Suddenly I need 6 Crowns?

Discussion in 'Dental Archive' started by Rich, Apr 13, 2005.

  1. Rich

    Rich Guest

    Recently I relocated from NJ to Arizona. I had been going to my dentist
    in NJ for 10 years & he never tried to "sell" me anything. A very large
    filling(25 years old) fell out of one of my molars & took half the tooth
    with it. So off I go to a new dentist in Arizona. I assumed this broken
    tooth would need a crown but she proceeded to tell me that 5 other teeth
    needed crown. Three of the teeth needed crowns because of excessive
    fillings & two of the teeth had root canals. All these fillings & root
    canals go back at least 20 years. According to this new dentist, these 5
    teeth need crowns to protect them from breaking. I understand that root
    canaled & heavily-filled teeth do not last forever but would it be
    imprudent to crown these teeth as they fail? The tooth that just broke
    was originally filled in 1968. That filling was subsequently replaced in
    1970 & 1975 due to decay beneath the filling and an additional filling
    was placed on the lingual surface at a later date. Based on this life
    expectancy I am not inclined to suddenly $3000 to "rescue" these 5 teeth.
    Your opinions are greatly appreciated.
    Rich, Apr 13, 2005
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  2. Rich

    Dr Steve Guest

    No one can tell you anything about your teeth from the internet. We can
    tell you generalities and explain terms to you. In general, if you just
    broke one tooth, you *could* quite likely have 2-3 others ready to break as
    well. My experience is that this usually occurs in patients who clench with
    great force while sleeping. Very few of these patients are aware they are
    doing this until we show them all the signs of it. If the margins on the
    other fillings are beginning to chip, it may be wise to replace the others
    as well.

    I can make some guesses here: As far as crown vs. filling. If you had the
    crown done on that tooth in 1968, it would (in most cases) still be fine.
    You would have avoided the three (counting now) subsequent re-treatments of
    this tooth. You now have 30 years of inflation to pay for, you have already
    paid two other times to re-fill it, you will need to pay for it to be
    re-filled prior to getting a crown now (unless you choose to get an onlay),
    and you still have to pay for the crown. Each time the tooth was retreated,
    more tooth was removed. It would have been much cheaper to get the crown
    back in 1968. Possibly the filling was not big enough in 1968 to need a
    crown, but I bet it was large enough in 1970 or 1975.

    Who knows specifically about your teeth? Get another opinion if you like.
    Ten different dentists will come up with ten different treatment plans, so
    be prepared for differing opinions. When do we say a tooth should have a
    crown or an onlay done to protect it? That is a judgment call which is
    based on years of training and experience. Depends on lots of different

    I assume we are NOT talking about a PPO or HMO/DMO type insurance scheme
    which forces dental offices to upgrade treatment offerings to cover their
    cost of doing business.

    Stephen Mancuso, D.D.S.
    Troy, Michigan, USA

    This posting is intended for informational or conversational purposes only.
    Always seek the opinion of a licensed dental professional before acting on
    the advice or opinion expressed here. Only a dentist who has examined you
    in person can diagnose your problems and make decisions which will affect
    your health.
    Dr Steve, Apr 13, 2005
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  3. Rich

    W_B Guest


    Because you cannot predict the extent of a future fracture.
    W_B, Apr 13, 2005
  4. Rich

    Rich Guest

    I appreciate all who have answered my post.
    Yes, this is a health plan; Cigna. I believe it is an HMO.
    You all bring up excellent points. It seems that any tooth that has been
    filled earlier in your life will eventually require a crown. I suppose
    crowns are better than dentures or implants.
    The thing that annoyed me was that I agreed to to fix only the broken
    tooth and when I went to pay the receptionist I was billed an extra $125
    for the crown because Cigna allows an extra $125 per crown for 6 or more
    crowns and I just so happened to suddenly need 6 crowns. It just doesn't
    smell right.
    Thanks again.

    Dr Steve wrote:
    Rich, Apr 14, 2005
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