OUCH!!!! Four front crowns at once?

[isaku5]

Okay, I''m a baby when it comes to dental procedures as a result of hair-raising experiences from childhood on.

I won''t elaborate--TMI, for sure. My current dentist (of 6 months) has stongly suggested putting crowns over my upper front teeth, two of which have been weakened by root canals done years ago, have been bonded, and are now spotting with yellow

At the same time, he suggests doing the teeth on either side for uniformity of colour.

I have never had any crown work done( must be the only procedure I missed) so I''m hoping you could provide some advice to this severely dental phobic patient.

 

[ladykemma]

valium and a friend to drive you home.

 

[door knob solitaire]

OH I am so sorry you are in such fear

.

I really mean that, because I LOVE to go to the dentist. (I hate HATE hate with FEAR to get my hair cut...) When I go to the dentist I get that wonder stuff I call nitro. I think it has a more technical name...but it takes me to la la wonderland. Please make an inquiry.

There has been so many advances in Dentistry...your experience won''t be ANYTHING like it was before. And wow oh wow how pretty you will be when you are done!!!!!

Really, it is going to be fine...

it may even be a relaxing spa like thing...if you would only GET THE NITRO!!

DKS

 

[lumpkin]

I can relate! I have a husband who is very nervous in the dentist chair, and I have a 5 year old who just had to have some things done.

My 5 year old was very uncooperative and fearful after having some initial work done. The key was to find a dentist he LIKED, then they sedated him with Versed and nitrous oxide.

Versed not only sedates, but it has an amnesiatic (?) effect where your memory of the procedure is either gone or very foggy. The nitrous oxide is a gas that just makes you feel super relaxed. I would also suggest getting a second opinion. There may be a less invasive way to get the same results.

Good luck! I really, truly empathize.

 

[AGBF]

Crowns don''t hurt at all, but having a dentist start one can take time. Usually a crown is done in two visits, the first one being the longer of the two. In the first visit the tooth is ground down. An impression of it is taken and sent to a laboratory so that a permanent tooth can be made to fit in your mouth exactly. Then a temporary crown is put in place. All of this takes time. You have a dentist fiddling around in your mouth for quite a while and you have to bite down for impressions and to hold things in place on each visit. Sometimes biting down on a stick for a long time is tiring on the jaw. I don''t love having a crown done, but it is-at worst-an annoyance. It is absolutely nothing like a root canal!

Deb

 

[isaku5]

Thanks everyone, that''s encouraging; I tried the nitrous oxide for the first time when I had the amalgam removed from the upper right quadrant and then on the same visit he extracted one of my two remaining wisdom teeth. I was warned that I''d be "loopy" and would need a ride home. Well, for whatever reason, the nitrous didn''t even relax me, let alone make me "loopy". I white-knucked it the whole time, got up and walked out--no assisstance needed. My poor DH (who has perfect teeth

)arrived prepared to pick up his basket case wife and I walked out to the car to meet him. Honestly, there wasn''t even the buzz that a glass of wine usually produces.

I will ask the dentist about Versed, but am actually considering deep sedation. Anyone tried that??

I know, I''m such a pathetic wimp when it comes to dentists. Any other medical procedure I have no problem with (so far).

 

[lumpkin]

I wonder if they adjusted the gas levels correctly. I''ve had nitrous before and it definitely makes you loopy. Although about 15 minutes after you quit breathing it, the effect is pretty much over. Usually they will start leveling it back to pure oxygen before they take off the mask.

It''s been many years, but I think they gave me Versed or something like it when I had my wisdom teeth taken out. I only had three for some reason, but one was deep back in the corner of the jaw. I really don''t remember the procedure at all except that my boyfriend came and got me and I was sooooo hungry and couldn''t eat. You have to fast whenever they sedate you beyond nitrous oxide.

 

[Kaleigh]

I just had a crown put on after a root canal. The crown doesn''t hurt at all. I can relate to fear of the dentist isaku, had such a bad experience with my porcelain veneers. I think Versed will work for you.... You have my sympathies.

 

[kcoursolle]

I don''t have any advice, but I just wanted to say good luck and happy recovery afterwards. I hate going to the dentist as well...just hate it!

 

[Skippy123]

Best wishes

Sending good vibes.

 

[Beacon]

Just did one crown - zero pain! I went shopping directly afterwards as a reward. Yes, they are in two visits. I had not had any crown done in years and now the "temporary" that they put on looks very nice, a good white color, just like a normal tooth.

Since you are dealing with front teeth, the main issue is cosmetic. Maybe ask if he has any photos of past work. You don''t want to see any gapping between the crown and the gum line on the crown.

Now I have to do one more crown. I need to get my gumption up, but really it is no more than an inconvenience - should not hurt much. Good luck!

