Bad Dentistry - Part 5
Posted Aug 07, 2013, Published 2013-08-01
After the Fall
After finally finding my fallen crown, I gently ran my tongue across the prepped area. It felt like a wizard's hat: thin, tall and pointy.
We headed for home but made a stop for lunch along the way. That's when the wizard's hat came loose. I now held it in my hand. It didn't look or feel like a piece of my tooth. I stashed it in the plastic bag that held my crown and called my once husband/dentist Rob.
Since my appointment with the prosthodontist was over a week away, he said, "Stop by my house on your way home, I'll cover the exposed root with cement for added protection. You don't want any bacteria there."
When we arrived, he asked our son Eric to assist but Eric promptly handed over his responsibility to Andy and left the room. (We always knew he didn't have the stomach for medicine,) So there I am lying in my ex-husband's lap while my current spouse shines a flashlight into my mouth. [Not as awkward, really, as it may sound; we all socialize quite often.]
Rob used IRM to protect the tooth and voila! The tooth was covered.
I showed him the crown and the wizard's hat. He explained the "hat" was just the cement the endodontist used to hold the crown in place after it had fallen out during the preparation for part two of the root canal treatment.
So, I wondered, if that is cement, not a thin, pointy prep that broke off, how had the crown stayed in place since April? What was the original understructure and what happened to it?
I decided it was time to visit the dentist who prepped my tooth. Since I decided to share this experience with you, it seemed like the fair thing to ask her to explain her work. I made an appointment, saying I just needed 10 minutes of her time. I let the office manager know that the crown had fallen out, I'd had a root canal treatment and may need a crown lengthening procedure.
When I arrived, her assistant put me in a dental chair and attached a paper bib. "I've come in for a conversation, not an examination," I explained. "Yes, we know," she said, but this is what the doctor asked me to do. "Well, I only need a few minutes."
The dentist kept me waiting a little while longer [I was her first "patient" of the day.] When she came in the room, I could tell she was prepared for a confrontation. I had no intention of making it confrontational. There's too much I don't understand to put her in such a position.
I calmly asked if she could explain to me, via the X-ray on her screen of #14, what became of my natural tooth that it ended up looking "like this." I pulled back my cheek to expose the tooth ground flat against the gingiva.
"Oh, clearly a piece of your tooth broke off," she said. "I would never prep a tooth like that; there'd be nothing to hold the crown on."
Just like that, she explained away what I am calling "bad" dentistry.
In other words, the best I can surmise is that, as a result of the root canal procedure, the prepped area was way too narrow; the same diameter the endodontist had to drill through to access the roots. Nothing more.
I have since made a relief using orthodontic wax to see what the prep would have looked like.
I realize it is hard to see some of the detail but I'd like you look again at the crown and compare it to this wax relief.
Please let me know what you think about what you see. I can tell you that the wall of the crown is 1.5mm. I'd appreciate public posts rather than private messages so everyone can join in the conversation.
Next installment: August 29.
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