Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

July 2, 2019

Am I Allergic to These Crowns?


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Dr. Hall,
 

I had 3 crowns cemented two weeks ago. They were recommended by my dentist in order to strengthen 3 teeth that had large 20 year old amalgam fillings that needed to be replaced but were too big to fill and crowns were recommended.
 

Since they started working on my teeth, the crown prep, impressions, temporary crowns, permanent crown cementation, the total work lasted 6 weeks. For the entire 6 weeks, since the beginning of the process, I have had severe dry mouth, a sore/burning tongue, and tingling/numbing feeling on the side of my mouth with the crowns. I was worried I might be allergic to some dental material being used but the dentist insists it can’t be an allergic reaction since there are no other allergy symptoms occurring. I even went for bloodwork with my primary care doctor to see if anything else could be causing the dry mouth but all bloodwork came back fine.
 

Is it possible that my body is rejecting the crowns, can I be allergic to some material, or is it completely unrelated? I just can’t figure out what’s causing the dry mouth that started as soon as they started working on my mouth. The dry mouth is also making it hard for me to adjust to the feeling of the new crowns because my cheeks and tongue keep sticking to them and adding to the foreign feeling in my mouth. I am so miserable.
 

Any advice would be appreciated.

Thank you,
Sandra from California
 
 
Sandra,
I don’t know where your dentist gets this idea, “it can’t be an allergic reaction because there are no other allergy symptoms.” There are varying intensities of allergic reactions with a variety of symptoms. With what you’re experiencing, it certainly sounds to me like an allergic reaction is indeed a possibility. But I can understand why your dentist would want to be in denial over that possibility because the solution, if you are allergic to anything in the crowns, would be to replace the crowns, maybe at your dentist’s expense. Now I’m not saying that what you’re experiencing is for sure an allergic reaction. I’m saying that is a possibility that should be checked out.
Here’s what I would do first—find out what these crowns are made of. You didn’t say anything about what type of crowns they are. If there is any metal in them, that’s where I would start. If there is, ask your dentist for a copy of what is called the identalloy certificate. This is a certificate that dental laboratories are required to provide dentists that lists the exact composition of any metallic alloys used in any dental restoration they make for the dentist. If there is any nickel in the metal, that is a prime candidate for an allergic reaction. Other possible metals that could be causing a sensitivity reaction could be beryllium or chromium. If the crown is metal-free all ceramic, a sensitivity reaction would be very rare, but I wouldn’t totally cross it off.
If you run into any roadblocks with this, I would get a referral to an allergist.
I would also add that it’s possible that the condition in your mouth is stress related. Since you had this reaction from the beginning of the work before the crowns were put into your mouth, that could be an explanation. If nothing else seems to provide an adequate explanation, maybe an allergist would be able to help you figure out if that is a contributing factor.
 
Dr. Hall

 

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

5 Comments »

  1. Thank you Dr. Hall for your answer. The 3 crowns are all zirconia I believe. I was thinking if it is an allergy then maybe it’s not to the crown itself but maybe to the cement they used for both the temporaries and final crowns. But your idea that it could be stress related is also good. I do believe I have been clenching and grinding my teeth more at night since this entire process started. It has been extremely stressful since I ran into problems with the crowns since the beginning and they had to be sent back and redone. That’s why it took 6 weeks to complete. One of the crowns was already cemented on when they realized it was too bulky so I had to go back the following week and get it cut off and a new impression taken. Needless to say, I will not be going back to that dentist because the “final” crowns they did still feel extremely bulky and too flat on the “biting side” since the bite for these crowns had to be adjusted multiple times. It’s been a nightmare.
    – Sandra

    Response by Dr. Hall
    I’d be very surprised if you’re having an allergic reaction to zirconia—it’s a very biocompatible material. An allergy to the cement would be very transitory if it existed. Stress reactions can mimic allergic reactions.

    I will say that a well-done crown should blend into your mouth so well that you don’t notice it’s there.

