Crown Advice

[Talullah]

Thanks so much to everyone for this support board. I've been immersed in it for the last 2 months as I'm trying to navigate a very trying dental situation. I've had a severe dental phobia for a long time after a lot of very negative experiences, most specifically that I am never numb enough and dentists have proceeded despite my protests, and a massive fear of all of my teeth crumbling and falling out. I'll post more in the general support thread, but I have a couple of questions specifically for the lovely dentists here.

I had a crown put on yesterday. It's a molar on the bottom right (not the back molar, second from the back). I opted for a gold crown, as I grind my teeth and on paper it seems like the best option in terms of strength and longevity. But now that I've had it done, I know it was a huge mistake. I hate it. I have a wide smile and I can see it when I smile. My confidence is absolutely shot. I'm a university lecturer and I talk in front of large groups of people for a living and I don't think I can live with this.

Q1: Is it possible to remove this crown and get a new one made of a tooth coloured material? I'm not concerned about the cost and I know it was my choice to get the gold crown, but I didn't realize just how devastated I would be by how awful it looks on me. The tooth is vital. It had a really large filling, which is why it was crowned. I'm absolutely terrified of losing the tooth completely due to my own dumb decision.

My second question involves the process of crowing a tooth. The dentist who did it is new to me and a fairly new grad at a clinic that has good reviews. They are supposed to be a practice that deals with anxious patients, which is why I chose them. I have seen her a couple of times for a filling, the crown prep and a temporary crown adjustment. She seemed caring and nice at those appointments. But yesterday was different. First, she was running about 30 mins late, which wasn't a big deal at all to me, but the whole process seemed rushed. She told me that I didn't need to be numb for the crown placement. This surprised me, as my tooth has not had a root canal and is very much alive. She seemed concerned because it takes longer for me to get numb and she was already running late. I went with it mostly out of fear as I didn't know what else to do. Taking the temporary off was ok and blowing air didn't really hurt. But then she needed to make adjustments to the prep. I don't know what instrument she used (sounded like a drill, but I have no idea), but it hurt, a lot. I jerked with the pain and raised my hand and she stopped, but she didn't numb me up, she just kept going on a different part. Eventually she got the crown on, after a ton of adjusting, both on the crown itself and on my actual tooth (with no anesthesia). I don't think my tooth was cleaned with anything before cementing, just blown with air. It was awful. I burst into tears as soon as I got in the car. I'm now terrified that my tooth will rot under the crown because it wasn't disinfected properly.

Q2: Is it normal for the crown placement to be done with no anaesthetic when the tooth is vital? Is it normal not to clean the tooth before placement? Are the crowns themselves disinfected before placement?

Thank you all so much.

 

[Gordon]

Q1: Is it possible to remove this crown and get a new one made of a tooth coloured material? I'm not concerned about the cost and I know it was my choice to get the gold crown, but I didn't realize just how devastated I would be by how awful it looks on me. The tooth is vital. It had a really large filling, which is why it was crowned. I'm absolutely terrified of losing the tooth completely due to my own dumb decision.

Sure. The prep would need to be redone, since the white coloured crowns need to be thicker than gold does, so slightly more tooth would need to be removed (don't panic we're talking about 1mm instead of 0.5mm ), Getting the old crown off might take a while, depending on what it's been glued on with, some cements are easier to shift than others.

Just as a passing comment really... Even as a dental student, I couldn't have told you anything about the state of my lecturers' teeth, I spent most of the time trying to keep up with my notes and staying awake (!). You might find that other people notice the new crown a lot less than you do... have you asked somebody you trust what they think?

Q2: Is it normal for the crown placement to be done with no anaesthetic when the tooth is vital? Is it normal not to clean the tooth before placement? Are the crowns themselves disinfected before placement?

I used to give patients the option. If the crown goes straight on without much fuss then most folks would probably prefer not to be numb for a couple of hours afterwards, others would rather just be numb from the get go. I think you got an inexperienced dentist who was flustered at running behind and tried to rush things a bit. I doubt if they were happy with themselves afterwards and I wouldn't let this put you off them if you've been comfortable with them before.
It might be worth your while saying something to them about being happy to reschedule an appointment in future if they found themselves in this position again rather than rushing with you.

It's not necessary to clean or disinfect anything. Crowns are disinfected at the lab before going back to the dentist in a sealed bag.

 

[Talullah]

Thank you Gordon for your reply. It helps immensely. I will definitely say something to the dentist. I would have been more than happy to reschedule. I don't like being rushed or feeling like I'm being rushed. I have a full check up on Dec 6. I'll see how I feel about her then to see if I want to go forward with any other treatment from her.

And thanks for reassuring me about replacing the crown. I'm on leave this term, and live in the country, so only my husband has seen it. He says he doesn't notice it. I believe him, but I think the issue really is that I notice it and I can't live with it. When I open my mouth it looks like a big empty space because it's so dark. When I smile, it's all I can see. I have a massive fear of my teeth and what they look like. I've been obsessing over it since it was put in and can't stop thinking about it. I struggle with self-confidence enough as it is, I don't need something else to worry about.

It's also all I can taste. It's a familiar metallic taste and doesn't go away. I don't want to taste that forever. It is giving me flashbacks of having braces when I was a kid, due to a traumatic injury from abuse (which is where all of my fears stem from). All I could taste was the metal from the braces and that was a horrible period in my life.

 

[Gordon]

Here's a bit of a weird tip. Sometimes eating a soft boiled egg can help with the metallic taste. The theory is that the soft yolk contains some sulphur compounds which can bond to the metal surface and change the taste. Might be worth a go if you don't mind soft boiled eggs At least to tide you over till you get the crown changed

 

[Talullah]

@Gordon Thank you! That’s a great tip and I will try it. Anything is worth a shot. This crown has really changed how everything tastes. Everything tastes horrible. It’s not something I came across at all in making my decision about this crown. Maybe some are more affected by it than others?

 

[Gordon]

Let me know if it works, it sounds a bit old wives' tale to me, but when patients have tried it, it does seem to work.