Crown after root canal

[givemushypeasachance]

I'm having the first stage of getting a crown fitted later today, after having a root canal on the tooth about a year ago. The dentist has told me that since the tooth is now 'dead' due to the nerve being taken out, that I won't need to have it numbed up beforehand. While I can see this logically, the idea of having most of the tooth drilled away for the crown to be fitted without any painkillers is freaking me out a bit - I'm not very good with dental pain. With fillings and such if it's all completely numb I don't mind what they do but I'm still on edge waiting for that twinge-burst of pain through my jaw, lurking in the wings, if they go that little bit too deep or whatever.

So has anyone had this done, can you reassure me that it isn't horrific even without any injections going on?

I'm a veteran of almost everything you can have done to your teeth right through to implants and I've had more root canal fillings and crowns than I can recall (as several crowns and two bridges have been replaced) No, it won't hurt a bit, but if you are nervous and ask I'm sure he will give you just a little bit of an injection. I sometimes find that all the rattling about in the mouth makes the surrounding teeth very niggly, or sometiimes there is a pinching sensation if they are close to the gum.

Root canal means there are no more nerves there for that twinge-burst of pain, however deep they go. (Can't go deeper than the nerves they pulled out during root canal, anyway)

Take a paracetamol beforehand if that will make you feel better

Why do people always think their dentists WANT to do horrific things to them? It's so irrational.

Why do you think your dentist might like you wriggling about in pain? Do you think it would make the precise preparation of your tooth easier for him?

Thanks for the replies - I'm just quite a wuss with dental work generally I think, I don't even like them poking about with the dental pick in a checkup!

Mrsmorton - I don't think my dentist would set out to cause me deliberate pain, but he's pretty brusque and quite a 'lets get on with this' no nonsense kind of a person. Having work done he'll do the injection the second I'm in the chair but doesn't always seem keen to waste time letting it numb up as much as possible, he'll be getting straight in there asap. When I had the second part of the root canal appointment it hurt at one point and I protested and squirmed a bit out of shock, and just got told off for moving!

I understand appointment times are limited but still find it a little disconcerting, and just wanted to make sure this was standard and normal and not a 'it might hurt a bit but it's quicker to do it this way' sort of approach.

Mrs Morton - stop being so damn snippy with people. Your input as a dentist is helpful but you need to appreciate that some people have had very bad experiences at the dentist.

MrsMorton whilst it is true that the tooth should have no nerve after rct, in prepping for a crown, the gums are involved and so I personally prefer to be numbed up to make it 100% comfortable. I only go to private dentists who pride themselves on painfree care - easier to do if not in a rush.

People with a drill phobia also find it much easier to relax if their tooth and gums are numb. It should be the patient's choice since they are paying the bill and if seeing a private dentist can easily vote with their feet.

givemushypeas a chance - having read your post again, find a new dentist - your description exactly fits the type of dentist who causes/feeds unnecessary phobia in patients.
I'm afraid it is easier to find patient-centred care privately as they can charge more and so take the time you need to feel comfortable.
Not waiting for the local to take is appalling...

Why does it involve the gum ukatlast ? In my experience (of being a dentist) more people are "phobic" of the injection than the drill and the biggest complaint is that their face feels numb afterwards. Just my ten year's worth.

How much preventive advice to you get from your private dentists?

I go to private dentists who can do local painlessly so that's not an issue. A slow injection is a painfree injection plus other techniques such as topical etc - info for dentists on the DFC website.

The gum is prised back in a full gold crown prep using retraction cord - it can be done gently but some dentists/hygienists are gentler than others.
A lot of drilling is involved sheering the outside of the tooth away - way more invasive than say a root canal going inside your tooth and it is therefore easier to relax if you are numb if you have had bad experiences in the past.
In the past NHS has let me down on prevention/cleaning, living abroad made me see the light on how basic the UK NHS offering is.
My private dentist allocates 30 mins for check-ups there is loads of time to chat lol. I see hygienist separately too. I floss daily.
If you really want to educate yourself as to the patient point of view (especially if you have experienced little dental care yourself) then the Common Fears and FAQ sections of the website are excellent.
www.dentalfearcentral.org

Hmm, your posts are well intentioned but your (understandable) lack of practical experience means they are a little misleading.

