Tooth crowns and decay.

[giddyup]

Had some pain with a rear molar that had been crowned about 7 years ago. In a visit to Bkk/Pattaya hospital this morning it was confirmed that the crown has to be removed and the tooth extracted because of decay. After quizzing the dentist I couldn't get a clear answer as how to prevent this happening. It appears to me that by the time the tooth gives a warning it may be too late. I have seen a couple of different dentists this year, neither mentioned anything about the problem tooth, even though it was obvious once pointed out that there was a gap between crown and gum. I think this may be the third tooth I have lost because of decay under the crowns. Now I have a situation where two adjacent molars will have been extracted, so I have a choice between some kind of dental plate or implants. At 75 I think that the remaining teeth are at risk as well, and it's going to be a very expensive proposition to get a mouth full of implants, but the alternative is false teeth, which kind of horrifies me. Just when you think you have one medical problem under control, another one pops up.

[lopburi3]

Are you having regular x-ray images taken?  Believe they normally take yearly for me and is not that expensive (taken every other cleaning).  I have had to remove/replace several crowns over the years.  Implants are expensive and not everyone is a good risk due to bone or sinus in area.  Believe they may offer you a removable bridge which is not expensive and serves well for normal eating - you remove at night.

[tonray]

7 minutes ago, lopburi3 said:

Are you having regular x-ray images taken?  Believe they normally take yearly for me and is not that expensive (taken every other cleaning).  I have had to remove/replace several crowns over the years.  Implants are expensive and not everyone is a good risk due to bone or sinus in area.  Believe they may offer you a removable bridge which is not expensive and serves well for normal eating - you remove at night.

I had same problem a month ago...the problem is x-rays cannot see under a porcelain on metal crown so you never know unless the decay has already gone too far and destroys the tooth. On x-rays crowns show as a big white blob. Opaque.

[giddyup]

25 minutes ago, tonray said:

I had same problem a month ago...the problem is x-rays cannot see under a porcelain on metal crown so you never know unless the decay has already gone too far and destroys the tooth. On x-rays crowns show as a big white blob. Opaque.

Exactly. I had X Rays taken this morning, they showed nothing.

 

36 minutes ago, lopburi3 said:

Are you having regular x-ray images taken?  Believe they normally take yearly for me and is not that expensive (taken every other cleaning).  I have had to remove/replace several crowns over the years.  Implants are expensive and not everyone is a good risk due to bone or sinus in area.  Believe they may offer you a removable bridge which is not expensive and serves well for normal eating - you remove at night.

The removable bridge sounds like a good option, even though it's getting to the false teeth stage, something I was hoping to avoid. Can't get past that image of a glass of water on the bedside table with a big set of choppers grinning at you.

[giddyup]

No one ever mentions, certainly no dentist I have seen, the downside of having crowns fitted. I remember asking the first dentist I used for crowns if there was any chance of decay forming under the crown. He said, if there is no decay there now, it won't happen. Considering I had a mouth full of amalgam, not sure how any dentist would know if there could be decay in the future. I guess, other than having crowns fitted there are only two other options, extraction of implants.

Edited August 3, 2017 by giddyup

[tonray]

5 minutes ago, giddyup said:

Exactly. I had X Rays taken this morning, they showed nothing.

 

The removable bridge sounds like a good option, even though it's getting to the false teeth stage, something I was hoping to avoid. Can't get past that image of a glass of water on the bedside table with a big set of choppers grinning at you.

I'm in the same boat...I have a large fixed bridge that makes up my 5 top front teeth (used to be a boxer and had fractured roots causing problems). It has served me well but this thing is 25 years old...and I know just from reading that any fixed bridge or crown after 25 years is likely to have a mess of problems underneath. I am likely looking at some type of implant denture where they sink maybe 3 posts and then mount an entire palate denture on that plate. Only a matter of time...I just hope I can handle all the stuff.

[tonray]

1 minute ago, giddyup said:

No one ever mentions, certainly no dentist I have seen, the downside of having crowns fitted. I remember asking the first dentist I used for crowns if there was any chance of decay forming under the crown. He said, if there is no decay there now, it won't happen. Considering I had a mouth full of amalgam, not sure how any dentist would know if there could be decay in the future.

