AIBU ... 18 months on at the dentists

[MissKittyBeaudelais]

So, I posted here a couple of years ago. I had a change of dentist as my old one left the practice. I’ve seen her now every 6 months and I’ve had a problem with an old crown I’ve had for 33 years. I’ve always looked after my teeth. Hygienist each 3 months; dentist every 6. The crown is painful. I’ve been told to just continue flossing/brushing/using Corsodyl and that even through the gum line has receded, the crown itself though old, is solid and they won’t replace it because of recession and gum line no longer “fitting”.

I’m really hacked off with this situation. My gum and tooth have been swollen, bleeding and extremely sensitive now for the past week. In fact, despite my hard work, it spends much of its time in this state.

Dentist told me in the summer that Denplan won’t cover the cost for aesthetic reasons and clinically, ill just have to carry on.

Anyone with any ideas what I can do? I could spend £800 to have it done “for cosmetic reasons”. I don’t have £800.

CHange dentist?

Would prefer not to. I’ve been there 12 years. Whole family goes there.

I’m in Denplan and so she’s tried filling the top of the tooth but the filling only stayed on for three days. When I went back she said “I didn’t really expect it to stay on long”. She also did another filling on a tooth and said the same thing “if this one falls off I won’t replace it because it’s so tiny, it didn’t really need doing” 😳 I get the impression she’s happy to use my Denplan cover on anything that doesn’t really need doing but this, which has been ongoing all this time, is “cosmetic” and can’t be done. I could afford the £180 to have it done on Denplan.

Before you do anything too drastic, try sensodyne. Put it directly on the gum line where the dentine is exposed (rather than brush with it). Give it a week or two, putting it on 2/3 times a day. It works pretty amazing, se well worth trying before anything else. (Ex dental nurse x)

As far as I can see there are only three possible answers to this:

1. Stay with this dentist and don't get it done
2. Stay with this dentist and pay £800 and get it done
3. Try another dentist

You clearly don't want to do no1. You say you can't afford no2. And you say you would prefer not to do no3. I'm not sure there are any other options.

An NHS crown is only about £400 and that's for a white one. Why is it £800?

NHS crown is Band 3 so that’s £269 in England.
Denplan works differently. You should contact the practice manager and ask to see a different dentist at the same practice. You can also speak directly to Denplan and raise concerns.
Two dentists can have two different treatment plans so maybe your Dentist may be right. But it’s worth getting a second opinion.
It does sound odd that the dentist is not prepared to re do a 33 year old crown, especially if recession is causing pain.
If I was you, I would have a conversation with the PM (and not the dentist) and if no luck, then a written complaint. They have to act on written complaints.
Good luck.

@bloated1977 ..... I’m not sure where that price comes from then. I will check.

I too am baffled. It’s so old that I think it’s a measure of how well I’ve looked after it (I have 6 crowns in total - as I was weened on Tetracycline in the 60’s). There’s always going to be deterioration and some gum recession over time. I was 20 when I had it done. I’m 57 now ffs. One other has been replaced in 1998 so even that’s 21!

Can you just get a second opinion at another dentists or do you have change dentist first/pay for it? I’ve no idea. Annoyingly, it’s started going down this morning. I was so cross yesterday that I was going to go in and ask to see the practice manager today but, there’s not much to see today 🙄

I must be stupid but I thought with pain it would merit replacing on NHS. And if not, why not.

It's not cosmetic if you're in pain. There's something wrong under there. Fight your case.

Also, I had a white crown on the NHS this summer and it was £289.

I know that this might seem daft but rinse your mouth with salt water everytime you eat or drink after a week or two it should deal with any infection

It sounds like your problem is your gums and gum recession not your crown.

If your gum is swollen and bleeding that's not the crown, its inflammation of your gums. And the right treatment is flossing and corsodyl

If you have recession and your tooth is sensitive, that's exposure of the root and not the crown.

