Dental Surgery for Tooth Decay and Crown Replacement

Dental surgery

I previously had my upper right wisdom tooth extracted, and the tooth in front of it had a large cavity that was filled and had a dental crown placed.
However, during the extraction of the wisdom tooth, the crown became dislodged, revealing a cavity underneath.
The dentist had to break the old crown to remove it, and now the tooth with the cavity is too small to support a new crown.
The dentist has suggested surgery to facilitate the placement of a new crown.

1.
What type of surgery is this? Will it be out-of-pocket? What does the procedure involve? (I want to be mentally prepared; I’ve heard it can be quite painful.)
2.
What should I be aware of?
3.
Are there any alternative treatment options available?

Chen, 20~29 year old female. Ask Date: 2005/05/17

Dr. Wu Jinjun reply Dentistry

Hello,
1.
What you described may be a "crown lengthening procedure." Currently, this procedure is not covered by health insurance and falls under the category of out-of-pocket expenses.
It is usually performed under local anesthesia, where the teeth, gums, and underlying alveolar bone are reshaped to fully expose healthy tissue before suturing, facilitating the subsequent fabrication of the crown.
2.
For oral hygiene, after the surgery, avoid consuming very hot or irritating foods.
Spicy foods should be avoided, and if you smoke, it is best to quit.
3.
If conditions permit, another option is to use orthodontics to extrude the teeth, although this may take a longer time.

Reply Date: 2005/05/17

More Info

When it comes to dental surgery for tooth decay and crown replacement, it’s essential to understand the various procedures involved, their implications, and the options available to you. Based on your situation, it seems you are facing complications due to previous dental work, including a large cavity in a tooth that has already been treated and capped with a crown. Here’s a comprehensive overview of what you might expect.

1. Understanding the Surgical Procedure
The surgery your dentist is likely referring to is a crown lengthening procedure. This is typically performed when there isn’t enough tooth structure above the gum line to support a new crown. During this procedure, the dentist will remove some gum tissue and possibly bone to expose more of the tooth. This allows for a better fit for the new crown.

Cost and Insurance: Crown lengthening is often considered a surgical procedure, and whether it’s covered by insurance can vary. It’s advisable to check with your dental insurance provider to understand what costs you might incur. If it’s not covered, you may have to pay out of pocket.

Procedure Overview:
- Anesthesia: Local anesthesia will be administered to numb the area, so you should not feel pain during the procedure.

- Gum and Bone Removal: The dentist will carefully remove the necessary gum tissue and possibly some bone to expose more of the tooth.

- Suturing: After the procedure, the area will be sutured, and you may receive post-operative care instructions.

2. Post-Operative Care and Considerations
After the surgery, you may experience some discomfort, swelling, and bleeding. Here are some important points to consider:
- Pain Management: Over-the-counter pain relievers like ibuprofen can help manage discomfort. Your dentist may prescribe stronger pain medication if necessary.

- Diet: Stick to soft foods and avoid anything that requires excessive chewing for a few days.

- Oral Hygiene: Maintain good oral hygiene, but be gentle around the surgical site. Your dentist may recommend a special mouth rinse to help with healing.

- Follow-Up: Attend all follow-up appointments to ensure proper healing and to discuss the next steps for placing the crown.

3. Alternative Treatment Options
If crown lengthening is not an option or if you prefer to explore other treatments, consider the following:
- Root Canal Therapy: If the decay has reached the pulp of the tooth, a root canal may be necessary. This involves removing the infected pulp, cleaning the canal, and sealing it. After this, a crown can be placed.

- Dental Implants: If the tooth is too damaged and cannot be saved, extraction followed by a dental implant may be a viable option. This involves placing a titanium post in the jawbone, which will serve as a root for a new crown.

- Partial Dentures: If multiple teeth are affected, partial dentures may be an option to replace missing teeth without the need for crowns.

Conclusion
Navigating dental procedures can be daunting, especially when dealing with complications from previous treatments. It’s crucial to communicate openly with your dentist about your concerns, the expected outcomes, and any alternatives available. Understanding the procedure, preparing for recovery, and exploring all treatment options will empower you to make informed decisions about your dental health. Always remember that maintaining good oral hygiene and regular dental check-ups can help prevent future issues.

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