    Comment by Sandra — July 3, 2019 @ 8:12 am

  2. These crowns feel horrible, but I do not want to go back to the original dentist since I’ve had such a bad experience and this was the second go around and they’re still too bulky. She of course says they’re fine and I just need to get used to them. I’ve had a crown before, I have one that’s 5 years old and I never had any discomfort with that one. These definitely have to be redone. 2 are for molars and 1 is for a premolar. If I do for some reason have a sensitivity to zirconia, what would be the next best option? Also, when should they be redone? I don’t want to put too much stress on the nerves/roots and end up needing root canals.
    – Sandra

    Response by Dr. Hall,
    I can’t imagine that you’re sensitive to zirconia, though some rare instances of sensitivity to zirconia have been reported in the literature. As far as materials for crowns, there are several other options. I don’t know where these crowns are, and that would affect the choice of material. One option, of course, would be the same material as your other crowns.

    Comment by Sandra — July 4, 2019 @ 9:13 am

  3. I’m hoping I’m not sensitive but the fact that all this started once that first crown was cemented has me thinking it might be related. I have found a few people online that have had similar reactions to their Zirconia crowns, such as dry/burning mouth, sour taste coming from the crowns, tingling/numbness near the crowns. Those are all things I have experienced so right now that’s all I can think can be causing my symptoms. I’ve even had bloodwork done to rule out any other conditions or syndromes and everything came back fine.

    The crowns are for teeth #13, 14, and 19. Would all porcelain crowns be a bad choice? I have one other crown that I have had for 5 years and it’s a PFM. I could go with that but I’m not happy with the dark line that appears at the gums after a few years. Also, if I were to get them redone, how long should I wait in order to not risk causing any further damage to the nerve and needing root canals? This whole situation has made it difficult to enjoy my daily life and I’m just trying to figure it all out.

    Comment by Dr. Hall:
    If you have any tendency to clench or grind your teeth, all-porcelain may not be strong enough on your molars. You have a couple of options. The e.max crowns are made of lithium disilicate veneered with porcelain, and that could be a choice for all of these teeth. They are very strong. Or, you could have porcelain fused to gold on the molars (#s 14 and 19) where the gumline isn’t visible and then do all porcelain on the premolar (#13). There would be no issue with the gumline being visible on your lower molar, and, if you have a normal width smile, the gumline on the upper molar would also not be visible. During my practice, I did many porcelain fused to gold crowns on first molars and never had an aesthetic complaint. But if you have a very broad smile, that upper first molar can sometimes be fully visible all the way to the gumline.

    Comment by Sandra — July 5, 2019 @ 2:59 pm

  4. Thank you Dr. Hall. So the e.max crowns are different from zirconia? If I have a sensitivity to zirconia then the emax should be fine?

    Also, as an experienced dentist, is there any other reason why all these issues would arise as soon as the first crown was cemented? I feel like it has worsened the longer I’ve had these crowns in and it’s making me physically ill. It’s like I can taste the crowns. Not very pleasant. Not to mention I’m still convinced these crowns were poorly made. They do not feel comfortable at all. It feels like they are putting pressure on my gums. #14 puts immense pressure on the lingual gingival margin. They also feel like pieces of plastic in my mouth. I never had these issues with the PFM I had put on 5 years ago. That one never took any getting used to. It was comfortable from the beginning but these feel so bad in my mouth and it’s almost been 6 weeks for #13 and 3 weeks for #14&19. – Sandra

    Response from Dr. Hall:
    Right. There are two relatively new high-strength ceramics. One is zirconia, the other is lithium disilicate. The e.max crowns are made on a foundation of lithium disilicate and veneered with porcelain for better aesthetics.
    It’s hard for me to tell what is wrong with your crowns without seeing you, but if the crowns don’t feel comfortable, there is something wrong with how they were made. You shouldn’t feel any pressure on your gums. If you want to share where you are in California, I may be able to come up with an excellent dentist who would be able to take care of this for you.

    Comment by Sandra — July 5, 2019 @ 5:13 pm

  5. Dr. Hall,

    Thank you so much for all of your continued help. It is truly appreciated. I’ve had such a bad and traumatic experience with the last dentist that I don’t know what to do now. I don’t want to return to her office because I don’t trust her. I would rather go somewhere else, even if it’s means paying out of pocket again. This whole situation has been extremely traumatic for me.

    I’m located in Southern California, Los Angeles County. Close to LAX. If there is a good dentist you recommend, I would definitely look into it.

    Thanks again, Sandra

    Response by Dr. Hall,
    Sandra, I’ll email you privately with my recommendation. There are several excellent dentists I know who could solve your problem for you, but there is one in particular that would be my first choice.

    Comment by Sandra — July 6, 2019 @ 4:26 pm

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