So the crown can be completely sound but you still have these problems. So its perfectly possible the dentist is right

If you're denplan theres no reason for the dentist not to replace your crown unless they don't deem it clinically necessary.

Well, I don’t mind paying £289. That’d be fine. It’s the £800 that was right out.

If my crown is hurting it's usually due to food stuck under it below the gum line. It subsides after a particularly brutal flossing.

I do all the flossing. Corsodyl. Put a layer of Sensodyne on before bed. Use the little brushes on my crowns. It’s the only one that’s a problem. Out of 6. I’ll call in tomorrow. If I can get it done at £239 I’ll happily pay that.

But your not an NHS patient OP, so you won't get a crown on the NHS.

Lots of people get inflammation in one area, it can just be harder to clean. It doesn't mean you need a new crown. Often sensitivity can be caused by gingival inflammation as well.

How deep do you go though? I have to be vicious and keep doing it until it bleeds freely.

Yes, it bleeds. Also, tastes funny. Xrays have shown infection on and off for 2 years plus. I don’t just “want” a new tooth... I don’t understand what the difficulty is. The filling I had done was a waste of time. The very thorough cleaning is having little effect. The last time I saw the hygienist she asked the dentist to come down and have a look at it, as it was a mess.

I have a tooth that is similar - it was a root canal and crown but the spacing on my teeth and trapped food over time has effected other teeth and some gum recession is meaning more trapped food. It is not the crown that is the problem its the gums and not alot can be done beyond what you do now. It has to just be managed I am several years down the line from initial problems and its mostly subsided with occasional flair up if I forget and eat meat on that side and it gets caught

@RB68 the thought of having this forever is awful. I didn’t want these crowns...I HAD to have them.

Is there anything else I can do? Bridgework? Implant? I just assume that if I had it replaced, it’d last u til I shuttle off my mortal coil, judging by how well it’s done to last all these years 😂

I got told that if they take the crown off to do an exploration underneath that the crown may not fit again. You are in pain and may have an infection underneath. If the crown won’t go back on hows that purely cosmetic? They did it the first time so you could eat, that’s what you need again surely? I’d be making sure the pain wasn’t just my gums before I got the crown off though. And an X-ray to see if anything obv going on underneath.

If its gum disease replacing the crown won't help, but if it's chronically infected then the whole tooth needs to come out. After that heals then you can discuss whether an implant is a viable option or not (will depend on how much damage the infection causes the bone)

I think the alternative as others have said is removal and either implants or a false tooth of somekind - every which way is expensive to be honest. I am really not that bothered on a day to day basis by mine these days just one in a blue moon and give it an extra good clean and poke the food out of the recess and a couple of days and back to normal. The teepee things are good to help too

I have just paid £500 for a zirconium crown, which was the most expensive option.

It would have been about £300 for porcelain or free on the NHS (but silver).

You obviously need to get it done. Look at the policy of your dental plan, if you’re this uncomfortable it’s not purely aesthetic. If they don’t agree and you have escalated it find a new dentist.

Surely, if I weren’t cleaning/flossing well, I’d have other dental problems? Other crowns would be the same?

I was told that I could only have an NHS crown replacement if the dentist felt it was necessary. Same for Denplan cover. How is pretty much constant pain, swelling, bleeding, throbbing, a “heaviness” in that tooth NOT a dental issue. How is that deemed “cosmetic” because gum recession has caused it? It’s 37 years old. I think I’ve looked after it really well!

It honestly sounds like its chronically infected as this has been going on for 18+ months.
This can just effect 1 tooth though if left untreated can spread. I really do suggest the salt water treatment as it will help draw out the infection (obviously keep up with the cortisol etc) and you can always see the nhs emergency dentist at the weekend if it's causing pain over the weekend (good way for a sneaky 2nd opinion).
I had this problem with 1 tooth after a hockey related injury and now have an implant and no other issues with it