 

[isaku5]

Thanks again everyone for your well-wishes! Lumpkin, do you know what the fasting period is with Versed? When I had the nitrous, it was 2 hours before the app''t.

Does anyone else, besides me that is, think that 4 teeth (2 hours plus in "the chair") is a bit much for a dental phobic? When I ask the dentist any questions such as I''m asking today, he brushes aside any concerns with a " Don''t worry; it''ll be over before you know it" So not right!!

Has anyone had experience with deep sedation before such a procedure, or would it be overkill?

Is deep sedation a synonym for anasthestic?

So many questions...sorry

 

[isaku5]

Date: 4/29/2007 8:11:21 PM
Author: Beacon
Just did one crown - zero pain! I went shopping directly afterwards as a reward. Yes, they are in two visits. I had not had any crown done in years and now the ''temporary'' that they put on looks very nice, a good white color, just like a normal tooth.

Since you are dealing with front teeth, the main issue is cosmetic. Maybe ask if he has any photos of past work. You don''t want to see any gapping between the crown and the gum line on the crown.

Now I have to do one more crown. I need to get my gumption up, but really it is no more than an inconvenience - should not hurt much. Good luck!

Excellent point, Beacon, about the gapping! Our DIL had 2 crowns placed on her front teeth and the resulting gaps almost drove her mad. When I mentioned recently that I was scheduled for 4, her exact words were, "Are you crazy? You saw what I went through". That comment didn''t alleviate my anxiety one iota.

 

[Kaleigh]

Date: 4/29/2007 8:13:01 PM
Author: isaku5
Thanks again everyone for your well-wishes! Lumpkin, do you know what the fasting period is with Versed? When I had the nitrous, it was 2 hours before the app''t.

Does anyone else, besides me that is, think that 4 teeth (2 hours plus in ''the chair'') is a bit much for a dental phobic? When I ask the dentist any questions such as I''m asking today, he brushes aside any concerns with a '' Don''t worry; it''ll be over before you know it'' So not right!!

Has anyone had experience with deep sedation before such a procedure, or would it be overkill?

Is deep sedation a synonym for anasthestic?

So many questions...sorry

I think that is a lot to ask of you. Easy for the dentist to say, no worries, but he''s not having it done, YOU are. I''d do 2 and 2. Deep sedation is something my friend has done, it''s expensive. But hey next time I need major work done, I''m doing that too.

 

[isaku5]

Thanks, Kaleigh. I have good dental insurance coverage, so I''ll check my policy.

 

[asscherisme]

Get a second opinion!!! I had a new dentist tell me I needed 6 crowns (after never having any). I got another opinion and guess how many I needed- ZERO! In fact the second dentist saw nothing the first dentist saw. So I went for a third opinion who agreed with the second. The third dentist said "Some dentists are more interested in the best interest of their bank account than their patients". I had always had honest dentists up until then and I was really pissed and upset that the first dentist tried to scam me into 4 crowns. Once you get a crown, you are stuck for life with maintaining and replacing as needed.

I would totally get a second opinion. Good luck.

 

[AGBF]

Date: 4/29/2007 8:20:52 PM
Author: isaku5
Excellent point, Beacon, about the gapping! Our DIL had 2 crowns placed on her front teeth and the resulting gaps almost drove her mad. When I mentioned recently that I was scheduled for 4, her exact words were, 'Are you crazy? You saw what I went through'. That comment didn't alleviate my anxiety one iota.

If you live near Connecticut I can tell you of a dentist who specializes in this kind of work (and teaches it at a dental school). He is meticulous.


Deborah

 

[isaku5]

Date: 4/29/2007 10:53:42 PM
Author: AGBF

Date: 4/29/2007 8:20:52 PM
Author: isaku5
Excellent point, Beacon, about the gapping! Our DIL had 2 crowns placed on her front teeth and the resulting gaps almost drove her mad. When I mentioned recently that I was scheduled for 4, her exact words were, ''Are you crazy? You saw what I went through''. That comment didn''t alleviate my anxiety one iota.

If you live near Connecticut I can tell you of a dentist who specializes in this kind of work (and teaches it at a dental school). He is meticulous.


Deborah

Thanks for your suggestion, AGBF, but I live in Ontario, Canada--about 50 miles north of Toronto. Do you have any contacts up here?

Btw, my dental policy offers all kinds of sedation including anasthesia; however, the work must be done in Ontario.

 

[lumpkin]

Isaku5, we scheduled it for 8:00 am and he couldn''t eat or drink anything after midnight. As soon as he was done they had us get him a shake to bring his blood sugar up. It was pretty easy that way, and if I were having work done with Versed, that''s how I''d do it.

