Cracked tooth--I have to get a crown and I am scared

[Harriet Vane]

I have a cracked molar. My dentist recommends a crown now even though it does not hurt. She says that if part breaks off, then it will hurt a ton, so better to crown it now. Next to that tooth is a molar that has lost a big chunk of a filling, so they are going to clean that up and refill it while they are at it.

 

I'm scared. I have not had to have any significant dental work since I was a kid. When I was young, I was not taught good dental habits, so I often had many cavities to fill. When I was twelve years old, I decided to be DONE with cavities and started really taking good care of my teeth. I have had no cavities since that decision. 

 

So now I will be in the chair for two hours, and I am scared.

 

Please tell me what to expect, both in terms of what will be done and how much pain to expect.

 

I anticipate it will be done with novocaine. They said they also offer laughing gas if needed. However, I do NOT react well to drugs, so I would like to avoid that option if at all possible. 

 

The other fear I have is that I cannot take antibiotics. I have had two  massive, systemic reactions to antibiotics, one of which was life-threatening. I assume there is no need with a crown, but thought I had better check. 

 

I will call the dentist tomorrow for some more information before the procedure on Tuesday. In the meantime, help me understand what to expect.

 

Thank you.

[regentrude]

You should not need any antibiotics if there is no infection. If there is, they won't crown the tooth anyway; they would treat the infection and do a root canal.

For just a cracked tooth, crown is treatment of choice.

 

The dentist will inject the numbing novocain into your gums; you will feel the quick pain when that happens. Sometimes they use a topical cream before injecting the needle.

Then you will wait for a few minutes until the numbing takes effect. Other than that, the procedure should be completely painless.

You may find it uncomfortable that they are working in your mouth because you can sense them tugging and drilling; headphones help with that. But you should not feel any pain. Gas should not be necessary.

 

I hate dental work; when i was a kid, they did not numb, you were supposed to deal with the pain. So every time I have dental work done, I am afraid it is going to hurt and I tense up in anticipation of the pain that may be - but never comes.

 

ETA: Forgot to explain: they will probably give you a temporary crown for a few days while they manufacture the permanent one according to the cast they took. Then you will have to come back, get the temp taken off, and the permanent cemented on.

Edited December 17, 2016 by regentrude

[Shelly in IL]

It's not that bad. Worst part is keeping your mouth open that long. You're number up and shouldn't feel much of anything - maybe some pressure. You'll have a temporary crown until the real one is finished and it'll be permanently attached. Easy!

[lewber]

It is easier than you think! I've had two. My dentist is awesome and numbs first even before shot. There is no pain.

I do not numb well so I'm advised to drink orange or apple juice, food, sugar before I go. My dentist told me that if you're hungry or blood sugar is low then the novacaine is absorbed into blood instead of numbing.

Also take some Advil when you're done. 'My mouth and jaw is somewhat uncomfortable from being tugged on and open all that time.

[SparklyUnicorn]

I didn't find it easy at all, but it wasn't painful when they were doing it.  More annoying than painful.

Definitely try the gas.  I didn't care for the IV sedation, but the gas was pretty good. 

[purplejackmama]

The most painful part is your wallet.

[Pippen]

I had one done a few months ago. They didn't even do a temporary crown because my dentiest used a 3-D printer to create the crown while I waited in the office. They put me in a massage chair while I waited for it.

 

As far as dental procedures go, this isn't a terribly difficult one from the patient side of things. I agree with what's been explained above--no pain--just some minor discomfort afterwards. The new crown will feel a little weird afterwards because while it's similar to your old tooth, there's no way for it to be exact. Even that feeling goes away after awhile.

[SparklyUnicorn]

The most painful part is your wallet.

 

aint that the truth... :glare:

[Elizabeth 2]

This is what I gave to my patients before they came, and many commented it made things mich better than other crown experiences.

 

Take the Advil *before*you go. Your inflammatory response of holding your jaw open will be reduced, rather than just treating it after. It also will prevent inflammation of the pulp, which can lead to more problems. See if you can go in first thing in the morning and see if they can give you Halceon or at least a Valium or xanex to take before you even leave home. Have someone drive you if that happens. Eat a good breakfast also, since you will be sufficiently numb for hours and may not feel if you chomp down on your cheek. Expect to eat soft or nearly liquid meals that day to be cautious since you said you strongly to medication. Last thing: ask if they can give you lidocaine without epinephrine. It does help with bleeding, but if you are already nervous can send you into a panic attack. I've seen it happen chairside. Use the Nitrous, if you don't like it, it clears very quickly just by breathing some normal oxygen. Plus, the nasal system prevents you from seeing as much of their instrumentation.

 

Also, makes sure to take really good care of the temporary. Clean around it but don't pull the floss up, just out through the side (toward your cheek) so it doesn't pop off before the appointment. Chew on the other side of your mouth.

 

You've taken good care of your teeth for a long time. This is part of it and you can do it.

[Miss Peregrine]

Had my first one a few months ago and in addition to the novocaibe there was a palatal shot. It's painful, even being numbed from the novocaine.

