Q: I recently had some crowns done in my mouth. Some are so tight I can’t floss them, the others have gaps that keep trapping food every time I eat. I am really annoyed with the dentist. What is wrong with my new dental crown?
A: In past columns, I have stated: “Welcome to another edition of “Don’t shoot the dentist.”, where innocent dentists are ridiculed by disgruntled patients for poor outcomes of treatment that they were not responsible for. The body is an unpredictable universe in which we cannot predict who will heal and who will not, who will wear shorts and flip flops to a funeral and who will be in a tux.
I would like to write a series of columns to address the more popular problems that cause patients to change dentists, other than when the dentist “fires” a patient. (I had an eighty year old lady punch me below the belt line back in the 80’s which lead to her firing. No wonder I only have one kid!)
When the lab makes the crowns, it is important to have the lab make the contacts nice and tight between the adjacent teeth so that we can make the final adjustment in the operatory on the day we insert them in the mouth. If the contact is to tight, the crown will not seat all the way, leaving gaps that will decay the tooth. Too open, and you will be storing more brisket between your teeth than a NY deli.
A good contact allows the floss to make a snapping sound as it passes between the teeth. A great method to do this is using a special thick floss impregnated with blue ink called Spotit. The tight spots will be marked, allowing us to adjust the crowns with a diamond drill outside of the mouth.
I have also found that since we began using digital impressions vs. the goopy, gagging clay-like molds of yore, we find less adjustments are needed. You can research this by Googling “iTero Element Digital Impressions”, or contact our office for more info.
Next blog: more reasons why patients “jump ship” and leave their dentist. (Without a fist fight!)
Dr. Mitchell Josephs practices Implant, Cosmetic and General Dentistry with an emphasis on implants, porcelain veneers, and complex crown and bridge treatment. He is on staff at JFK Medical Center and is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry. He completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.
By Dr. Mitchell Josephs