[Emergency Dental] Wife's porcelain crown came off, what to do?

As most people know bad teeth leads to heart disease so this kind of thing might become an serious issue in a few years. Having worked on an ambulance my whole adult life, you would be suprised how often we are called for toothaches

 

Don't worry, you don't sound obnoxious, just ignorant.

 

Just to add a couple of my thoughts here. There are a few things that can cause pain or discomfort after a root canal. First, its normal to feel a general soreness around the tooth for a few days after the procedure. If the discomfort persists for longer than a week, then it can be caused by two things:
1) Incomplete root canal
2) ill fitting crown

If the root canal is not done correctly, then the patient will get a re-infection of the tooth...so that's when you know the root canal failed.

If the crown is such that the bite is incorrect (the crown was too high), then you will get that continuous, general feeling of discomfort around the tooth. This is going to be the most likely cause of her feeling the pain on the tooth.

Therefore, when you go to the dentist, have them re-cement the crown and "take the tooth out of occlusion"...just tell the dentist that, haha...it might shock him for a patient to use that language, but basically, you want the crown to not really hit the opposing tooth during biting, which could definitely help her feel better, if that was the reason for her discomfort in the first place. So just make sure the bite is correct and that there are no high spots when they check her bite after recementation.

Warning: Patient Education (long and boring)
The roots of our teeth are attached to the bone through fibers called periodontal ligaments. They are these tiny little specialized connect tissues that attach the tooth to the alveolar bone and also give rise to sensations...such as when you are biting too hard on something and you realize you should stop. In any case, when a patient gets a crown (and it doesnt matter if the tooth has been root canaled or not), the final thing the dentist does is check the patient's bite with something called articulating paper (blue paper that marks the spot of contact when biting). From the blue marks, we are able to tell which teeth are contacting, so we make the proper adjustments so that all teeth are contacting the same. In some patients, its hard to have them mimic their exact biting pattern...so the perfect adjustments cant be made 100% of the time. If the crown is too high (even 1/10 of a millimeter can cause a lot of discomfort), then the periodontal ligaments that surround the tooth can become inflamed because that tooth is receiving more of the forces than the surrounding teeth. As a result, discomfort is felt...much like a bruise. Those fibers surrounding the tooth keep getting overused and the feeling of pain is continuous. The only way to fix that is to make an adjustment where the tooth is not in contact (or even very light contact), with the opposing tooth, and that will give the periodontal ligaments time to heal and become "normal" again.

 

I kinda wanna read that hate thread on rezdawg again just to laugh at the haters bc this man knows his ish. He's a real cool guy in real life. I still need to set an appt but my schedule is hectic right now. Hopefully soon!

 

Haha, thanks man, you and wifey need to come by!

I had to delete all my posts in that thread because someone submitted it to the news station or my school or something, lol. I still remember getting a call from one of the higher ups in the school...but he basically just laughed at the situation with me. He still brings it up to me when I see him when I return to Boston. People made way too big of a deal about sharing homework answers, etc...happens all the time in dental school and has no bearing on anything else. Too many uptight people in that thread, haha, that time period was such a pain to deal with.

People just need to chill, enjoy life, and support each other through the ups and downs of being a Houston sports fan.

Cheers fellas!

 

Ah, so you're smarter than the team at frontline that spent weeks reporting that story. Gotcha, and good to know! Please share your in depth wisdom about how the (ever growing) number of poor in America take care of their teeth. Pretty please?

 

I havent seen the video you posted yet...but I will say that the majority of Medicaid dental offices are corrupt on some level. My first job out of dental school was for a Medicaid office...and as soon as I realized what was going on, I started looking for a practice to buy. I didnt want anything to do with that. I, basically, was being pressured into producing a certain number regardless of how I got there. I even remember my boss trying to lecture me. She questioned if I realized the pay off when I do fillings instead of crowns...and I would reply to her that I have ethics. Soon after, Medicaid and the state board were on her tail and that's when I got out of that mess. Plenty of my friends that start at Medicaid offices have had similar experiences. Its pretty disgusting seeing kids come in with 15 crowns in their mouths when all they needed was small fillings.

 

Thanks a ton, rezdawg! The side of the face is definitely swollen, but not close to the size of a grapefruit. It hasn't been root canaled before. I'll be sure to schedule something asap. Unfortunately, like B-Bob pointed out...

...due to not being able to afford dental care, I have had to wait until it became bad enough to go to the ER. I'll figure something, out though.

Thanks, again, for the advice, Rezdawg.

 

There is always the option of extracting the tooth and then having that space filled later with a bridge or an implant when finances become stabilized. The extraction is typically $200-250...where as a root canal/crown combo can run you $1500-2000.

Hope it works out for you.

 

Don't you still have to get the nerve removed/filled if you extract a tooth? Otherwise that gap would be sensitive to pain right?

 

Nope, a blood clot fills the space and tissue heals over the extraction site.

 

Can the extraction route be permanent? Is the bridge/implant necessary? Thanks, again!

 

sorry to hear man.. hope you get better soon!

 

Thanks. Appreciate it!

 

Depends on which tooth it is...the problem with having an empty space is that the teeth will start shifting to "fill in" that space...which can result in your bite changing on that side of your mouth, which will then effect your bite on the opposite side of your mouth. Then it'll be very expensive to fix everything at that point. But, unfortunately, that's the route many have to take because of lack of options.