They are pretty good liars I'm afraid. I had a root canal done thru the crown and at the time the dentist told me he did not why the tooth was infected....3 years later decay under that crown was still there and ate the tooth away...the roots which had been filled were fine but now there was nothing on top to mount a new crown onto....surgeon had to cut it out in 2 pieces because he could not grab anything.

[giddyup]

4 minutes ago, tonray said:

I'm in the same boat...I have a large fixed bridge that makes up my 5 top front teeth (used to be a boxer and had fractured roots causing problems). It has served me well but this thing is 25 years old...and I know just from reading that any fixed bridge or crown after 25 years is likely to have a mess of problems underneath. I am likely looking at some type of implant denture where they sink maybe 3 posts and then mount an entire palate denture on that plate. Only a matter of time...I just hope I can handle all the stuff.

I blame all my dental problems on the dentists that used to visit schools when I was a kid. Call me a cynic, but I believe they were paid by the number of teeth they drilled, consequently perfectly healthy teeth were sacrificed.

Edited August 3, 2017 by giddyup

[tonray]

Just now, giddyup said:

I blame all my dental problems on the dentists that used to visit schools when I was a kid. Call my a cynic, but I believe they were paid by the number of teeth the drilled, consequently perfectly healthy teeth were sacrificed.

Back in the old days when silver/mercury was still being used, they used to basically drill out the whole tooth to fill because it was easier to get it glued in even if there was only a small cavity. The result is that when that filling fails or cracks, now the tooth needs a crown because the hole is way to big to re-fill. I have so much that needs replacing, I cry thinking about it.

[giddyup]

1 minute ago, tonray said:

Back in the old days when silver/mercury was still being used, they used to basically drill out the whole tooth to fill because it was easier to get it glued in even if there was only a small cavity. The result is that when that filling fails or cracks, now the tooth needs a crown because the hole is way to big to re-fill. I have so much that needs replacing, I cry thinking about it.

There wasn't the same emphasis put on dental care when I was young as there is now, but my old man insisted that I brush my teeth  at least once a day. Of course flossing was unheard of.

[tutsiwarrior]

I lost a tooth due to decay under the crown...had it root canaled then didn't replace the crown (restore the chewing surface) and uneven chewing pressure then caused the tooth to split and, alas...first a crown, then a root canal and I ended up losing the mother anyway...

 

I recently had a front tooth pulled...the doc said that there was nothing left and that he couldn't save it...it looked OK from the front but behind there was nothing left and I said: 'why didn't it hurt so that maybe it could be saved?' and he just shrugged...

 

now I quite like my snaggle toothed countenance...it gives my smile 'character'...

 

 

 

 

Edited August 3, 2017 by tutsiwarrior

[giddyup]

Just got back from the dentist, needed two adjacent crowned teeth removed (painless) because both were decayed under the crowns, cost 4,600 baht. In a month I can get fitted for a partial plate that will fill the gap. Not something I ever wished for, but another one of the joys of getting old.

[KittenKong]

On 03/08/2017 at 1:28 PM, giddyup said:

I think this may be the third tooth I have lost because of decay under the crowns. Now I have a situation where two adjacent molars will have been extracted, so I have a choice between some kind of dental plate or implants. At 75 I think that the remaining teeth are at risk as well, and it's going to be a very expensive proposition to get a mouth full of implants, but the alternative is false teeth, which kind of horrifies me. Just when you think you have one medical problem under control, another one pops up.

 

My dentist told me 30+ years ago that I would never lose any teeth to decay but that gum disease would be a constant problem, and boy was he right.

 

I have hardly any fillings but at nearly 15 years younger than you I'm currently getting my fourth implant (luckily I can afford them) for teeth lost to gum disease and I bet that more will be needed before long. I have no crowns or bridges or plates and I dont want any.

 

Edited August 5, 2017 by KittenKong

[champers]

Dentures are not as bad as you may think. I have half my teeth missing (gum disease, fear of dentists and my own neglect) and replaced with dentures. You get used to them in days. Mine fit so well I don't need a fixative. A chemist here gave me a nice container to keep them in when I bought some cleaning tablets. I sometimes forget to put them in when I go out, but I am not the self conscious type.

[giddyup]

1 hour ago, KittenKong said:

 

My dentist told me 30+ years ago that I would never lose any teeth to decay but that gum disease would be a constant problem, and boy was he right.

 

I have hardly any fillings but at nearly 15 years younger than you I'm currently getting my fourth implant (luckily I can afford them) for teeth lost to gum disease and I bet that more will be needed before long. I have no crowns or bridges or plates and I dont want any.

 

I'm not sure implants are a viable option at 75, and could see costs escalating to around 800,000 baht if I just had all the molars done.

[smo]

On 8/4/2017 at 1:31 PM, giddyup said:

Just got back from the dentist, needed two adjacent crowned teeth removed (painless) because both were decayed under the crowns, cost 4,600 baht. In a month I can get fitted for a partial plate that will fill the gap. Not something I ever wished for, but another one of the joys of getting old.

May I ask how a partial "plate" works? Like more than one implants installed on a plate and then the plate gets affixed to the gumline? Also how much did they quote you for each implant? (you did mention lately that "escalating to around 800,000 baht if I just had all the molars done" but I don't know how many molars are involved). I just broke one of my front teeth, but in general my teeth have also entered the "decaying" stage for quite sometime now so I kinda look forward to a dental future not unlike yours right now.... I agree that the visual of a pair of dentures clattering in a glass of water by the bedside is not something that can be un-seen! 

[giddyup]

12 minutes ago, smo said:

May I ask how a partial "plate" works? Like more than one implants installed on a plate and then the plate gets affixed to the gumline? Also how much did they quote you for each implant? (you did mention lately that "escalating to around 800,000 baht if I just had all the molars done" but I don't know how many molars are involved). I just broke one of my front teeth, but in general my teeth have also entered the "decaying" stage for quite sometime now so I kinda look forward to a dental future not unlike yours right now.... I agree that the visual of a pair of dentures clattering in a glass of water by the bedside is not something that can be un-seen! 

A plate is removable, it just fills up the space where teeth have been removed. Better you do a Google search where there will be photos that give you a clearer idea. I just did a tough calculation of 16 molars, 8 top and 8 bottom @ around 75,000 baht each for implants, but I won't be going down that road. Here's a link https://www.google.co.th/search?q=partial+dental+plate&tbm=isch&tbo=u&source=univ&sa=X&ved=0ahUKEwifhLTS2MLVAhVDv5QKHTp9ALAQsAQIcA&biw=1600&bih=736

Edited August 6, 2017 by giddyup

[Here2008]

8 minutes ago, smo said:

May I ask how a partial "plate" works?

A 'partial plate" is a removable dental prosthetic.

 

AKA false teeth of the kind which are soaked overnight in a glass on the bedside table ! 

[giddyup]

1 minute ago, Here2008 said:

A 'partial plate" is a removable dental prosthetic.

 

AKA false teeth of the kind which are soaked overnight in a glass on the bedside table ! 

I agree, not pretty, but at 75 vanity is a thing of the past.

[DavisH]

On 8/3/2017 at 2:45 PM, giddyup said:

No one ever mentions, certainly no dentist I have seen, the downside of having crowns fitted. I remember asking the first dentist I used for crowns if there was any chance of decay forming under the crown. He said, if there is no decay there now, it won't happen. Considering I had a mouth full of amalgam, not sure how any dentist would know if there could be decay in the future. I guess, other than having crowns fitted there are only two other options, extraction of implants.

I'm pretty sure a tooth can decay under a crown. One of my crowns came out and there was some decay on it. Fortunately not too much so the dentist cleaned the tooth re-cemented the crown on. It would only require a bit of the cement detaching and allowing food to get in. Hence the bacteria followed by the acids they produce. I have had one tooth taken out because the tooth below the post had decayed beyond repair. I could get a permanent bridge but that means damaging the surrounding teeth and making it hard to clean them. So I'm holding off on that.

 

[mogandave]

A partial just kind of snaps in and out. You do not need to take them out at night. They work best if they have good teeth on both sides to hold them in. They are generally cheap and last a couple years.

A bridge is something like a partial but they are installed permanently. They cost about the same as multiple crowns. Beyond the cost, the big downside is you have to crown the healthy tooth next to the missing tooth.

