New Post and Core or New Dentist?

[AnniesDish]

Hi everyone, I'm new to the forum.

I had a root canal in order to get a post and core and a crown about 6-9 months ago. Around Easter I was eating a cadburry egg and chipped the back of my crown. After that it became loose so I went to the dentist.

He pulled off the crown, cemented it back on and said it should be fine. Later that night I was eating a piece of toast and the crown came right out. Went back to the dentist, he cemented it back in and said if it came out again he was going to have to replace the post and core.

I have been babying it since then in fear of it happening again. It has never felt right, my bite is off and sure enough it is shifting around.

This is so frustrating. It's hard enough to get the time off work to go to the dentist let alone come up with the money (no insurance.) Plus I am terrified that it is going to hurt to remove the old post and core.

Does anyone know if there are any other options? Should I get a second opinion? Btw, it is a a tooth just to the side of my very front teeth. Just pulling it is not an option.

Thanks in advance for any advice.

 

[brit]

Plus I am terrified that it is going to hurt to remove the old post and core.

There is no need for it to hurt, get numbed up. The best options for you, I am not so confident on but I suppose the best is keeping the current crown, followed by extraction and implant or least good some kind of bridge arrangement (downside it affects the 2 teeth on either side which is not a good idea at the front especially).

 

[Dr. Daniel]

Hey
I do not know what is the situation with your tooth, so my opinion is limited.
Placing back the crown is the cheapest solution. In order to evaluate if it is an appropriate solution, that depends not only on the tooth itself (the core and post that it has now) but also the hall teeth.
If you feel that your bite has changed since the placing of the crown, than it is better to go to the dentist again.
Did your dentist explain why is it needed to change the core and post?
In any case, there should not be any pain when replacing the core and post. I myself do it on many occasions without anesthesia (again, depends on the clinical situation).

 

[De8934]

There is no need for it to hurt, get numbed up. The best options for you, I am not so confident on but I suppose the best is keeping the current crown.

Sorry to but i here, but I have had 2 inlays fall out in 12 monhs done by an NHS dentist and to fix it he needed to retreat one and reshape the other, neither was done with local aeasthetic, I was told I didn't need any because there was no nerve in these teeth because they had been root filled. Like Dr Daniel says, maybe the injection isnt necessary.

The 4 root fillings done over 9 visits and it made my bite different. I never has jaw pain before the fillings and although I told the dentist, the response was that I'll get use to it.

Well It did settle down once one broke in 4 place and had to be removed, 2 others had to be redone and the last one has holes in the top of the inlay which I'm told is because I grind my teeth and constantly causes niggling pain which no one knows whats wrong!

In my case a new dentist is called for. I keep looking.

 

[brit]

Sorry to but i here, but I have had 2 inlays fall out in 12 monhs done by an NHS dentist and to fix it he needed to retreat one and reshape the other, neither was done with local aeasthetic, I was told I didn't need any because there was no nerve in these teeth because they had been root filled. Like Dr Daniel says, maybe the injection isnt necessary.

Yes for sure but if someone has 'fear of pain' as their main issue, then 'getting numbed up' is the obvious solution (so long as the dentist has good injection technique). Just like sedation, numbing is sometimes for patients not for procedures - as Gordon used to say.

Some patients need sedation for things I am happy to do with just local and some others may be happy to do some things with no local when I would rather have a painfree injection because I find it easier to relax that way. A private dentist who wants to keep you happy will pander to either, though will advise what they feel is best in most cases. Horses for courses.

FWIW I had my first crown prep on a root canalled tooth with no local, it wasn't painful, it was a bit sore around the gum line for part of it but not awful, definitely bearable - I could have used my stop signal and opted for local if I wanted it at any point but I didn't opt for it despite at times thinking to myself, well actually I'll be glad when I'm outta here today, not the usual relaxing experience. Remember they are blasting off the outside of your tooth for a crown prep, it's not internal drilling which seems less invasive and more gentle somehow.

Second time - also no nerve the tooth has had a root canal (same dentist), my dentist made it really easy for me to opt for local - he remembered my saying I had found it hard to relax at the end last time (he cares enough to ask for feedback you see) - so I had my usual painless injection and a really relaxing appt...so there's never any question for me in future: local it is....I even found the impressions easier with my mouth partly numb (I don't have an issue with impressions btw).

I have my cleaning without local but I only go to gentle hygienists - have had a bad time with the other kind lol.
Numbing is for patients and their preferences as well as for certain procedures for sure.

 

[Dr. Daniel]

Yes for sure but if someone has 'fear of pain' as their main issue, then 'getting numbed up' is the obvious solution (so long as the dentist has good injection technique). Just like sedation, numbing is sometimes for patients not for procedures - as Gordon used to say.

If a patient is afraid of feeling pain, numbing the tooth (when it is not needed) is one possible solution, it certainly not the only. If it works out well for a specific person (like for brit) it does not mean that it will work out well to others.
I see the local anesthesia as mainly a mean to avoid pain (during the dental treatment) but not necessarily as a mean to reduce the fear from pain.

 

[brit]

If a patient is afraid of feeling pain, numbing the tooth (when it is not needed) is one possible solution, it certainly not the only. If it works out well for a specific person (like for brit) it does not mean that it will work out well to others.
I see the local anesthesia as mainly a mean to avoid pain (during the dental treatment) but not necessarily as a mean to reduce the fear from pain.

Ah but it was needed (I tried it both ways remember, I trusted his view that we could get away with out it the first time), it was uncomfortable around the gum line (retraction cord etc) to the extent that I'd rather be elsewhere.
If something really is painless then I do not want or need LA for it - I am actually an extremely relaxed patient.
Too many dentists kid themselves that things are just a bit uncomfortable and that they are causing no pain when actually they are. The sooner your profession accepts this and puts patient comfort first and foremost across the board, the sooner dental phobia will no longer exist.

I think it's far healthier for patients to opt for local anaesthetic when it's not maybe strictly necessary than it is to dose themselves up on valium etc from their local medical doctor or use nitrous at the dentist's - they wouldn't need to contemplate doing this if dentists weren't unwittingly causing so much routine pain and discomfort in the first place.
Case in point recent poster goes to NHS dentist, he is very nice but he 'really hurts her' doing a bit of cleaning - has this helped her go back? I think not.

 

[Dr. Daniel]

The sooner your profession accepts this and puts patient comfort first and foremost across the board, the sooner dental phobia will no longer exist.

I totally agree. This is one of the most fundamental problems with dentists (not all of the dentists but to many). The only person who decides about whether something is painful (or not pleasant) is only the patient because pain is in the end a subjective feeling. It is sad that some dentists decide for their patients about that. It is important that the dentist guide, explain, advise etc... but to follow the patients needs.
By the way, when using a retracting cord, anesthesia is needed (even superficial just for the gums).

 

[comfortdentist]

I totally agree. This is one of the most fundamental problems with dentists (not all of the dentists but to many).

The only person who decides about whether something is painful (or not pleasant)
is only the patient because pain is in the end a subjective feeling

. It is sad that some dentists decide for their patients about that. It is important that the dentist guide, explain, advise etc... but to follow the patients needs.
By the way, when using a retracting cord, anesthesia is needed (even superficial just for the gums).

You do not need to get use to the bite.
If the post and core is loose then perhaps their is not enough sound tooth to hold onto and that is why the post worked loose. If you have inadequate tooth to hold onto then you might be better off with an implant instead. At least find out why the cause of this problem is prior to accepting treatment.