I think you really should see another dentist to confirm the work is necessary. If you do need to have it done and you are going to be sedated, I probably would have all the work done at once. They will later have to take off the temp caps to put on the permanent ones, but that''s not such a big deal. And two hours in the chair when you are sedated probably won''t be so bad as having to come back and do it twice, at least to me.

I think if you go under general anesthesia they book an operating room at the hospital for that. Correct me if I''m wrong....

 

[AGBF]

Date: 4/29/2007 8:13:01 PM
Author: isaku5
Has anyone had experience with deep sedation before such a procedure, or would it be overkill?

If this is not general anesthesia and does not put your life at risk, I would not call it "overkill" to help you get a medical procedure done. The reason I explained the process of having a crown made was to give you a sense of what was involved so that you could assess whether it was something which you thought you could tolerate or not. The only reason to suffer through something is when there is an advantage to doing so. If deep sedation is very low risk and you are very phobic, why torture yourself by a long stay in the dental chair? (I am postulating that sedation is low risk. I am unaware of what the term even refers to in terms of anesthesia. Why don''t we clear this up?)

Deb

 

[AmberGretchen]

Valium is worth trying or looking into as well - in the same family as Versed (benzodiazepines), but slightly different. I got a double-dose (10 mg total) before having all four wisdom teeth removed

about two and a half weeks ago. Once it kicked in I was WAY more relaxed than I would have been otherwise. I was a nervous wreck before that, and I''ve not done very well with stronger sedation in the past, so this was my only option, but I''d do it again if/when I need additional dental work (hopefully not for a long time!!).

 

[CodyB]

Are you sure your dental insurance will cover cosmetic procedures? I''ve never heard of any doing so in the US.

I join in the several suggestions to get a second (and maybe third) opinion. And be very, very certain of the experience and skill of any dentist who is going to crown front teeth. As well, the dentist needs to have a high degree of aesthetic sensibility, not just for color but also for shape and congruence with your other tooth structures. (For example, did you know that there is a difference between men and women in the actual shape of their teeth?) Once your tooth structure is ground down to the little nubbin that the prosethetic tooth is glued to, there is no turning back. Even if properly done, the crowns have to be replaced after several years, and regular professional cleaning and care is imperative.

What about porcelein veneers (with the same caveat about the practitioner''s competence)?

You are talking about a permanent change in your appearance, hopefully an improvement, but... You are also talking about permanent changes that have the possibility of affecting your ability to eat and speak, if not done properly.

Sorry to butt into your discussion, but it seems to me that sedation should be the least of your worries. Research this decision at least as thoroughly as you would the purchase of a diamond. Then get the opinion of at least one additional expert (an "independent appraisal" of sorts).

I sincerely wish you the best in obtaining a successful and pleasing outcome. And do check on your insurance - the only pain you may have when it is all over is a whopping bill you have to personally pay!

 

[AGBF]

I found CodyB''s points interesting. I had not zeroed in on the points he did since isaku was not asking about them. My crowns are all gold crowns on back teeth except for a few porcelain (or whatever) crowns on teeth closer to the front that can be seen more easily. I have no experience with crowns on the very front teeth.


Deborah

 

[FireGoddess]

Okay, this is not going to make you feel better, but it was my only crown experience and I thought you should know. Perhaps you want to get one done and see how it goes before you commit to all 4 with this dentist??

I had to have 2 crowns done and scheduled just one to see how it went. The doctor was very nice and explained the possible complications, etc. I had the tooth drilled down and the temp crown put on. Over the next week I experienced a gradual increase in pain in the tooth to the point I had to rush in and have them look at it. The shock of the drilling on the tooth caused the tooth to DIE and I had to have a root canal. I was really, really mad. This is a potential complication that they tell you about but the doctor assured me it had ''never happened to a single patient of his.'' Well, guess who was the first? I''m still mad to this day and haven''t had the second crown done yet. Avoidable? Probably not. But to say I didn''t lose faith in the dentist would be a lie. The endodontist however (who did my RC) was a real pro and I haven''t had a single problem with it. But I''m deathly afraid to get the other crown done, as you can imagine.

It would make sense to get them all done at once, but after my experience, I would be loathe to do that! I hope yours goes better - in all probability it will because what happened to me happens very infrequently. But that''s little consolation when it happens to you!

 

[isaku5]

Date: 4/29/2007 11:13:34 PM
Author: AGBF

Date: 4/29/2007 8:13:01 PM
Author: isaku5
Has anyone had experience with deep sedation before such a procedure, or would it be overkill?