[catz]

I have had both a root canal and a crown on a cracked tooth (2 different procedures) done in the past year and the anticipation of it was MUCH worse than the actual thing.  Advil before going is a good thing and I always take an advil before going to the dentist anyway.  It's not like it's super fun sitting in the chair that long, but it wasn't that bad.

[Lanny]

Let me tell you about why I do not eat fish now...  Many years ago (1995 or 1996?) when I was single, the Maid cooked a Lunch that had fish with bones. Well, I bit into a bone,  which I was not expecting to encounter, and I bit into it hard. At the time, I never thought the tooth was damaged and I did not go to a dentist. By the time I did go to the dentist, the tooth had to be pulled. Then, I needed to have a Bridge made...  Pain and $.    I have also had Crowns made and that is a walk in the park, in comparison to what I wrote earlier.   GL

Edited December 17, 2016 by Lanny

[gardenmom5]

I've had broken teeth before a crown.  yes- it will hurt like the dickens if the nerve is exposed.  (scenes from marathon man were coming back to me.)  and, you can't eat.  I kept trying to find what I could put on it until I could get in. candle wax. . .

 

I'm in the middle of a crown right now - I have a temporary - (third time at christmas! really?  really!?!)  my son asked me when I'm being coronated.  the filling came loose - and a cavity developed underneath.  no pain currently - but if it were to break, or hit through to the nerve - it would be bad.  I wanted to wait until next month - but dentist was concerned it wouldn't last that long.

 

 

if you can tolerate fillings - you can tolerate a crown.  they might use more novocaine - depending upon location.  it just takes longer. and two visits - because they need to make a mold for the permanent crown. 

 

they will make a mold of your tooth, then do what they need to do to prep it for a crown.  after they prep your tooth, they will make a mold and a temporary crown.

 

do you know what material you will use?

 

some type of resin?  I think there is a new one out.

porcelain - hard, does have to be redone eventually

gold - expands and contracts at the same rate as your tooth (due to temp) - costs more. rarely needs to be redone. My dentist did a residency in fl - he had quite a few patients with 30 - 40 year old gold crowns in perfect condition.

 

 

the silicon for the mold has a texture like gak - but it stays in one piece.  it's also pretty fast. (a minute or less)  I'll take it over film for x-rays any day.

 

IF your temporary pops off  - there is otc temporary dental cement.  or you can use toothpaste, or pliable candle wax (which has to frequently be redone  (annoying).  - I'm allergic to the eugonol in temp dental cement.  I also had to use it twice as long as the label says because it was a long  christmas weekend - and no one was available.  I have a new dentist this time.

[scrapbookbuzz]

You have been given some great advice here! I've had SO many crowns and root canals, I've lost count. But that's because

I love sugar. So let that be a lesson! Anyway, it's more annoying and painful in the hit to your wallet and the time spent in the chair

than it is actually in your mouth. I think you're most scared of the unknown and believe you will find it won't be nearly as bad as 

your brain is trying to make it in your imagination right now. ;-)

 

[gardenmom5]

I had one done a few months ago. They didn't even do a temporary crown because my dentiest used a 3-D printer to create the crown while I waited in the office. They put me in a massage chair while I waited for it.

 

As far as dental procedures go, this isn't a terribly difficult one from the patient side of things. I agree with what's been explained above--no pain--just some minor discomfort afterwards. The new crown will feel a little weird afterwards because while it's similar to your old tooth, there's no way for it to be exact. Even that feeling goes away after awhile.

 

I'm so impressed with my current temporary.  (the only imperfection is the sides has the texture of very fine sandpaper)  if the crown is this good - It'll be the best one I've ever had.

 

and that is one reason why getting a crown before it hit's the nerve.  if it does - it's a root canal.

[Elizabeth 2]

Ah, the bolded happened to me the other day. I didn't have a panic attack but I stopped the procedure till I could clarify that what felt like a sudden burst of adrenaline (like a predator was chasing me, lol) was normal and not me having a heart attack or something. It would have been good to know what this was before it happened.

Aw that's not cool. A good assistant, or at least the dentist should have explained this as part of the procedure. I've heard of this happening far too often when some explaining and patience would help the patient feel better.

[Lawana]

After numbing, you shouldn't feel pain. The drilling takes a looooong time. Making the mold for the crown was extremely unpleasant to me. I felt like I couldn't breathe well or was choking. The gum around the tooth was sore for a few days. My jaws were sore for several days.

 

That sounds bad, but it really wasn't overall. I forgot to not eat sticky things and popped off a temporary crown eating a caramel. Oops

[PollyOR]

Good luck!  

 

My crack was old and my tooth was falling apart before I went to the dentist.  So, no pain.

 

My doctor is an older man.  He did use oregano oil.

 

I've had a lot of fillings (genetically weak teeth?) and getting a crown was so much easier.

[Happy]

You can do this! Be aware of your breathing--when I'm tense I stop breathing or I breathe shallowly. Take slow, deep breaths and let them out slowly. You'll release a lot of tension this way.

 

I had some bad experiences at the dentist when I was young so I'm always tense. I love getting a valium and gas and numbing stuff. The more out of it I am, the better. Ask the doctor to give you advice based on your allergies-

 

I've taken headphones and soothing music--it helps, but I can't hear the dentist or his super fun assistant, so I stopped.

