held on and is good for so long , now that is quite encouraging! I'd probably want to stick with lab too, even if I have to do the impressions which are not a favorite thing :) though now I have a few good impressions on impressions as of late :)
 
B

blackhound

Well-known member
Joined
Jun 23, 2012
Messages
247
Location
Pennsylvania, USA
The crown was not completely off. He wiggled it all the way off and then was able to cement it back in. Although 'cement' is probably not correct. The Cerec crowns are bonded to the tooth in a different way from traditional crowns.

This all feeds into my frustration with dentistry and the way procedures are presented to a patient. The dentist who placed the CEREC clearly had bought into the technology and had a financial investment. I was never given the option of a lab crown and frankly I didn't know that there was a real difference. I feel taken advantage of because I didn't know the differences and I wasn't given that information by the dentist who had a real financial incentive to make a CEREC crown.

I'm not as concerned about the CEREC on #4 as I am about the CEREC on #30. I think that was a bad choice by the dentist, again with financial incentive, to put a crown on a tooth that does all that heavy grinding and chewing when the opposing tooth (#3) has a traditional porcelain/metal substructure crown. I really fear that the CEREC will fail. I've been told that the CEREC material is super strong and blah-blah-blah, but again, if I had been given info to make an informed choice I would have said no, I want a traditional lab built crown.

And I think this commoditization of dentistry also includes implants and the pushing of implants where, again, there should be an informed choice. I had this experience with the CEREC dentist. (And yes, I'm long gone from this guy's practice.)

I broke a cusp off a tooth and it was broken clean right above the gum line. He pushed and pushed for an implant. The tooth wasn't fractured, there was no pain or pressure pain, the break was clean. My other option was a root canal, post and core, and crown. That was my choice. But the pressure to place an implant for what was a pretty standard dental situation was uncalled for. I'm sure he would have made way more money from an implant whether it was medically necessary or not.

On impressions: I might be one of the few who really doesn't mind impressions. It's awkward but it's not a freak out for me, although I completely understand how other folks can be triggered by it.

Blackhound,

This is very interesting , thank you, I always wondered about Cerec myself, sounds like frustration at best. Do you have to go and get it replaced ? did they cement back on, that is one of my major fears, crowns randomly coming off. Amazing that other crown held on and is good for so long , now that is quite encouraging! I'd probably want to stick with lab too, even if I have to do the impressions which are not a favorite thing :) though now I have a few good impressions on impressions as of late :)
 
B

blackhound

Well-known member
Joined
Jun 23, 2012
Messages
247
Location
Pennsylvania, USA
So I finally have my appointment set with the periodontist so he can unravel the mess that was made of my bite. Appointments with him do not fill me with dread and do not trigger my fear that my teeth are going to be mutilated. I'm sure he can fix it so I can eat normally again.

But always swirling around in the back of my mind is 'what if' I get a cavity, or another tooth breaks and I have to see a dentist. My 6 month appointments for cleaning and exam trigger all the bad feelings and those feelings are always lurking around the edges. UGH.
 
B

blackhound

Well-known member
Joined
Jun 23, 2012
Messages
247
Location
Pennsylvania, USA
I just keep coming back to thoughts about whether or not all this dentistry stuff is worth it. Periodonist stuff? Yep. Definitely worth it. But dentistry? Not so much.

I have pretty run of the mill issues with my teeth but they invariable turn into huge dramas. I just can't do this anymore. The multiple visits, the cost, and the emotional angst. Since December I have had 4 visits to try and deal with what was a small area of surface decay and my occlusion is still not resolved. It will be resolved --- tomorrow -- when I see the perio but this. just. isn't. worth. it. at. all.
 
krlovesherkids777

krlovesherkids777

Super Moderator
Staff member
Joined
Jul 26, 2017
Messages
2,768
Location
Minneapolis, MN
Sorry the dentist is alot of frustrations and thing seeming to spiril in the wrong direction. Really glad you have a good perio to help you figure this out and hope he can help with as much as possible and understanding. Wishing the best for your appt so you can get this sorted out.
 
