This week I was scheduled to have two posts placed in my crown-lengthened tooth. That didn't happen.
Instead of feeling no pain in the tooth, it became increasingly sensitive to pressure. Then, a few weeks ago, I couldn't tolerate anything cold in that quadrant of my mouth. So I went to see the prosthodontist who tapped the teeth in the area. The cold sensitivity was coming from #15, not #14 and he thought it would go away. It did.
But he also acknowledged that #14 should not be sensitive to touch. He sent me back to the endodontist. He considered for a second the possibility of a fourth canal but the X-ray gave no such indication. He thought it more likely that I had a microscopic fracture that could possibly be found via an apicoectomy.
That would have further compromised my bone. He consulted with the periodontist and prosthodontist about the best course of action.
I realized, at long last, that the long-term solution was an implant after all.
The periodontist took a cone beam...
The following week, the prosthodontist confirmed that, indeed, the next step would be the crown lengthening procedure followed by six weeks of healing time before he would insert a post to further support the crown. And, as Bill Mrazek, CDT, recommended, the best restoration in this case, would be a PFM. He and his office are the cat's meow when it comes to professionalism and patient care and I'm fortunate to become their patient.
The periodontist he recommended was the same one I'd already called so that added to my feeling of being in the right hands. I've since had the crown lengthening procedure. The stitches are out and I'm on the mend.
I couldn't be any more impressed with the periodontist and his operation! He gave me arnica, with instructions to start taking these tiny natural remedy pills for quicker healing two days before the crown lengthening procedure. I love that he takes a holistic approach to his work and plan to have my dental cleanings there in the future.
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.]
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The Night of June 6
A bunch of us were sitting around the fire pit on my patio, protected from the rain by a covered pergola. It was a Thursday night. We—LMT staff members, Andy and I—were enjoying our visitors from the Chicago LAB DAY setup team. Without warning, my laughter was replaced with a yelp; what started as a low-grade ache suddenly turned into a searing pain in my mouth.
I knew in that instant that #14 was saying it's time for that root canal procedure.
But we still had another day of scheduled activities with our visitors, so ibuprofen and I coexisted until Monday morning when I made a beeline to the endodontist, a friend I trust implicitly. He attached the rubber dam and tackled part one of the pulpectomy.
I was really surprised he drilled right through the crown. He was really surprised the crown itself wasn't fully polished and was such a "lump."
"What were you thinking?" he asked, wondering why I accepted "the lump." I told him I assumed I'd have had...
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Decision day. I went in to have the filling removed to see what was left of the tooth. Even this standard procedure is one that separates excellent dentists from just okay dentists. Unfortunately, this dentist is "just okay."
After the decision was made, I learned that there were several things she might have been able to do to better stabilize this tooth. But none of these things were on the table.
Take another look at the X-ray. [And, by the way, take a look at the bitewing to note the occlusion.] Note that there is a good amount of natural tooth surrounding the filling. From her perspective, replacing the filling didn't seem like an option. There was some decay underneath; my fault for letting things slide so long.
Should she have more adeptly and promptly been able to assess the source of my pain? Should she have been able to see this decay before removing the filling? Should she have been more assertive with me when I deferred taking action by letting me know what...
Lately, Iâd noticed some pain when chewing, but I wasnât sure whether it was coming from that tooth or the opposing PFM crown. Though #19 had a root canal [the one from LMTâs second crown experiment, 1987], there was a chance that the tooth had cracked.
Sometimes one poor decision turns a routine restoration into an expensive, time-consuming series of additional procedures and discomfort. I think there were two poor decisions made in my case. Check one for the practitioner and one for me.
This is my story and it pretty much dominated my summer.
With all the bad news about stiff competition and price erosion, I thought we all could use a “feel good” reminder that you deliver an invaluable service to the patients who receive your work; I’m one of them!
In March 2013, I went to a local general practitioner to have number 14 looked at. I was unable to chew without getting a shooting pain. (I wrote about this earlier and, for the details and more photos, go to http://lmtmag.com/series/baddentistry.)
Unfortunately, because this dentist didn’t realize how traumatized the tooth was—and didn’t give it a chance to settle down after removing a cracked filling—her treatment resulted in the loss of the tooth; not all at once, but little by little such that the summer of 2013 was dental hell.
I changed course and sought recommended specialists to take over my case but, in the end, I was scheduled for an implant. The Biomet 3i implant—selected and placed by periodontist Michael Sonick, DMD, Fairfield,...
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