after 4 bite adjustments. Dentist says wait 3 days to see if I I can still feel the tooth when I chew. He has ground the tooth to almost nothing and is even now grinding the bottom teeth just trying to get the adjustment right. I am going back again next week. I do not want anymore adjustments, I want the tooth fixed. What else could be wrong. Adjustments are not helping.
Reply to Answer Ill Fitting Crown. My New Crown Never Feels Right Even
Doctor Answers (6)
Crown doesnt feel right after many Adjustments
A well fitting Crown should allow you to bite and chew in comfort after it has been inserted. Proper tooth preparation and impression technique should provide the lab technician accurate information to allow the fabrication of a well fitting crown. In regard to your specific complaint the need for adjusting the new crown as well as the opposing tooth indicates that your crown prep tooth was under prepared. One of the key elements of good crown preparation is providing enough room for the lab technician so he can provide you with a crown that has enough structural durability regardless of the materials you choose. From your complaint the exact nature of your discomfort can be attributed to possibly more than one reason. Tooth pain can come from a poor bite or how the upper tooth or teeth relate to the lower teeth. Another possible source of your discomfort can be from the nerve becoming inflamed from the preparation and the existence of previously placed filling materials and the removal of deep decay. This must be evaluated from the history of the tooth in question as well as current x rays. It appears that your crown needs to be redone to provide you with a proper bite relationship and comfort. If after that pain persists the tooth may require Root Canal Treatment as well.
Crown that is high
In order to place a crown on a tooth, the tooth needs to be reduced a certain amount to create space for the crown. It sounds like the chewing surface of your tooth may not have been reduced sufficiently. Another cause for an ill fitting crown may be an inaccurate impression. If it's not possible to further adjust the crown, then the crown may need to be taken off to reduce your tooth a little bit more if needed, take a new impression, and make a new crown. Best, Dr. Elizabeth Jahanian
Well Fit Crowns
Precision is key when making a crown. The tooth must be prepared to allow sufficient space for the restorative material (gold alloy or porcelain) and anatomical design. The impression must be highly detailed and accurate to insure a fully deated and sealed crown on the remaining tooth surface. Lastly, the registration of your bite must be accurate.
When a crown is adjusted to the point of wiping out the occlusal design and/or reducing the opposing tooth, a design problem is probably the cause. Either the tooth was insufficiently reduced or the bite registration did not record full closure of your teeth.
Replacement of the crown may be needed. This would allow confirmation or appropriate tooth reduction and recording of a completely closed bite. A little inconvenience to obtain a comfortable and properly fitting crown.
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Ill Fitting Crown
A crown should not require that much adjustment to make it fit. A well-done crown requires multiple steps to be done precisely, from tooth preparation to impression to crown fabrication (which also requires multiple steps). If any of the steps in the process is not quite right the crown will be compromised. A crown that is "ground to almost nothing" generally indicates that there was not sufficient tooth structure removed during the preparation of the tooth. If you are not satisfied I would ask that the crown be redone. In my office, if a patient is not satisfied with anything we do it is redone at no cost to the patient...I would hope this is the policy in every dental office.
Crown Adjustments not helping the pain.
There is a potential that your tooth might be infected. Once the nerve dies an infection/abscess might suddenly occur causing the tooth to move higher into the occlusion which would interfere with your bite. If it is in the early stages an X-ray may not show anything yet. If this is the case a root canal would be required. With so many adjustments it sounds like your nerve has been affected to a stage where it cannot be reversed. If your pain is persisting even after you eat or drink and/or if it appears spontaneously than unfortunately the symptoms are pointing out for a root canal. Good luck.
Ill fitting crowns could improperly cemented
Have your dentist take an x-ray to make sure the crown was cemented properly.
Crowns shouldnt need that many adjustments, and there are many reasons for crowns not fitting properly.
Distortion in the impression
Distortion in the model
Poor lab technique
Incorrect placement during cementation.
If the crown was not cemented properly you will most likely need a new one.