Addressing Issues with Dental Crowns: When to Adjust or Replace?

Q: Addressing Issues with Dental Crowns: When to Adjust or Replace?

Hello Mr. <br>Acan： If during the orthodontic process you feel that the teeth with braces are pressing against the neighboring teeth, it is important to evaluate whether there is sufficient space for the teeth or if the braces are too large. <br>It is recommended to consult with

Issues with anterior dental crowns?

Hello Doctor, I would like to ask: In high school, I accidentally damaged my right front tooth and later had a dental crown placed.
However, I have a skeletal overbite issue.
Now, after more than three years of wearing braces, I feel that the crown on that front tooth is noticeably larger than my left natural tooth (quite obvious), and it sometimes feels like it is pressing against the left front tooth and the gums, which often feel inflamed.
However, my current orthodontist does not seem to think there is a problem.
I would like to know if the crown can be adjusted to be smaller by the dentist, or if it needs to be completely remade.
If it does need to be replaced, should I wait until the orthodontic treatment is completed, or can I start the remake now so that the crown can fit better while continuing the orthodontic treatment? Thank you, Doctor!

Acan, 30~39 year old female. Ask Date: 2024/03/13

Dr. Zeng Guanghui reply Dentistry

Hello Mr.
Acan: If during the orthodontic process you feel that the teeth with braces are pressing against the neighboring teeth, it is important to evaluate whether there is sufficient space for the teeth or if the braces are too large.
It is recommended to consult with an orthodontist for an assessment and possible solutions.
Dr.
Tseng Guang-Hui, Department of Dentistry, Nantou Hospital.

Reply Date: 2024/03/13

More Info

When dealing with issues related to dental crowns, particularly in your case where you have experienced discomfort and aesthetic concerns with your dental crown, it is essential to approach the situation methodically. Here are some key considerations and recommendations based on your description:
1. Assessment of the Current Crown: It seems that your dental crown has not only caused discomfort but also appears larger than your natural tooth, leading to pressure on adjacent teeth and potential inflammation of the gums. This situation warrants a thorough evaluation. If the crown is indeed too large or improperly contoured, it can lead to issues such as bite misalignment, gum irritation, and even damage to neighboring teeth.

2. Consultation with Your Orthodontist: Since you are currently undergoing orthodontic treatment, it is crucial to communicate your concerns with your orthodontist. They may not have noticed the issue, but your feedback is vital. Discuss the discomfort you are experiencing and how the crown's size is affecting your overall dental health. They may recommend a referral to a prosthodontist or a general dentist who specializes in crowns and bridges for a second opinion.

3. Options for Adjustment: If the crown is too large, there are generally two options: adjusting the existing crown or fabricating a new one. Adjusting the crown (also known as "grinding down" the crown) can sometimes alleviate discomfort and improve aesthetics. However, this is only advisable if there is enough material left on the crown to maintain its integrity after adjustment. If the crown is already thin or if significant changes are needed, a new crown may be the better option.

4. Timing for Replacement: If a replacement crown is necessary, the timing can be crucial. It may be beneficial to wait until your orthodontic treatment is complete to ensure that the new crown aligns perfectly with your final bite. However, if the discomfort is significant and affecting your quality of life, it may be worth addressing the crown sooner rather than later. Discuss this timing with both your orthodontist and the dentist who will be fabricating the crown.

5. Potential for Gum Issues: The inflammation you mentioned could be a sign of gum disease or irritation caused by the crown. It is essential to address this issue as well. Maintaining good oral hygiene, including regular brushing and flossing, is crucial. If the inflammation persists, your dentist may recommend a professional cleaning or further periodontal treatment.

6. Importance of Communication: Throughout this process, clear communication with your dental care team is vital. Make sure to express all your concerns, including any pain, discomfort, or aesthetic issues. This will help them understand your situation better and provide the most appropriate care.

In summary, addressing issues with dental crowns involves a careful assessment of the crown's fit and function, open communication with your orthodontist and dentist, and making informed decisions about adjustments or replacements. Your comfort and dental health should always be the priority, so do not hesitate to seek further opinions if you feel your concerns are not being adequately addressed.

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