B

blackhound

Well-known member
Joined
Jun 23, 2012
Messages
247
Location
Pennsylvania, USA
Thanks for the support and well wishes. This is all so frustrating when you take care of your teeth, have regular cleanings and checkups and then feel like you are failed by the professionals.

But I just came back from the perio and in 20 minutes he fixed everything. My bite is properly restored. Finally.

Teeth #2, 3, 4 were messed up as I thought. #3 was hitting the incline of the tooth below. #4 is the CEREC crown that recently came loose and the problem was the crown wasn't properly made for my occlusion. #2 was just along for the bumpy ride.

Teeth #15 and 18 on the opposite side of my mouth were also out of wack. Adjusting those two immediately made the molars on the other side close properly.

My experience with dentists has been that they hyper-focus on the tooth they worked on and only adjust that tooth. The periodontist is looking at the whole mouth and how micro adjustments affect the occlusion as a whole. He also told me that since most people have mismatched dentistry from years of restorations being done at different times by different dentists, occlusal problems are not surprising.

I also found out that if, GOD FORBID, I need another crown or general restoration to impress upon the dentist that my teeth need flat planes on the chewing surfaces because my bite is open in the front. I have no idea what that really means but I've inscribed that in stone in my memory and I can insist on any restoration being done that way.

I wish I could clone him and have his clone be my general dentist.

Sorry the dentist is alot of frustrations and thing seeming to spiril in the wrong direction. Really glad you have a good perio to help you figure this out and hope he can help with as much as possible and understanding. Wishing the best for your appt so you can get this sorted out.
 
krlovesherkids777

krlovesherkids777

Super Moderator
Staff member
Joined
Jul 26, 2017
Messages
2,768
Location
Minneapolis, MN
:welldone::perfect::wow:Your Perio sounds amazing!! total keeper there! So happy you got so many answers !
 
B

blackhound

Well-known member
Joined
Jun 23, 2012
Messages
247
Location
Pennsylvania, USA
updating for the record:

#2 surface decay.

First appointment the tooth was not correctly shaped and left me with a big food trap between #2 and #3 and screwed up occlusion.

Second appointment to correct the badly shaped tooth closed the food trap gap and left me with even worse occlusion.

Appointment with perio corrected occlusion.

Current: #2 is showing signs that are not good news. Sensitivity to hot and cold that wasn't there before. Surmise that the tooth is in the first stages of death and there may be a root canal in my future because that tooth was worked on too many times to fix some basic surface decay. This perfectly plays into my dental anxiety and makes me want to run and hide. Fair or not, my feelings are that I was failed and my trust violated.

So I've spent a lot of time, a lot of $$ (with even more $$$ quite probably coming down the pike for a root canal and crown), a lot of anxiety and fear FOR SURFACE DECAY that couldn't be done properly on the first attempt.

All this does is ratchet up my dental anxiety and make me want to avoid treatment at all costs. The financial burden is very real. My anxiety is very real. My distrust of dentistry is very real.
 
B

blackhound

Well-known member
Joined
Jun 23, 2012
Messages
247
Location
Pennsylvania, USA
Personal observation.

All the years of old school dentistry with amalgam fillings and, by current standards, old technology never produced issues with my teeth or my bite. I went in, had the work done, went home and moved on with my life.

All the work I've had done with modern technology has produced a never ending cycle of issues with my teeth and my bite. It's never a single visit and my dental anxiety is at a record high.
 
B

blackhound

Well-known member
Joined
Jun 23, 2012
Messages
247
Location
Pennsylvania, USA
Appointment booked with endodontist. #2 has not settled down. Hot and cold sensitivity is definitely an issue. I can't even ...... I'm hoping this experience will be on a par with the experiences I have with my periodontist.

I think a lot about dentistry and the ways I perceive it has failed me and the ways I would actually want things to be.

