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Dentistry/problems after proceedure


Hi there,

Let me start by saying I actually submitted this question to another dentist before realizing that his little blurb said that he only answers orthodotist questions, and I've never used this site before so I don't know if this posts twice or what (it made me put in a different E-mail address for this one) so if this is a repeat, I am sorry!

That said, I was wondering if you could give me a little advice on how to proceed with a situation I've found myself in.  I recent went to a dentist for the first time in many years.  I used to go once a year every year up until I was 17 and I never had a cavity.  Then I became an adult, and like many adults, could not afford dental insurance.  now that I have insurance, I went to a dentist because I was feeling some pain in one tooth.  The dentist said that he saw that there was a bad cavity in that tooth and he believed needed a root canal.  He said it didn't look like there was decay on the X-ray indicating this, but he had a feeling from his examination that once they went in for the filling that it would have to be elevated to a root canal.  I went in for the root canal and he put in a temp filling and scheduled me for another appointment to get a temp crown for 3 weeks later.  This tooth did not stop hurting though.  I called the dentist 5 days after the root canal and they said the temp filling was probably just too high.  They switched me to another dentist (the original one I was not too pleased with because he just complained the whole time about how small my mouth was, which it is, but that's why I picked a place called "family dentistry" since my mouth is probably the size of a child's).  This dentist went in and shaved down the back of my tooth/filling, and it was almost immediate relief.

fast forward to two weeks later when I go to the new dentist to get the post and core done, as well as one other filling, and to be fitted for the crown and a temp crown to be made.  It took him about 3 hours to do everything because he kept jumping back and forth between patients, and I feel like they were very violent with my mouth because I left the appointment with a ripped lip that ended up scabbing over for a few days.  All in all, it hadn't been a very good experience.  but now that tooth is hurting again!  It feels like it did with the temp filling that was too high.  I have an appointment in 8 days to have the permanent crown put on, and I've been making sure I have some gum on the other side of my mouth to elevate my teeth to prevent the teeth from knocking together (this was the only temporary solution I could think of).  Drinking warm tea also seems to help with dulling the pain slightly.  Is this something I should call them about, or is it something that is normal that I should just wait until my appointment next week.  With my bad experiences I'm not really excited to have them back in my mouth and rip my lip again, which has finally healed, so I'm not in a hurry to run in there, but at the same time the tooth pain is just getting worse.  Also, I wasn't sure if they would be able to do the work next week if my mouth is still in pain like this.  When they made the temp filling last week, the assistant who was making it kept commenting that she didn't think she could shave it down much more otherwise there wouldn't be any crown left.  What advice do you have?  Also, is it normal for this to really happen, or do you think I should be looking around for a new dentist.  As a kid I don't remember anything ever being this disorganized, but then again I also didn't have any cavities.  Any advice would be greatly appreciated.



Dear Kelly:
I am so sorry to hear of your troubles.  There are several issues at play here and I will address them in order of importance:
1.  You yourself told me that you used to go to the dentist every year for a check up and a cleaning.  Why did you stop??? Not having dental insurance IS NOT a reason to stop going to the dentist!  There are plenty of dentists that will see you and take payment by cash, check or credit cards.  Most offices will charge you about $150 for a check up and a cleaning.  I cannot tell you what to do with your money, but you need to look at your own priorities and decide what is important to you.  The root canal and crown problems that you are having now, which could easily been avoided, are MUCH more expensive, you could have paid for ten years of cleaning for that price.  I am glad that you are taking initiative now and are taking care of yourself.
2.  The other issue is that you are NOT getting proper work done by your dentist.   A provisional/temporary crown should fit beautifully, not give you any problems and by in proper bite.  In additions, in states where there is a shortage of dentists, an assistant is allowed to help the dentist in fabricating provisional restorations.  However, a dentist needs to check the work and make sure that the fit is proper.  You are in Maryland.... there are thousands of dentists there...

Here is what to do...
Usually the temporary work is an indication to what the final work will be.  I suggest that BEFORE you get any work finalized, you go and see a dentist for a second opinion.  Since you are already having troubles, I also suggest that you go and see a Prosthodontist which is the expert in restorative, cosmetic and implant dentistry.  Let an expert evaluate the situation and the quality of the work.  It will cost you some money, but many Prosthodontists will bill your insurance for you. will have a link to a Prosthodontist near you.
If you continue with the current course, you will have problems in the future and it only gets more expensive.  
This is a common problem... people do not want to spend their money on quality dentistry when it is affordable and costs only a few hundreds of dollars.  The problems get much costlier right away and they still go for a cheep fix.  When the problems become very expensive, and are in the thousands of dollars, the insurance only covers about $1500 of it and then the patient cannot afford the rest and ends up loosing their teeth.

I am glad that you are trying to take care of your mouth.  Please take a moment, stop, evaluate your priorities and go see an expert to make sure that your problems do not get any worse with the work that you are getting.

...and NO, the problems that you are having ARE NOT NORMAL course of work for a crown.  I do commend you for the ingenuity of placing gum on the other side to even out the bite.  You MUST have that adjusted right away.

Best of luck,
Dr. Zev Kaufman


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Zev Kaufman, D.D.S.


I can answer any question from simple routine dentistry to very complex dentistry with emphasis on reconstructive, cosmetic, and implant dentistry. My expertise is in co-ordination of very complex treatment plans with other dental specialists or as a one-man-team, since I have extensive training in Prosthodontics, Surgical Implantology, and orthodontics.


Over a decade in private practice of Surgical Implantology and Prosthodontics. Founder and owner of Prosthodontics & Implant Surgery of Manhattan, PC. Clinical Assistant Professor at the Post-Graduate Department of Periodontics & Implant Dentistry at New York University College of Dentistry. Lecture weekly since 1999 on advanced Implant Prosthodontics at New York University College of Dentistry Post-Graduate Program in Periodontics & Implant Dentistry. Former clinical assistant professor of Dental Radiology at the NYU College of Dentistry. Former clinical and lecture faculty at Lincoln Hospital, Dental residency program. Former clinical and lecture faculty at St. Barnabas Hospital (Bronx, NY) dental residency program. Lecture nationally on Prosthodontics and Implant Dentistry.

Memeber of the American College of Prosthodontics. Memeber of the Acacdemy of Osseointegration. Member or the Omikron Kappa Upsilon (OKU) Honors Dental Society. Member of the American Dental Education Association.

Graduated with Honors from New York University College of Dentistry. Post-Graduate training and certificate in the specialty of Prosthodontics. Post-Graduate training and ceritificate in Surgical and Prosthetic Implant Dentistry. Honors-program in Comprehensive and Applied Practice Management. Honors-program in Orthodontics.

Awards and Honors
NYU Cervice award to the community. OKU honor society. National Dean's List. National Who's Who.

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