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Dentistry/no xray before (no temporary) crown

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QUESTION: I went to a dentist because my crown fell off.  She said she could glue it back on but that it wouldn't stay because it was chipped. Also she said, in order to get a new crown I would have to have the gums around that tooth cut off (sorry, lacking better wording) because there wasn't enough tooth for the crown.  So, that's what happened.  I paid 1000$ to have the gum removed and after 3 weeks I went back to my dentist to have the tooth prepared for a crown.  

She told me to come back in a week for the crown but didn't put a temporary one in so it hurt whenever I drank water for instance.  I went back to her and when I told her about the pain, she kind of went pale and said that maybe I have a nerve there still, that she thought I didn't have a nerve there because I had a crown. Then she took my xray and it turns out I have a nerve.  Now she put the crown but didn't cement it all the way to see if I'm going to have pain, which I don't anymore.  Unfortunately the gums and teeth on my right side are hurting a lot, I guess from irritation of just eating on that side for a month so I've been drinking a lot of painkillers nonetheless.  
Anyway, MY QUESTION IS:  Should I have even had my gums 'removed' if I had a nerve inside the tooth?
Thank you so much in advance!  Really looking forward to your response...

ANSWER: In answer to your question, yes, crown lengthening (removal of gum tissue and bone) can be done to a tooth regardless of whether or not it has a nerve. An xray should have been done the day the crown fell off, and definitely before the gum surgery to assure that the tooth was stable and without infection. Not all teeth with crowns have the nerve removed, most crowns are done on live teeth (still have the nerve).
I hope that I have answered your questions.

---------- FOLLOW-UP ----------

QUESTION: Thank you so much!  I just wanted to make sure I got it...  the dentist told me she will put on the new crown temporarily just to see if I will still have pain as she thought that the nerve now might have to be extracted.  If that's the case, would I have had to go for the crown lengthening anyway, or would there have been another procedure instead?

Answer
Usually, if there is a lot of discomfort, a crown is placed temporarily with a mediacated cement to help calm the nerve down. If this works, then it is fine to go ahead and cement the crown permanently. If the sensitivity gets worse or does not lessen, this is a sign that the nerve is not healing, but dying. When this happens, a root canal is necessary to remove the nerve, so that an infection does not begin.
Regardless of all of this, the crown lengthening had to be done in order to have enough tooth to hold a new crown, if it hadn't been done, the new crown would have been falling out all of the time, due to lack of retention.

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Marielaina Perrone DDS

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I am a Family, Cosmetic, & Implant Dentist. I am well versed in virtually all of dentistry including dental surgery, dental implants, endodontics, periodontal disease, cosmetic dentistry procedures, dental phobia treatment, etc. Essentially if it is dental related I can help. Cosmetic Dentist Henderson Nevada Las Vegas Cosmetic Dentist Las Vegas Dental Implants

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I graduated from Stony Brook University School of Dental Medicine in 1997 with my D.D.S. degree and have been in private practice ever since. I currently maintain a private practice in Henderson, Nevada.

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Dental School: Stony Brook University School of Dental Medicine 1993-1997 Post Grad: Stony Brook University School of Dental Medicine Advanced Education in General Dentistry 1997-1998

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