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Dentistry/CROWN REPLACEMENT DUE TO TOOTH DECAY

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Question
IS IT TYPICAL FOR OLDER CROWNS (5 TO 10 yrs  old) TO GET TOOTH DECAY DUE TO OPEN MARGINS FROM CEMENT FALLING OUT OVER TIME. I FLOSS AND BRUSH MY TEETH ON A DAILY BASIS (2X'S/DAY...SOMETIMES MORE.)
ALSO I RESIDE IN CONNECTICUT AND MY DENTIST IS CHARGING ME $1200 FOR EVERYTHING (FILLING AND NEW CROWN)FOR TOOTH#18.IS THIS EASONABLE?
I HAVE NO INSURANCE FOR DENTAL REPAIRS....THANK YOU FOR YOUR TIME

Answer
Dear Douglas:
I am sorry to hear that you are having a problem with the crown you have.  Many crowns last years and years without any problems. However, it is not uncommon, even for the best of crowns to get recurrent decay under the gumline even after only a few years in service.
It is very difficult to tell the reason for the decay.  It can be due to an inferior quality work, but mostly it is due to the genetic makeup of the patient and mostly due to imperfect home care habits and not seeing the dentist/hygienist for regular maintenance cleanings.
I completely undertand your frustration, expecially if you do brush, floss, and see your dentist/hygienist regularly.
I have seen perfectly executed dental work leak the cement out around the crowns just due to the fact that the patient is a severe tooth grinder and the stresses he had put the crowns through were just too much.
Unfortunatly, after 5-10 years, it is entirly unreasonable to have your dentist be responsible for the probelms with the work.  It is actually an accepatable time frame, even by most insurance companies (and they watch the bottom line very carefully).
As to the fee...
At $1200 for the crown you will be paying an average fee for the work.  I can tell you that here in New York City, most specialists (Prosthodontists) will charge you $2000-$3000 for a crown and the general/family/cosmetic dentist will be at about $1500.
Unfortunatly, I cannot give you anymore information without examining your mouth and X-rays, but I will be more than happy to recommend a Prosthodontist colleague in your area for a second opinion from a specialist.
Best of luck,
Dr. Zev Kaufman

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Zev Kaufman, D.D.S.

Expertise

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.

Experience

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.

Organizations
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.

Education/Credentials
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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