Implants are great, I have a few, one about 20 years old without a problem. Only downside is the price.


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[lopburi3]

For just several teeth they can look like this (depending on where and teeth you still have) - snap into place.

 

Edited August 6, 2017 by lopburi3

[KittenKong]

21 hours ago, champers said:

Dentures are not as bad as you may think.

 

Maybe, maybe not. I'd rather not find out. Implants seem as near to having your own teeth as it is possible to get and so far I'm very happy with them (apart from the price).

 

I had braces when I was in my teens and absolutely hated them. I never want any sort of device that I can feel in my mouth ever again.

[KittenKong]

1 hour ago, mogandave said:

Beyond the cost, the big downside is you have to crown the healthy tooth next to the missing tooth.

 

Yes, that puts me right of bridges. It seems insane to bugger about with a healthy tooth in order to attach something to it.

[giddyup]

37 minutes ago, KittenKong said:

 

Maybe, maybe not. I'd rather not find out. Implants seem as near to having your own teeth as it is possible to get and so far I'm very happy with them (apart from the price).

 

I had braces when I was in my teens and absolutely hated them. I never want any sort of device that I can feel in my mouth ever again.

Believe me, I never envisaged myself having to wear dentures, but at 75 and with so many teeth that are at risk, it's just not viable to be spending huge money on implants. Plus I don't want to spend whatever time I have left in a dentists chair.

Edited August 6, 2017 by giddyup

[KittenKong]

31 minutes ago, giddyup said:

Believe me, I never envisaged myself having to wear dentures, but at 75 and with so many teeth that are at risk, it's just not viable to be spending huge money on implants.

 

I'm not criticising and I suspect that in your shoes I would do exactly the same as you.

[mogandave]

 
Maybe, maybe not. I'd rather not find out. Implants seem as near to having your own teeth as it is possible to get and so far I'm very happy with them (apart from the price).
 
I had braces when I was in my teens and absolutely hated them. I never want any sort of device that I can feel in my mouth ever again.

I wore a partial for years before I got the implants and got used to wearing it in a few days.

Nothing like braces...

[smo]

On 8/6/2017 at 8:15 PM, giddyup said:

A plate is removable, it just fills up the space where teeth have been removed. Better you do a Google search where there will be photos that give you a clearer idea. I just did a tough calculation of 16 molars, 8 top and 8 bottom @ around 75,000 baht each for implants, but I won't be going down that road. Here's a link https://www.google.co.th/search?q=partial+dental+plate&tbm=isch&tbo=u&source=univ&sa=X&ved=0ahUKEwifhLTS2MLVAhVDv5QKHTp9ALAQsAQIcA&biw=1600&bih=736

Thanks for the link, gyddyup. btw, I went in for a check up at Mahidol dental clinic (in bkk) today. Doc says that an implant to cover that ghastly hole where the front tooth used to be would cost around 60K baht, so she grudgingly goes the crown route, in conjunction with a root canal on the remaining base of the tooth, the total cost of which would be 20K. Before anything is done, I came home with a temporary tooth, which makes me feel "human" again.

I just wonder why a root canal is necessary in this case, kinda "killing" the tooth now that it has become useless?

Edited August 9, 2017 by smo

[mogandave]

Thanks for the link, gyddyup. btw, I went in for a check up at Mahidol dental clinic (in bkk) today. Doc says that an implant to cover that ghastly hole where the front tooth used to be would cost around 60K baht, so she grudgingly goes the crown route, in conjunction with a root canal on the remaining base of the tooth, the total cost of which would be 20K. Before anything is done, I came home with a temporary tooth, which makes me feel "human" again.

I just wonder why a root canal is necessary in this case, kinda "killing" the tooth now that it has become useless?

She'll likely want to remove the roots and insert posts to act as the structure that will support the crown.

[smo]

7 minutes ago, mogandave said:

 

She'll likely want to remove the roots and insert posts to act as the structure that will support the crown.

 

On the other hand, there is a smaller side tooth that needs root canal because doc says the cavities have come into the pulp part of the roots. However she emphasizes root canal only, no crown is necessary. So what gives? I always thought that doing root canal is to pave the way for putting on a crown.