Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

July 8, 2019

My dentist wants to wait till the nerves settle down before replacing my crowns


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Dr. Hall,
My dentist convinced me to replace all my old amalgam fillings even though many were still stable. She was going to replace them with either composite or crowns depending on the size of the filling and how much tooth structure would be left. Anyway, we started on the project, and about six weeks ago she did three zirconia crowns for me. These crowns are so uncomfortable for me. They feel bulky to me, they press on my gums to the point that sometimes it hurts, and my bite feels off, making these teeth sore. It’s causing me a lot of stress, which especially concerns me because I have a new baby that I am nursing, and it’s like the stress is affecting her. She hasn’t been able to sleep lately and has been waking up crying all the time.
So I canceled the rest of her treatment plan. But of course she refuses to refund the money for the 3 crowns because she’s convinced they are fine and says if there is any problem, she will fix it. I don’t trust her to fix it though.
But now I have gone to a new dentist, and I want her to re-do these crowns. I realize that I will have to pay for this out-of-pocket, but I really want to get this done. But this new dentist says she does not want to touch my crowns until I give the nerves time to heal and lower the risk of needing root canals. But that can be months. I don’t know if I can wait that long.
 
– Gail from New Jersey
 
Gail
I’m confused by the reluctance of your new dentist to replace these crowns, saying that the nerves need to heal. The problem you have with the crowns—pressing on the gums, bite is off, they feel bulky—have nothing to do with the nerves of the teeth. If those nerves were irritated, there would be heightened sensitivity to cold in those teeth. While it doesn’t sound like your first dentist has a strong level of expertise when it comes to crowns, it doesn’t sound like your new dentist has a firm understanding of dentistry either.
Yes, a crown preparation, where the dentist is cutting deeply into the tooth, can be irritating to the nerve of the tooth—in some cases highly irritating. But removing an existing crown is only mildly irritating, if any at all. If, indeed, the nerves had been highly irritated by the first crown preparations, which it doesn’t seem like has happened, six weeks would be enough time for them to settle down.
I wish you well and hope you get this problem solved. I see no reason for a delay in replacing these crowns, and I am very wary of the level of expertise of this new dentist of yours. She is displaying timidity in tackling this problem—not a good sign at all. I warn patients in several of my blog posts about how easy it is to push some dentists outside of their comfort zone, and she is giving you a red flag here that she isn’t comfortable re-doing these crowns. Maybe what is making her timid is the difficulty in grinding off zirconia crowns. They are very tough and very hard to grind off, especially if they are bonded on. The worst thing you could do would be to urge her to go against her instincts here.
If you’d like help finding a dentist who could do a good job on this for you, let me know and let me know exactly where in New Jersey you are. I know a number of excellent cosmetic dentists there.
Good luck,
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.

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