Firstly, thank you for your comments on how to give a pain free injection, I'm sure other non clinicians would be very interested to hear how we achieve these on a daily basis.
Secondly, retraction cord isn't always needed, in fact it's far easier and healthier to keep the crown margin above the gingival level if possible. A full Gold crown is less likely to need retraction cord (which incidentally is pretty retro now but still used if we've run out if its successor) than a porcelain crown.
Thirdly root canal treatment is possibly the most invasive dental procedure there is that is carried out on a natural tooth in a patient's mouth. A crown prep is little more than a big filling.

Lastly, hygienists never place retraction cord (or its equivalent) in the UK.

The new NHS dental contract is based on prevention and oral health as an indictor of the patients suitability for advanced treatment (such as crowns) I was totally flamed on here last time I tried to explain it so I won't bother trying again. I have had dental care including a root canal treatment, a crown and four extractions so I feel I am moderately well placed to comment, as well as seeing thousands of patients a year for ten years, many of whom have followed me as I've moved practice.

I can't be bothered quite frankly to go backwards and forwards with these issues.

I agree on the crown margin - my DH had one privately recently in UK where margin was kept above gumline. Overseas mine was done as full very high gold content gold crown.
Overseas was not USA by the way - I dislike their system - I never said Assistants placed cord did I?

I understand how UK NHS dental is supposed to work and I avoid NHS dentistry having experienced it in 1960s and 1970s and early 1980's because I want to see the same experienced dentist of my choice every time I go (apologies for sounding like Mrs Thatcher - I didn't ever vote for her) and for them to have sufficient time to not make me feel like I am a nuisance and to care enough to make the experience pleasant rather than try without LA and only add it if 'necessary'.

Continuity of care from the same dentist is a major plus for patients and NHS rarely offers that in dentistry these days.
I am sorry you responded so negatively but I actually really like my dentists - the ones I have chosen - same cannot be said for those foisted on me - a different one every 6 months in 1970/1980s.

Forgot to add my comments on how invasive were based on my point of view as a patient. I would much rather have a root canal than a crown prep.

My NHS dentist is lovely, and very good at his job -I've had two bridges, a crown and a root filling through a bridge all done to a very high standard since I started seeing him. he knows I'm nervous and always goes out of his way to ensure there is no chance of any pain.

I was totally flamed on here last time I tried to explain it so I won't bother trying again

Maybe that's because your explanations tend to be very domineering in tone and people get fed up with your I AM RIGHT, YOU ARE WRONG, YOU ARE A MERE AMOEBA AND YOUR OPINION DOES NOT FIGURE IN MY UNIVERSE style.

You may be right but I hope you have a better chairside manner with your patients than you do on here! Tone it down a bit and we'll respect your opinion more.

Actually if a full crown is involved rather than an onlay-type it is more invasive of tooth structure - google pics of crown preps - than a root canal. After a root canal your tooth still looks whole on the outside whereas after a full crown prep it does not.

After discussion of pros and cons, I chose a gold crown over porcelain for longevity reasons... if cosmetics had bothered me it would have been porcelain fused to gold not metal. I hate that metal line you see on crowns in people's mouths.

Well I survived without any anaesthetic, I don't know whether it was below gum level or whatever or not - I don't know what this crown is being made of actually. Someone at work asked if I was having gold or natural coloured and wasn't aware there was an option - it's just 'a crown' as far as I know. But anyway it wasn't much fun as the drilling away is a horrible cold sensation combined with the fear that any second now it'll hurt - though it didn't - but it wasn't too bad. Won't make a hobby of it but the whole process took 20 minutes and then I escaped again with this weird temporary crown for the next two weeks.

Longterm I may try to switch to a dentist who's 'chairside manner' I get on with better, but I do want to try to just not be a wuss about it as well. He's a perfectly nice man really but even the sweetest dentist would still be the person doing the needle-jabbing and horrible drilling and poking. My parents have pretty rubbish teeth and they go private back in Devon with a chap who saw my sister and me as NHS when we were teenagers and he's the cuddliest person imaginable but I'd still get a bit of 'the fear' sat in his waiting room...

Quote OP 'But anyway it wasn't much fun as the drilling away is a horrible cold sensation combined with the fear that any second now it'll hurt - though it didn't'

Exactly...if you are numb you can be much more confident it won't suddenly hurt.

It's pretty bad that you don't even know what crown you are getting - according to GDC guidelines you are supposed to be giving informed consent to the procedure.

I had this done twice last year (expensive!!). I'm sorry but I can't remember if I had pain relief for the crown fitting or not. All I can tell you is that it was completely fine. Just a bit of a jaw aching experience keeping my mouth open that long. I have to say I have the most amazing dentist you can imagine. I had a really debilitating virus for 2 years and sometimes he was more help than my Dr!