One of the issues I will carry as vendetta forever is the way I was monetized at a previous dental practice related to my gum disease. I had bleeding gums and deep pockets. Naively I believed they were working in my best interest. They were not. I spent 2.5 years with repeated deep cleanings, arestin placement in the the pockets, 3 month recalls, and repeated assurances that just one more procedure, one more appointment, one more this and that would make all the difference. I know now that was bunk and all it did was keep my $$ in their practice at the expense of my dental health.

When the lightbulb finally went on in my head and I went to a periodontist it was clear I had been gaslit. The pockets were so deep there was no way they could clean them without surgery. If they didn't know that? They shouldn't have been licensed to practice. If they did know that? It was completely unethical to not refer me over to a perio when I wasn't making any progress on controlling the bacterial infections. They just weren't risking my teeth they were risking my overall health.

And this is one of the failures I think about with the dental profession as a whole and how it mimics the medical profession. The absolute reluctance to call out practitioners who are doing harm to patients through incompetence or greed. I understand all the reasons why that doesn't happen but the bottom line to me is that real people suffer real monetary and physical damage because sketchy practitioners are not called out and held to account by their peers.

My dental anxiety wasn't always a thing. It was built by experience and the feeling I can no longer give the dental profession my trust while still having to visit a dentist so I can retain my teeth. It's a horrible emotional loop.
 
B

blackhound

Well-known member
Joined
Jun 23, 2012
Messages
247
Location
Pennsylvania, USA
It is very difficult to read the postings on this site and offer support since many of the posts are triggering, especially those that detail botched dental work. I wish dentistry had more predictable outcomes. Even basic procedures seem to be a crap shoot. The stress of even a cleaning and exam is extraordinary because of the fear that something will be found that needs work and it will not be done correctly. The anxiety is really overpowering at this point. I don't have fear of the process -- needles, drills, sights, smells, sounds -- I have fear of the botched outcomes that seem to dog me no matter the dentist. I don't worry about cosmetic outcome. The worry is always functional outcome which is consistently wrong.

And now I'm looking at a root canal which doesn't actually scare me at all because the endo will not be doing anything that will change my bite. What terrifies me is the second step of having a crown placed on the tooth since it is a molar and the occlusion I just had corrected by the perio will be destroyed once again.

My bite can't be that unique or difficult to manage when, of course, the periodontist manages it just fine. So why can't the dentist get this right? Ever? In the past 6 years I have had 3 different dentists because of this issue. Is this something that really isn't taught in dental school? How is it possible that 3 random dentists can't get my bite corrected with multiple tries after they do a restoration? And I'm not talking fussy, hairsplitting complaints by me. I'm talking full out wrong -- pain, teeth not meeting, not being able to chew -- not a close call at all.

I swear the only way to win this game is not to play.
 
Last edited:
B

blackhound

Well-known member
Joined
Jun 23, 2012
Messages
247
Location
Pennsylvania, USA
I think I am going with a new plan. I am not getting any more work done by a general dentist that can be done by a specialist.

I'm old enough to remember when dentists handled cavities and fillings and a basic cleaning. Anything else was handed off to a pro who had the additional training and certifications. Now dentists handle all sorts of things from implants to perio to endo to prosthodontics. I'm not comfortable with that the more I think about it.

Having a periodontist handle my gum disease has given me a disease free mouth for the past 7 years. I'm seeing an endo this week to deal with a rotten tooth because, like the perio, he has the additional training and board certification in his field to do the job, and hopefully this experience will be a good one. But I know one thing however it turns out -- I'm not anxious up front about his qualifications to do the job. Same goes if/when I need a crown. I'll see a prosthodontist.
 
B

blackhound

Well-known member
Joined
Jun 23, 2012
Messages
247
Location
Pennsylvania, USA
Hang on. Here we go. Off to the endodontist. I sure hope this guy is as good as advertised. o_O
 
krlovesherkids777

krlovesherkids777

Super Moderator
Staff member
Joined
Jul 26, 2017
Messages
2,768
Location
Minneapolis, MN
Blackhound.. :clover::clover::clover: Yes, hoping the same thing for you! Let us know how it goes!
 
Top