Dental question

pickledonionspaceraider · 12 November 2019 at 12:39PM

HI there

I am hoping a dentist may see this and advise please

I have a capped upper tooth, at the front, second from middle

Over time, the cap has shifted downwards, and twisted, it looks pretty rubbish as is not inline with my teeth and has a gap between the gum

My NHS dentist has told me there is nothing can be done, as if he attempted to remove the crown, it may pull out the remains of the original tooth

I went to a private dentist, who pretty much wanted to do a bridge for the entire front four teeth - which would be great as the other teeth are not entirely visually spectacular, but they are stable and not in a bad state, so I didn't want to go down this road as it was invasive and very costly (5K) as he wanted to remove two teeth and bridge across four - anyway that is out of the question

My question is, what are my options with this capped tooth? I really dont know what to do

It really knocks my confidence , talking, eating, and smiling i dont even smile with my mouth open these days

Toothsmith · 12 November 2019 at 1:27PM

It's only a dentist who can see it who can give you the options you may have with it.

You've had a couple of options already that seem perfectly reasonable. Did the private guy give you any 'alternative' options to the bridge?

pickledonionspaceraider · 12 November 2019 at 4:18PM

Toothsmith wrote: »

It's only a dentist who can see it who can give you the options you may have with it.

You've had a couple of options already that seem perfectly reasonable. Did the private guy give you any 'alternative' options to the bridge?

Hi Toothsmith

On a personal note, for me, to leave it as it is (as the NHS dentist said) , isn't perfectly reasonable. I want something doing (as it knocks my confidence)

On the private dentist, he didn't give any alternatives. I don't see how that one is a reasonable alternative really, to have a bridge when really, to get my teeth to a state where I am not embarrassed, all I need is one tooth sorting out

pickledonionspaceraider · 12 November 2019 at 4:22PM

Can a dentist remove a crown, after it is glued? I have had this for a good 15 years I would say

Toothsmith · 12 November 2019 at 4:34PM

The thing is, caps don't shift downwards and twist over time. If the crown isn't firmly cemented to the tooth it's sitting on, it comes off.

So - it is more than likely the tooth under the cap has something very wrong with it. Decay, infection, gum disease or a fracture, which have caused the whole tooth to make this movement.

Each possible problem would have it's own solution and that is why it's impossible for me without seeing you, and with a description that I know will be inaccurate.

The NHS dentist doesn't want to touch it as he thinks it will not survive further treatment, and the private dentist you saw wants to take it out as well as some others.

So - having a crown taken off is something that is possible - but why would the dentist want to? It will not have shifted on the tooth, and the only place it could be re-cemented would be exactly where it is now. That's where it fits.

It might be possible to take the crown off and make a new one but neither dentist you've seen think that would be a good idea, and as they have seen it and I've not, I cannot disagree with them.

On average - a crown has a life span of 10-12 years anyway - so the information that you have had this one for 15+ now also makes me think that the dentists you've seen so far are right, and you have to either live with it until it finally fails completely, or decide what to do next.

pickledonionspaceraider · 12 November 2019 at 4:49PM

That's what I am trying to do Toothsmith (decide what to do next)

So you think the tooth itself has twisted / moved? That surprises me , i don't have pain or gum disease (I have been checked within the last few weeks by the hygienist - who did the gum measurey thing) No one has ever said anything, and the dentist just puts filling putty in between the gum and crown as there are a few mm where something has moved

To be honest, hearing that caps have a life span of 10-12 years makes me happy. I want the bloomin thing to fall out - and it makes me angry that I had it in the first place

as a younger person, I always hated this tooth, before the crown - as the tooth itself was twisted. and a dentist told me he could file it down and crown it, so it would be straight. I wonder if gradually, the crown has started to follow the natural twist in the tooth, but i dont know

i hope it falls out

thanks for talking to me about it, appreciated

Toothsmith · 12 November 2019 at 5:52PM

This is why making guesses without seeing the patient is always a bad idea! You've just thrown in another possibility there that wasn't covered in my previous answers!

If the tooth was twisted, but crowned straight - then maybe it's the bite forces, or muscle forces in & around your mouth that twist the tooth. It's possible that your own original tooth had grown into that position because of the forces on it, and these forces have acted over the last 15 years to move the 'improved' tooth into a similar position!

But - that's only an extra thing to throw into the mix. I still think that if 2 dentists don't think re-crowning this tooth is the simple solution, then it's not the simple solution.

Sammy2018 · 13 November 2019 at 6:27PM

Hi Toothsmith. If the tooth underneath has shifted over time and therefore moved the crown to create a gap, what solution is there to close that gap?

Would it be as simple as just replacing the crown, making sure the gap is closed?

Bearing in mind the tooth underneath has moved? Would the dentist be able to straighten that tooth before putting on the new crown?

Erinome · 14 November 2019 at 1:00PM

I can only say that cosmetic dental work on the nhs is VERY limited. (I don't like the way my teeth look either!) Sorry, probably not what you wanted to hear.

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