Archives for January 2021

I think I’m allergic to my new dental crowns

Posted on January 26, 2021 by AllSmiles.

I think that somehow I am allergic to my new crowns. All three crowns seem to be infected. Now I wish I had switched to a holistic dentist. But this is my first time receiving crowns, so I did not know what to expect. I told my dentist that there was leakage around the temporary crowns. She took the temporary crowns off, did a fluoride treatment on my teeth, and prescribed antibiotics. When the final crowns arrive, my dentist filed them a lot because my bite was off. The crowns seemed okay, but whenever I drank something, fluid would rush beneath them. I wore temporary crowns again for two weeks, but my new crowns make my gums burn, and my teeth are sensitive. My dentist did not bond them on, and I do not want her to bond them. Could an allergy to one of the dental chemicals be causing this problem? – Reginia

Reginia,

Without an exam from Dr. Tostado, we cannot give you an accurate diagnosis, but we can offer some insight.

Do Not Allow Your Dentist to Cement Your Crowns

If your crowns are irritating your gums and teeth, do not let your dentist cement them. The discomfort will no go away without your dentist identifying and treating the problem.

Burning Gums with Dental Crowns

If your dental crowns are burning your gums, you may be sensitive or allergic to the crowns or substances used in the process.

Porcelain-fused-to-metal crowns – If you have metal sensitivity and your dentist placed porcelain-fused-to-metal crowns, you may be allergic to them. Ask your dentist to look at the dental alloy certificate from the lab and tell you your crowns’ exact composition.
Pure ceramic crowns – Although it is rare to react pure ceramic crowns, it is not impossible. Ask your dentist which materials the lab used to make the crowns.
Dental cement – Again, find out the ingredients in the bonding agent and other materials that your dentist used.

If either the crowns or the bonding agent contains chemicals for which you do not have a known allergy or sensitivity, you may need testing to determine the culprit.

Consider Getting a Second Opinion

After photo of natural-looking dental crowns from a San Antonio holistic dentist

Holistic dentistry ensures your crowns are biocompatible

We are also concerned about your dentist’s approach to the irritation and sensitivity you have experienced. Although fluoride remineralizes teeth, it is not an antibacterial that removes infection. Instead, a peroxide rinse or applying chlorhexidine is appropriate.

Given your circumstances and the fact that you still need dental crowns to restore your teeth, we recommend that you find an advanced cosmetic dentist with a holistic approach and schedule an appointment for a second opinion. After an exam and the second-opinion dentist’s findings, you can decide if you want to switch dentists to complete your crowns.

Gilberto Tostado, DDS of San Antonio, sponsors this post.

Where can I order implant overdenture replacement parts?

Posted on January 14, 2021 by AllSmiles.

The male retention caps on my removable overdenture are worn. I have four dental implants supporting my denture, and my dentist charges $30 for each retention cap—a small piece of plastic. Why is he charging so much? I cannot afford to pay my dentist $120 every time the caps need replacing. I looked online and saw a set of four caps for $45, but only dentists can order them. Is there another way I can purchase male retention caps for my dental implants? Thank you. – Benji

Benji,

Thank you for your inquiry.

As you may know, male retention caps give your implant overdenture a secure fit while moving naturally over the implant as you speak and chew.

Although dentists have high office overhead, male retention caps are small items that have minimal impact on daily dental office operations. Although we cannot say why your dentist chose a fee of $30 for each cap, we have some ideas for more affordable ways to get replacement caps.

Where to Order Implant Overdenture Male Retention Caps

Implant overdenture locator caps in and outside the package

Pink, blue, and red locator caps

If your dentist’s fee for male retention caps is too high, consider these options:

Ask another dental office – You can explain your situation to local dental offices. You will probably find an office willing to order them for you at cost. Dental professionals are usually sympathetic, and a dental assistant may be willing to order the retention caps for you. The dentist does not have to be involved because the staff places orders.
Alternatives to online dental suppliers – Search online for the male retention caps. A website like eBay offers dental implant locator caps without requiring documentation that you are a dental professional. But you must know what size retention caps you need and how to put them on your overdenture. Retention caps are available in different retention strengths—soft and firm.
Talk to your dentist – If you have not talked with your dentist about your budget and your online research for the cost of male retention caps, you might consider it. Your dentist might be willing to reduce the price or give you details about which retention caps you will need to fit your denture.

