Crown Requirements

[alan860]

Hi.

Looking for a bit of advice from any dentists out there.

I’ve just been in to get a few crowns fitted. Ok, these things happen.

However, the dentist now says I need another 2, but before she can crown the teeth, she needs to do a filling.

Now, for me a crown negates the need for a filling. Can someone please advise if this is correct or am I being scammed? If I’m not being scammed, a slight explanation would be great if possible.

Thanks folks

 

[MattKW]

The filling is part of the foundation ( or "core") supporting the crown, plus any natural tooth remaining.

1. Sometimes the old filling might have a questionable area underneath it visible on the X-ray, possibly indicating decay. So you have to take out the filling to make sure. I don't put crowns on top of someone else's dodgy work, because I'll be blamed if things go wrong.
   
2. When drilling for a crown, it sometimes happens that this removes the "grip" of the filling and it falls out. Sometimes that's no big deal, and it doesn't need replacement at the time. Sometimes I swear under my breath and have to do a filling on the spot. The dentist needs to try and assess the likelihood and consequences of that before doing the crown preparation.
   
3. If it's one of my fillings, then I have a good idea of what went in, but there have been a number of times I will remove the old filling first.

 

[alan860]

The filling is part of the foundation ( or "core") supporting the crown, plus any natural tooth remaining.

1. Sometimes the old filling might have a questionable area underneath it visible on the X-ray, possibly indicating decay. So you have to take out the filling to make sure. I don't put crowns on top of someone else's dodgy work, because I'll be blamed if things go wrong.
   
2. When drilling for a crown, it sometimes happens that this removes the "grip" of the filling and it falls out. Sometimes that's no big deal, and it doesn't need replacement at the time. Sometimes I swear under my breath and have to do a filling on the spot. The dentist needs to try and assess the likelihood and consequences of that before doing the crown preparation.
   
3. If it's one of my fillings, then I have a good idea of what went in, but there have been a number of times I will remove the old filling first.

Thanks Matt.

That does make sense, I always just thought that that aspect was part of the basic prep work before fitting a crown. Not something that was quoted separately.

Yes, I’d rather make sure the foundation was sound before applying a 1000 dollar piece of ceramic over something that was going to be exposed to high forces. It was just the way the dentist explained it, they said fill it now then back next week for a crown. I know they also quote separately for root canal work if required, but again if I’m putting a high value item there, I’d want to make sure the thing wasn’t going to be disturbed again, so for me root canal would be a part of the prep too.

Normally I would never question something like this, but there was a few things happened during that consultation that looked a bit suspect so figured it best to ask rather than for ever suspect.

Alan

 

[MattKW]

Most of the crowns I do are for patients I've been seeing for many years, so I know what's going on and replacement before the preparation is often unnecessary. Even so, sometimes I have patched the teeth a number of times, and it really needs to be rebuilt in one piece.