 

 

[Anne in CA]

I have not had a crown, but the first extensive dental work I had was when I was 36 and it freaked me out too. I was lucky (I had Kaiser) and they were rock stars. It was all fine even though I really worried a lot.

[alisoncooks]

I've been terrified of the dentist since I was a child. I went regularly as a child, but stopped for about 6 years after getting married. Unfortunately, I inherited my mom's bad teeth. :( I had 6 cavities that visit.

 

Then, because I didn't learn my lesson, I stayed away for another decade...until I broke a molar. I had a root canal and a crown from that...followed by another massive filling (that the dentist really thought was going to be another root canal/crown), plus another cracked tooth. (And a few small fillings.). Eeeeesh.

 

Anyway, I've seen the dentist several times this past 18 months. My fear has gotten better. My only advise is to not hesitate if something feels off -- it took several adjustments before my new crown was tolerable.

[Pegasus]

Worst part is keeping your mouth open that long. 

 

 

My mouth and jaw is somewhat uncomfortable from being tugged on and open all that time.

 

 

Your inflammatory response of holding your jaw open 

 

 

Ask for a bite block.  This is a little wedge of rubber/plastic that they can put between your teeth on the opposite side.  You rest your jaw on the block rather than straining to keep it open.  I have no idea why this nifty little device is not standard as it has made major dental work so much easier for me. I ask for it every time my mouth needs to be open longer than a minute or so.

[Anne]

You probably have already done this, but be sure that your dentist knows about your reaction to antibiotics.

 

Anne

[Stacia]

You can do it!

 

Like you, I had a ton of fillings as a kid. And a dentist who was not averse to inflicting pain. I was terrified of dentists until well into my 20s.

 

I have had a couple of crowns. Considering the strides made in care & handling (vs. how cavities were done eons ago in my childhood), a crown was a piece of cake. My dentist uses a topical numbing cream first, which makes getting the novocaine needle fine. Many years ago, I did try a combo of novocaine and laughing gas & that was a big mistake. I was so nauseated & sick for hours. Now I stick w/ novocaine only & that works fine.

 

Anyway, I have found getting crowns WAY easier to handle than getting fillings as a kid.

 

:grouphug:

[happi duck]

Aw that's not cool. A good assistant, or at least the dentist should have explained this as part of the procedure. I've heard of this happening far too often when some explaining and patience would help the patient feel better.

So is the thing that can make you panicky the shot they give to numb you?

 

I have panic disorder so I forget to think that feeling panicky could have a specific cause.

 

I have always hated being numbed and go without when I can convince the dentist.

 

I only recently noticed that the shots cause a physical reaction. Usually work is far apart so I rack it up to fear. Recently I had work done a week apart.

 

After several shots for root canal my hands were shaking uncontrollably, I wanted to run and had tears in my eyes.

 

For crown prep I had one shot and was quivering and nauseous.

 

Sounds like I need to ask about not getting epinephrine...Do I have that right?

 

My DDS knows I deal with panic attacks and *hate* being numbed. Maybe she's already giving me something else though it hadn't been mentioned.

 

Thanks for sharing...this might be really helpful info for me!

[Elizabeth 2]

So is the thing that can make you panicky the shot they give to numb you?

 

I have panic disorder so I forget to think that feeling panicky could have a specific cause.

 

I have always hated being numbed and go without when I can convince the dentist.

 

I only recently noticed that the shots cause a physical reaction. Usually work is far apart so I rack it up to fear. Recently I had work done a week apart.

 

After several shots for root canal my hands were shaking uncontrollably, I wanted to run and had tears in my eyes.

 

For crown prep I had one shot and was quivering and nauseous.

 

Sounds like I need to ask about not getting epinephrine...Do I have that right?

 

My DDS knows I deal with panic attacks and *hate* being numbed. Maybe she's already giving me something else though it hadn't been mentioned.

 

Thanks for sharing...this might be really helpful info for me!

 

Yes, Ma'am!  One patient had anxiety so badly she couldn't eat more than a piece of toast and coffee that morning.  I ran across the street and got her a smoothie in the middle of the appointment because it would trigger her anxiety if she didn't have more to eat.  Once she had protein in her, blood sugar back to normal, she handled the epi much better.  

 

The epinepherine helps prevent excessive bleeding.  It is very helpful in certain situations, such as crown prep and RCT (root canal therapy).  But.  They can use a minimal amount by using it only for the innervation (immediately around the tooth) and on the palate for upper arch.  There are other options for the block.  

 

So, how to handle this.  1) think back: did you eat a meal before hand?  Not some juice.  Or a piece of toast. These cause blood sugar to drop too quickly and create a bad combination with the epi.    Protein, fat and carbs for longs lasting energy.  If you haven't eaten well before your appointments, do it this next time.  2) Ask for them to use their non-epi option.  They are required to have some on hand, but to make sure, speak with the DDS/DMD/lead chairside assistant before your next visit.  3) If the doctor really doesn't want to work without it completely, then ask if they can reduce how much you get.