Expert: Mark Bornfeld DDS - 5/29/2005

Question
Dear Dr. Bornfeld,
Thank you for offering to assist me by answering my questions. About 8 years ago, a local dentist crowned all of my teath.  I have been very satisfied with his work during most of the following 8 years, however, recently many of the teath have become worn down, cracked, or sheared off on their frontal surfaces. The work had cost me thousands of dollars, and but dentist who did it has moved away. My concerns are:

1) When I decided to have all the teeth crowned, I assumed they would laat me the rest of my life. Is it likely that I was supplied with a poor, low quality set of crowns ?
2) Can repairs likely be made without total removel and total replacement of the crowns ?
3) If so, in layman's terms, what method of repair might most likely be selected by the repairimg demtist ?
4) Lastly, do I seek a doc who practices general dentistry, or is there a specialty field more adept to do this type work ?

Thank you, again.  

Answer
Dear Mr. Moore,

Your initial premise that your crowns would last the rest of your life is either too optimistic for your crowns or too pessimistic about your expectations for a long life. Unfortunately, crowns seldom last a lifetime, as is the case with most other things. I cannot pass judgement about the quality of your crowns based on the limited information you have provided, but I would agree that an 8-year crown life span is somewhat disappointing, especially if several of your crowns are self-destructing at once. Whether their early demise is the result of faulty workmanship, poor choice of service, or just a very strong bite, this would call for a re-assessment of whether a similar type of repeat treatment is wise.

In my experience, repair of crowns is not reliable, and this would especially be the case with the type of wholesale destruction that is manifested by your crowns. The type of repair that is feasible and appropriate would depend on the material of which the crowns are composed, the location on the teeth where the crowns have sustained damage, and your dentist's judgement. However, you should view any attempts to repair your broken crowns as an interim measure; most of these repairs neither look good nor are they strong enough to bear up under the considerable stresses of chewing.

Most general dentists should be able to provide assistance with your concerns. However, all general dentists should know the limits of their skills, and provide a specialty referral if they feel that their patient's interests are best served by such a referral, which in this case would be to a prosthodontist.

Hope this helps...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY