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Archives for November 2023

Is My Tooth Dying Beneath the Crown?

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Does this persistent pain in my tooth beneath the crown mean that it’s dying? In early August, I received 3 same-day crowns on my bottom right teeth. When I chew on that side of my mouth, one of the teeth hurts, and I feel nerve pain. I returned to the dentist twice. Each time he shaved the tooth and said that the problem was from the way that I chewed. Before I got the crowns, I did not feel any pain. Why is my dentist blaming this on me? Could the way I chew affect same-day crowns differently than my natural teeth? I am annoyed. Thanks for your help. Myra from SC

 

Myra,

You would need an exam and X-ray for an accurate diagnosis. However, it is unlikely that your sensitivity and pain are because you have a same-day crown. A dentist uses precise CAD/CAM technology, which makes them easier for the dentist to fit.

Why Do Your Same-Day Crowns Hurt?

When your same-day crowns—or any new crowns—hurt when you chew, there are two possible causes.

  • Your bite is too high – If a dental crown is higher than the surrounding teeth, the upper teeth hit it first and harder than the other teeth when you chew. Your tooth will become sensitive.
  • Your tooth is infected – If a tooth is infected, the ligament connecting your tooth and jawbone can become inflamed. When you bit or chew, the tooth is tender and sensitive. Or the inflammation may cause a constant toothache.

Lingering Pain After a Bite Adjustment

A dental implant with components labeled - crown, abutment, implant screw

Dental implant

If your pain and tingling continue despite your dentist adjusting the bite twice, your bite is probably not too high. It is time for your dentist to x-ray your tooth and see if it is infected.

Signs of a tooth can be subtle on an x-ray. If your dentist cannot see an infection, you may need a second opinion from an endodontist (root canal specialist). The pain you describe sounds like you have an infection that needs prompt attention to prevent the condition from worsening and requiring extraction and a dental implant from a periodontist (gum, bone, and implant specialist).

Ask your dentist for a referral to an endodontist. Or, if you can self-refer to a specialist, schedule an appointment promptly.

Dr. David Pumphrey, an Atlanta periodontist, sponsors this post.

Going to Costa Rica for Dental Implants and Have Nothing to Lose

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I’m going to Costa Rica for a dental implant and have nothing to lose. Why pay more after seeing two implant dentists in the U.S. and experiencing dental implant failure twice? I decided to try this out with one implant, and if it works, I return for another. I’m tired of running from implant dentist to periodontist without any success. This drama has been going on for three years. Many American dentists are against dental tourism, but I want to try. I’ve compiled a list of questions for my video consultation. I hope to write again to let you know about my surgery and recovery. I live nowhere near your office, so you can’t convince me to visit your specialist. Thanks. Midge from CO

 

Midge – Dental implants can be more affordable in Costa Rica and other countries than in the U.S. However, you must consider if the savings are worth the commitment and risks. We understand your frustration from dental implant experiences in the U.S., but we encourage caution regardless of your provider’s location.

What to Consider Before Getting Dental Implants Outside of the U.S

A dental implant with components labeled - crown, abutment, implant screw

List questions and schedule consultations before choosing a dental implant provider

Whether you decide to receive dental implants in the U.S. or outside of it, consider the following factors:

  • The education, credentials, and qualifications of the implant surgeon and their team
  • Is your new dental implant team qualified to identify the causes of your previous dental implant failures and resolve them?
  • Will you need bone grafting before getting dental implants? Is the new team skilled in bone graft procedures?
  • The quality of the dental implant fixtures
  • What does the dental practice do to ensure successful implant placement and avoid mistakes?
  • Does the country have strict regulations on dentistry?
  • What is the cost of travel and accommodations?
  • How many follow-up visits require you to return to the country where you received the implants?
  • What would you do if there was a problem with the implants?
  • What would you do if your circumstances changed during treatment and you could not return to Costa Rica for follow-up care?
  • Who will restore your dental implant with a crown?
  • What are your total out-of-pocket expenses?
  • Have you reviewed the Centers for Disease Control and Prevention’s medical tourism guide?

Before choosing a dental implant provider out of the country—or in the U.S.—we recommend thoroughly investigating the provider and its services.

Atlanta periodontist Dr. David Pumphrey sponsors this post.

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