Never Ending Issues with a Front Upper Tooth Crown Not Fitting, What Can be Done?

Original crown and post were done in 2006, but the crown never felt good and adjustments didn't help. Then the post broke in 2009 and was replaced. Now the crown came off and I was told it doesn't fit (no kidding), so I agreed to a new crown. And now the crown doesn't fit and the dentist wants to adjust neibouring teeth, and not the crown, saying it can get compromised. I am in constant pain, but I don't want to further adjust healthy even teeth. I want the crown to fit. What do I do?

Doctor Answers 5

Continuing problems with front crown not fitting

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It's very difficult to diagnose your problem without examining you, but here are some of the issues you might be dealing with:

1. Occlusion. The way your upper and lower teeth meet eachother and function together, plays an extremely important role in whether or not your dental work will "survive". 

2. The quality of the laboratory being used to fabricate your restorations. Some dentists use very cheap off-shore laboratories so that they can discount their own fees for service.

3. The quality and expertise of the dentist providing the services.

4. the integrity and quality of the root that the dentist has to work with. Sometimes, there is so little left of the root, that it is not adequate to support a post and crown. In that case, the root may haveto be extracted and replaced with an implant.

5. The periodontal (gum and supporting bone structure) condition of your teeth has to be taken into account. Poor bone support might result in shifting teeth and poor occlusion.

New York Dentist

Time for a new plan

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I agree with Dr. Dorfman. Likely the tooth is failing. The most predictable long term approach may be to replace the tooth with an implant. Bone regeneration is going to be necessary. It's a matter of whether the implant can be placed during the extraction or if you have to regenerate the site first and have the implant placed later. I would get a 2nd opinion from someone very reputable in your area.

Peter Joseph, DMD
Baltimore Dentist

Poor Fitting Crown on a Front Tooth

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This is a dilemma.  It Sounds as if there are heroic efforts being done to correct issues from the past. My guess is there is a root fracture.  If you have pain this is not a good sign.  Unfortunately the prognosis for this tooth is probably poor and you may be on the road to an extraction, bone graft and implant.  If there is any question about the prognosis of the tooth, consider the implant sooner than later to prevent damge to adjacent teeth, bone and gumtissue.  Without seeing you or evaluating your radiographs and records, this is just speculative, but probably correct. 

Brian Dorfman, MD, DMD
Phoenix Oral & Maxillofacial Surgeon

Correct diagnosis is the key to this dilemna

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I agree with Dr. Neuhaus.  It is difficult to give advice without seeing your tooth.  The part that concerns me as well is the fact that you say you are in constant pain.  Pain is a signal that something is wrong.  YOu have had a number of crowns and a root canal treatment on this tooth.  You also have to be sure that there is not a fracture in the root, and that the root canal treatment is sound and remaining successful.  It is important for the crown to "grip" onto the root surface at least a couple of millimeters.  THis "grip" is called a ferrule.   I would advise that you first discover what is causing your problem.  Once that is determined, an appropriate treatment plan can be formulated.  After you know the best way to procede, then procede.  I have seen many people go ahead with inappropriate treatment that doesn't solve their problem.  This perpetuates a vicious cycle that seems to never end.   I hope that helps ... Good Luck.

Martin Frankel, DDS
Toronto Dentist

Never Ending Issues with a Front Upper Tooth Crown Not Fitting, What Can be Done

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We understand what you are going through, but there is always a solution for everything. Your smile is, without question, one of your most important attributes. A winning, bright, white, straight smile can provide you with endless amounts of confidence. Studies have shown that people with pleasant smiles are more likely to get ahead in the business world, and feeling confident is always a plus when it comes to your personal life. If you require more than a simple fix, you can do porcelain veneers, dental implants, dental crowns, and teeth whitening to give you a smile you are proud to show the world.A dental crown is a tooth-saving procedure that can help you preserve your tooth and your attractive, healthy smile.All-porcelain crowns are slightly more attractive than PFM crowns as they have a more natural luster, better color matching options, and will not show metal if your gums recede or if the crown experiences wear.

Pamela Marzban, DDS
Fairfax Dentist

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.