We wish you a swift resolution.

Gilberto Tostado, DDS, of San Antonio, TX, sponsors this post. Dr. Tostado has post-graduate training in prosthodontics and dental aesthetics.

Does my root canal canine tooth suddenly need a crown?

Posted on January 5, 2021 by AllSmiles.

Almost 30 years ago, a dentist did a root canal on my right canine tooth. Although the tooth is not bothering me, my dentist suggested placing a crown to prevent it from breaking. She said that if the tooth breaks, I might lose it and need a dental implant. Should I be concerned about the tooth breaking? – Johandry

Johandry,

Thank you for your inquiry. Although Dr. Tostado would need to examine your tooth and x-ray to determine if it is susceptible to breaking, we will answer your question in general terms.

Does a Root Canal Tooth Require a Crown?

Some dentists prefer to place a crown over every root canal tooth. But whether a crown is a necessity depends on the tooth’s condition and location. Some teeth are more susceptible to breaking.

Tooth condition – If a tooth is already is fractured or most of its healthy structure is missing, your dentist may recommend protecting it with a crown.
Tooth location – Molar, premolar, and front teeth have different functions that naturally exert force and stress to teeth.
- Molar teeth – Molar teeth chew and grind food, and the force causes stress that healthy teeth can handle. But the stress can push the four cusps, or peaks on the tooth, apart and lead to fracture. Premolars have similar risks.
- Front teeth – Horizontal stresses affect front teeth, which we use for biting. Front teeth absorb some of the stress for molar teeth. Canine teeth have long roots to help them absorb horizontal stress. When your teeth are grinding from side to side, the canine teeth force the back teeth apart to relieve horizontal stress. Other front teeth absorb stress when you slide your lower jaw forward.

How to Protect a Root Canal Tooth from Fracture

Protecting a root canal tooth from fracture depends on whether a front or back tooth is affected.

Back tooth – A crown or an only will cover the chewing surface to help the tooth absorb stress and prevent it from splitting.
Front tooth – Although the traditional method is to place a crown over a front tooth, a crown can weaken the tooth. The neck of the tooth (near the gumline) is the weakest portion of the tooth. A porcelain crown requires your dentist to shave about one millimeter from every side of the tooth. Up to 30% of the tooth may be lost, and root canal treatment removes the tooth pulp. About 50% of the tooth original fracture resistance remains.

Unless a front tooth has a preexisting fracture, has little structure remaining, or is dark in color, many advanced cosmetic dentists avoid using a crown, which can further weaken the tooth.

Fiberglass post

Three phases of dental implant - three components, root form in bone, crown on abutment.

Get a second opinion to ensure your tooth is not at risk for needing a dental implant

After root canal treatment, some advanced cosmetic dentists use a method like this to strengthen a front tooth against fracture and prevent the need for extraction and a dental implant:

Clean out the root canal filler material
Insert a white, flexible fiberglass post deep inside the tooth to strengthen it
Fill missing tooth structure with strong composite material

The post reduces the risk of horizontal fracture and prevents the need for a crown. If root canal treatment causes the tooth to darken over time, a dentist can use a porcelain veneer to conceal the discoloration.

Ask your dentist if your x-ray shows that your tooth is weakening and requires a crown. You can also schedule a second-opinion appointment with an advanced cosmetic dentist to determine if your tooth is at risk of fracture.

Gilberto Tostado, DDS, of San Antonio, TX sponsors this post. Dr. Tostado has post-graduate training in prosthodontics and dental aesthetics.