Dentistry/crowns

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Question
combined crowns
combined crowns  
hello doctor i am 37 and had a combined dental crown on the upper front three root canalled teeth  for five years.i almost sleep with open mouth in the night(my wife said)did this cause protrusion of the front combined crown?

Answer
Hi Renjith and thanks for your question.

I am sure you can appreciate that without proper examination and evaluation of all diagnostic toold such as X-rays, I cannot give you a definitive diagnosis.  What I can tell you is that although the teeth have had root canal treatment, it does not exclude them from underlying periodontal disease, which would cause loss of the supporting bone for the roots and allow for movement.  In fact, there are 2 pathological conditions, endo-perio lesions and perio-endo lesions, which develop as a "complication" with root canal treatment, where the original infection is not completely resolved by the root canal and the acidic nature of the pus erodes the bone support for the remaining tooth and root.  There might even be underlying periodontal disease unrelated to the root canal and your dentist should examine this in greater detail and possibly refer you to a periodontist if needed, so that this can be eliminated as a possible cause.  Also, the position of your tongue could affect the position and movement of the front teeth, especially during sleep when you have no control over function, but one would assume that the tongue muscle itself would not stay in a state of active contraction pressed against the inner surface of the front teeth.  You may want to consider having a night guard or bite plate made for wear during sleep to eliminate this as a possible cause and stabilize the occlusion while you are asleep - this may slow down the movement, even though it wouldn't eliminate the cause if underlying periodontal disease is present.  Either way, get your dentist to do a full perio screening of all your teeth and evaluate the bone support or lack thereof - its a good place to start.  I hope this helps and wish you all the very best further, take care.

Kind regards
Dr Craig Peck

Dentistry

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Dr Craig W Peck ( B.Med.Sc., B.Ch.D., Clin. Botox, Cosmet. Derm.)

Expertise

I am a General Dental Practitioner, with special interests in Cosmetic Dentistry & facial aesthetics and Periodontology, placing a strong emphasis on the establishment and maintenance of a healthy periodontium (the support structure of the tooth) before cosmetic options are considered. I uphold all principles of prevention above interventional treatment and try as far as possible, to remain conservative in my approach. I believe in detailed, open and honest patient discussion, establishing what the patients expectations are and what the reality is of achieving this and involving the patient at every level of the treatment. I have strong principles on ethical treatment and appropriate patient management. I have chosen to treat and rehabilitate many nervous and phobic patients, who, for whatever reason, find it impossible to take part in the very important task of even a routine check-up. I will accept questions relating to general and cosmetic dentistry (in conjunction with the use of facial cosmetic procedures) and dental fears/phobias. I will be more than willing to answer any academic questions in dentistry, biology, physiology, psychology and health sciences in general. As most dentists will tell you, there is often not only one way of dealing with a dental issue - so very often, there is no precise right and wrong way of approaching the problem. All clinicians vary when it comes to treatments and what works best in their hands is often the treatment that is advised. Be understanding of this and bear in mind that nothing lasts forever! Patients are happy to accept only a one-years warrantee when buying a new car, but seem to expect that dental work is going to last them their lifetime.

Experience

I have worked for many years in the UK and RSA as a general dental practitioner - within the NHS, private practice and the government dental health services. I am certificated for the administration of Botox and Dermal Fillers for facial lines and wrinkles as I have attended further courses in minimally invasive facial cosmetic procedures. I started seeing an increasing number of patients who presented with severe to moderate dental fears, even with full-blown phobias, so I started with the slow and patient task of tackling this problem and have successfully rehabilitated many patients. The key is good, effective, concise and understandable communication, shifting control from the dentist to the patient in order to slowly, but confidently, regain their trust back in dentistry, thereby giving them the feeling of achievement and this self-empowerment which drives them to the next level of treatment.

Organizations
Academy of General Dentistry. American Dental Education Association. IAPAM (International Association for Physicians in Aesthetic Medicine). Professional Speakers, Writers and Managements Consultants in Dentistry. The British Dental Association. UK Aesthetics Group. ARC - Aesthetic Professionals. Botox. Aesthetics & Beauty. American Association for Dental Research. FDI - World Dental Federation. SOURCE1uk. World Dental Hygiene Forum. ProDentalCPD. Public Health Dentistry. Dentist Network. LinkedIn. Who's Who of South Africa.

Education/Credentials
B.Med.Sc. Degree (Medical Physiology and Medical Virology; Physiology Cum Laude; Stell 1994). B.Ch.D. Degree (Bachelor of Dental Surgery; Clinical Dentistry Cum Laude; Stell 1997). CPR and CPR-Advanced Courses (2000/2001; UK). Clinical Botox (UK, 2001). Cosmetic Dermatology (Botox and Dermal Fillers; RSA 2011).

Awards and Honors
Placed on the Dean's List at University for academic achievement (1994). Highest achievement in the subject Dental Materials. Medal from 3M and the Radiology Association of South Africa for highest achievement in the subject Dental Radiology and Imaging. Medal from The Periodontal Association of South Africa for highest achievement in the subject Periodontology. Highest achievement for Oral Medicine. Highest achievement in Oral Pathology. Received the DASA (Dental Ass. of South Africa) Gold Medal for highest achieving dental student across the 5 1/2 years of the Degree. Passed the subject, Clinical Dentistry with distinction in final year.

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