If this is not general anesthesia and does not put your life at risk, I would not call it ''overkill'' to help you get a medical procedure done. The reason I explained the process of having a crown made was to give you a sense of what was involved so that you could assess whether it was something which you thought you could tolerate or not. The only reason to suffer through something is when there is an advantage to doing so. If deep sedation is very low risk and you are very phobic, why torture yourself by a long stay in the dental chair? (I am postulating that sedation is low risk. I am unaware of what the term even refers to in terms of anesthesia. Why don''t we clear this up?)

Deb

Thanks so much, Deb, for your info. I have to confess that I have not done any research on types of sedation yet except the nitrous. According to my insurance plan, there are many all of which are covered.

 

[decodelighted]

GET A SECOND OPINION!!!!!

If the problem is mostly cosmetic -- porcelein veneers are a GREAT option. My sister had her front teeth done that way & has been very happy with the results.

I''ve had one crown done after a back tooth broke in half & it was no picnic! I''m going to look for a new dentist before any more major work.

All the more reason to - say - start with one & judge their work -- or start with something LESS OBVIOUS than your front teeth.

Oy!

 

[isaku5]

Date: 4/30/2007 12:41:01 AM
Author: CodyB
Are you sure your dental insurance will cover cosmetic procedures? I''ve never heard of any doing so in the US.

I join in the several suggestions to get a second (and maybe third) opinion. And be very, very certain of the experience and skill of any dentist who is going to crown front teeth. As well, the dentist needs to have a high degree of aesthetic sensibility, not just for color but also for shape and congruence with your other tooth structures. (For example, did you know that there is a difference between men and women in the actual shape of their teeth?) Once your tooth structure is ground down to the little nubbin that the prosethetic tooth is glued to, there is no turning back. Even if properly done, the crowns have to be replaced after several years, and regular professional cleaning and care is imperative.

What about porcelein veneers (with the same caveat about the practitioner''s competence)?

You are talking about a permanent change in your appearance, hopefully an improvement, but... You are also talking about permanent changes that have the possibility of affecting your ability to eat and speak, if not done properly.

Sorry to butt into your discussion, but it seems to me that sedation should be the least of your worries. Research this decision at least as thoroughly as you would the purchase of a diamond. Then get the opinion of at least one additional expert (an ''independent appraisal'' of sorts).

I sincerely wish you the best in obtaining a successful and pleasing outcome. And do check on your insurance - the only pain you may have when it is all over is a whopping bill you have to personally pay!

CodyB, thanks for mentioning many concerns I hadn''t really given a lot of thought to; changes in ability to eat and speak far outweigh any pain I had dreaded.

My dentist sent in a pre-determination to the insurance company which agreed to pay 50% of the cost to a max of $2000./ year. My estimated out of pocket expense would be $2000-- half of the 4k cost.

 

[isaku5]

Date: 4/30/2007 12:43:51 PM
Author: FireGoddess
Okay, this is not going to make you feel better, but it was my only crown experience and I thought you should know. Perhaps you want to get one done and see how it goes before you commit to all 4 with this dentist??

I had to have 2 crowns done and scheduled just one to see how it went. The doctor was very nice and explained the possible complications, etc. I had the tooth drilled down and the temp crown put on. Over the next week I experienced a gradual increase in pain in the tooth to the point I had to rush in and have them look at it. The shock of the drilling on the tooth caused the tooth to DIE and I had to have a root canal. I was really, really mad. This is a potential complication that they tell you about but the doctor assured me it had ''never happened to a single patient of his.'' Well, guess who was the first? I''m still mad to this day and haven''t had the second crown done yet. Avoidable? Probably not. But to say I didn''t lose faith in the dentist would be a lie. The endodontist however (who did my RC) was a real pro and I haven''t had a single problem with it. But I''m deathly afraid to get the other crown done, as you can imagine.

It would make sense to get them all done at once, but after my experience, I would be loathe to do that! I hope yours goes better - in all probability it will because what happened to me happens very infrequently. But that''s little consolation when it happens to you!

FireGoddess ( glad to see your beautiful pear back in your avatar

). Thanks for your candour. I think I''ve made up my mind to do as you did, one crown first on the discoloured tooth. Like you, I seem to be the exception for any dental procedure. The tooth in question has already had a root canal ( as has the tooth next to it).

A few years back, I had a great dentist who did 4 or 5 root canals painlessly, but he retired and since then I have been searching for someone of similar personality and expertise. No luck so far, but everything my present dentist has done has worked out well for me me, and I think I have enough confidence to proceed with ONE at this time. I will certainly pass along the no-gap instuctions.

Thank you everyone who responded. As always, whether it''s sparklies or pearlies

, you provide excellent advice.

 

[isaku5]

Always happy to read your "straight from the hip" advice, deco! Yep, one at a time is the way to go. Apparently, none of my less obvious teeth need crowns...yet.