Help! Does a loose crown need to = either a bridge or implant?

[member 1]

Two of my front teeth have crowns. The initial ones I had were fitted by the NHS, and lasted exceptionally well, probably in excess of 20 yrs. However, in 2009 I was seeing a private dentist who recommended that both needed to be replaced. I was a bit reluctant about this, but since he was the ‘expert’ who I had to trust, I went ahead and had two porcelain crowns fitted.

Costing around £1,000 I felt this was expensive treatment, although the dentist explained to me that porcelain were the best, and I was hopeful that they would last just as long as what I had before.

I have now moved to an NHS dentist, who I really like. Sad thing is however that one of my crowns has recently become loose, and re-cementing hasn’t helped. I’m not happy about this, especially as I’ve now found out that the suspect crown has a very short/narrow pin, which makes me feel that it was never destined to last long.

So I’m now thinking what would be the best way forward. My preference would be to keep a crown, perhaps (??) with a longer/broader pin to ensure a better fit, though I may need to go along with one of the options suggested by my new dentist, of having either a bridge or an implant instead.

Any thoughts and/or suggestions on this matter would be hugely appreciated.

 

[brit]

Why not give the private dentist the chance to fix it and stand by their work? Let him re-cement it, not the NHS dentist - it comes under aftercare I would have thought. Maybe it requires a different kind of cement.
If the crown can be fixed - that is the best least invasive option. An implant is the next best but can you afford one they are not available on the NHS? NHS dentists are also not usually qualified to do them either and would have to refer you.
The trouble with a bridge is that it (adversely) affects the two teeth on either side and should be avoided for that reason alone - of course it is available on NHS however.
I'm not a dentist by the way. Good luck.

 

[member 1]

Many thanks for your good advice Brit. I’ve since been back to my current NHS dentist who suggested that in her opinion the troublesome crown should be replaced by a bridge, which I was very hesitant about as this would have involved the extraction of what tooth remains, and she hadn’t advised me that a bridge may adversely impact the two teeth on either side: I really appreciate you bringing this to my attention.

Rather than going ahead with this proposed treatment, I have taken forward your suggestion of getting back to the private dentist who carried out the crown replacement. I have to say I wasn’t particularly keen to do this since I felt as if I was disregarding the advice of my current dentist and instead challenging the prognosis that had been made by my former dentist, which in my mind, is something, patients don’t do.

However, the outcome of getting back to my old dentist has been good – he’s offered to fit a new crown at no cost to me, which this time will be secured by a post rather than a pin. Hopefully, fingers crossed, that will last.

 

[comfortdentist]

If the problem is a loose post on a short tooth then another option beside an implant or a bridge is to replace the post and core and also do a crown lengthening which is a minor gum surgery where some bone is removed to allow the gum to be pulled up higher thus giving you more tooth to hold onto.

 

[brit]

Many thanks for your good advice Brit. I’ve since been back to my current NHS dentist who suggested that in her opinion the troublesome crown should be replaced by a bridge, which I was very hesitant about as this would have involved the extraction of what tooth remains, and she hadn’t advised me that a bridge may adversely impact the two teeth on either side: I really appreciate you bringing this to my attention.

Rather than going ahead with this proposed treatment, I have taken forward your suggestion of getting back to the private dentist who carried out the crown replacement. I have to say I wasn’t particularly keen to do this since I felt as if I was disregarding the advice of my current dentist and instead challenging the prognosis that had been made by my former dentist, which in my mind, is something, patients don’t do.

However, the outcome of getting back to my old dentist has been good – he’s offered to fit a new crown at no cost to me, which this time will be secured by a post rather than a pin. Hopefully, fingers crossed, that will last.

Fingers crossed as you say. There is more incentive for private dentists to stand by their work and fix things (assuming they haven't traumatised the patient - then I would never suggest returning to them) since the Dental Complaints service was set up under the auspices of the GDC: https://dcs.gdc-uk.org. You don't need this at the moment since he has acted ethically in agreeing to retreat you for free.

Your NHS dentist probably assumed that you had no desire to return to the private dentist, even she will see that a fixed crown is better than a bridge seeing as an implant is not even available on the NHS. Compromising 3 teeth when you could compromise just the one which is already compromised should seem like a bad idea to any conservative dentist. Best wishes.