What is put onto the prepared tooth before the final crown is placed? (wondering about sorbitol, chlorhexidine digluconate)

[Annie364]

I'm currently getting my first crown done, on the LR7 molar. It's a root canalled tooth so it has no nerve in it. I've had the first stage where the dentist removed some of the tooth surface to prepare it. It's a tricky one to restore as it is on its own without teeth either side and has tipped inwards a bit. During this time he took a number of alginate impressions, and a few times he used a Cordosyl mouthwash to rinse the area.

I don't know if the rinse was used before taking the impressions and/or before placing the temporary crown. I think he did use it the next day on the prepared surface when replacing the temporary crown which had fallen off.

I am going in next week for the permanent crown.

I know that the Cordosyl has chlorhexidine digluconate which is anti-bacterial, and I don't want to ask him not to use it if it is good for stopping bacterial growth under the crown, and it's part of his procedure. However the Cordosyl has "Sorbitol Liquid 70%" in it as well, and sorbitol does feed caries bacteria even if slowly, according to what I've seen. I don't like the idea of sorbitol being used on the prepared tooth just before the crown, with any sorbitol left on the surface or soaked into the dentin being sealed in there under the crown.

- So I was wondering, what are the substances a dentist typically uses on the prepared tooth just before placing the permanent crown? So after he takes off the temporary crown, what is the procedure? Does he rinse it with something first (water? Cordosyl?), then is anything else placed on it (eugenol or something else?), then cement, then the permanent crown?

Apart from the sorbitol in the Cordosyl, I also wonder if I got a nerve pain reaction to the chlorhexidine digluconate in it.

The reason I think this is it seems like a similar type of substance in Closys/Ultradex (chlorine dioxide) seems to set off nerve pain if I use it a few days in a row. It's happened on two separate ocassions now, which makes me also wonder about the chlorhexidine digluconate. I will be testing the Closys again in the future once this current pain has gone away.

- Could it be possible to get a nerve pain reaction to chlorhexidine digluconate? Similar to the allergy people get to it I suppose, but not the skin reaction, instead a nerve pain reaction which would be neuroimmune.

[Background on the pain: Since the 1st stage of the crowning a week ago, I've had a bad sore pain in the jaw next to this tooth and around the tooth itself (not the gum surface but more an aching inside). It has been slowly improving over this week with aspirin. I think the pain could be caused by a combination of things, mostly the trauma from the shaping and the pushing on the tooth (the roots of that tooth are extremely close to the nerve bundle in my jaw shown on CBCT), and also the necessarily awkward shape of the temporary crown, but also possibly the chlorhexidine digluconate in the Cordosyl.]

- Lastly if I asked him not to use the Cordosyl rinse when placing my permanent crown, will I get a worse outcome for the tooth - i.e. will the bacteria on the exposed prepared tooth not be properly disinfected before the permanent seal of the crown is put on top?

Thank you very much.

 

[Gordon]

Normal procedure is just to wash it off with water and dry, there's no reason to use Chx at that stage. Sometimes we'll use something called Gluma to seal off the pulp tubules and reduce post-op sensitivity but no point in doing that on a root treated tooth.

 

[Annie364]

Thank you Gordon, that solves it for me! I was wondering if some kind of disinfecting agent was needed on the prepared tooth before putting the crown on.

Just washing off with water sounds perfect. I might just double check with him before he starts doing the permanent crown, that he won't be using Cordosyl for it.