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    Tyluna's Avatar
    Tyluna Posts: 1, Reputation: 1
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    #1

    Apr 4, 2006, 09:31 PM
    Crown lengthening necessary?
    I had a root canal on Fri and went back to the dentist on Mon for a temp crown and fitting for a permanent crown. The dentist took out the temp crown that the endodontist had used and grinded away most of my tooth. After that, she drew me a diagram, told me that I needed a crown lengthening and referred me to a periodontist, and informed me that she would not put on a crown if I didn't have a crown lengthening ($750 procedure which my insurance does not cover). The billing person in the dental office referred me to another dentist (in the same office) who also said I needed crown lengthening, but he said he would do the procedure free of charge.

    My questions are:
    1. Is a crown lengthening really necessary? My gum line is fairly high on this tooth and I think having it higher will look odd. Also, $750 is a really high cost to a grad student. It was NEVER mentioned by my dentist or anyone else when the cost of a root canal and crown were discussed.

    2. Is it possible that I need a crown lengthening because the dentist grinded away too much of my tooth structure? She left very little tooth. She never discussed how much she would be removing or anything related to size prior to grinding my tooth.

    3. Is a dentist qualified to do a crown lengthening? Or is it better to go to a periodontist?

    4. Where can I find more information regarding crown lengthening pros and cons, both critiques and recommendations?

    Thank you for your time and help.
    fredg's Avatar
    fredg Posts: 4,926, Reputation: 674
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    #2

    Apr 5, 2006, 05:06 AM
    Hi,
    I am not a Dentist, nor a Professional in this area. I am a 64 yrs old man, who has had just about every known dental problem, and gum problem... now have some Great dentures!
    I would personally go to another Dentist!. one that is recommended by friends, or others in your local area. Any Dentist who starts doing work on you, not explaining beforehand what they will do and why, should be avoided. It's like going to a surgeon, who operates on you, without telling you anything about what he will do beforehand... avoid it.
    All this sounds just a little bit "too convenient" to me, with all the referrals.
    Check with another Dentist before you go spending all this money.
    I do wish you the best of luck.
    curious23's Avatar
    curious23 Posts: 1, Reputation: 1
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    #3

    May 30, 2006, 01:37 PM
    WOW! Your situation sounds so much like mine. I seem to only find shady dental offices because the people seem to be trying to suck every penny out of me. The idea of crown lengthening was NEVER EVER mentioned to me until I got to my appointment to get the crown. They told me that it would be $750 on top of the cost of the crown if they decided to do the crown lengthening procedure. They told me they wouldn't know if they had to do it until they started drilling away at my tooth. How convenient for them- destroy my tooth and THEN tell me they I need to do the procedure... I'd have no choice. Of course my insurance does not cover this either.
    I left the office at that point and am trying to seek some more advice on the matter.
    If you've discovered anything about this procedure, I'd love to know!
    Good luck to you!
    debdrunner's Avatar
    debdrunner Posts: 1, Reputation: 1
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    #4

    May 16, 2007, 04:29 AM
    I had the same thing happen! I was told I needed root canal.had that done, then told I need a crown.It took him 3 hours for the first visit he drilled on forever and when I went back he said there was a problem. I might LOOSE the tooth completley!! He needs to consult with another staff member to see if they can preform crown legthening!! I believe he screwed up!:mad: :(
    gumchewer's Avatar
    gumchewer Posts: 1, Reputation: 1
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    #5

    Jun 28, 2007, 07:35 PM
    :rallyes: I know this question was posed a very long time ago, but, perhaps, someone will be helped now or in the future by my answer. As I write this, I am 4 days post surgery with the 3rd crown lengthening I have had. Not fun, annoying pain for days afterwards and the surgery required way too many big shots... but, having said all that, I do not think anyone is being ripped off. This procedure has allowed me to save teeth, which should always be the ultimate goal. After a root canal, a tooth HAS to be ground down in a crown is to be used, as is often necessary because root can teeth become very brittle and break. If there is not enough tooth above the gum line to crown the tooth properly and keep it protected from breakage and further decay (yes that can happen even after a root canal) then the proper technique IS to do a crown lengthening. I just had to pay nearly $1000 for mine, and I, too, have no dental insurance, but in the long run it will be worth it. If you think your dentist is ripping you off, you should not be utilizing that dentist. I trust mine and know he has my best interests in mind when he has designed the treatment plan.
    I think, despite the pain I am suffering, that this treatment is worth it in the end.
    santolla's Avatar
    santolla Posts: 1, Reputation: 1
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    #6

    Jul 20, 2007, 10:53 AM
    I think these dentists are scam artists! I just had crown lengthening and don't really believe I needed it since there was plenty of my broken tooth available and it wasn't mentioned till after I paid for everything. Did they want more money from me. And damn... this procedure F**Cking hurts now!

    Everything that has ever gone wrong in my mouth was a denists error. I paid a fortune to have 5 bloody fillings replaced last year and the one they claim to have replaced was never and it broke, then 2 days later my tooth broke as well. I've had dentist chip my teeth, I've had dentist fill cavities leaving decay under it. That was a very expensive dental mistake!

    And since I move around the globe, I'm never at the same dentist so I can't go back and sue the F**Ckers for ruining my mouth and costing me heaps of money.

    And... I just found that the bloody dentist who has recently been working on my broken tooth has taken it upon herself to file down the tooth next to it. WHY?? Did she bump her arm or do it on purpose. Why file a perfectly good tooth.

    I say F**CK the dentists. Lets all get our dental degrees and do our own mouths. Their robbing bastards they are and I hate them all!!

    Whos' with me?
    dentalphobic70's Avatar
    dentalphobic70 Posts: 1, Reputation: 1
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    #7

    Jul 24, 2007, 12:27 AM
    Quote Originally Posted by Tyluna
    I had a root canal on Fri and went back to the dentist on Mon for a temp crown and fitting for a permanent crown. The dentist took out the temp crown that the endodontist had used and grinded away most of my tooth. After that, she drew me a diagram, told me that I needed a crown lengthening and referred me to a periodontist, and informed me that she would not put on a crown if I didn't have a crown lengthening ($750 procedure which my insurance does not cover). The billing person in the dental office referred me to another dentist (in the same office) who also said I needed crown lengthening, but he said he would do the procedure free of charge.

    My questions are:
    1. Is a crown lengthening really necessary? My gum line is fairly high on this tooth and I think having it higher wil look odd. Also, $750 is a really high cost to a grad student. It was NEVER mentioned by my dentist or anyone else when the cost of a root canal and crown were discussed.

    2. Is it possible that I need a crown lengthening because the dentist grinded away too much of my tooth structure? She left very little tooth. She never discussed how much she would be removing or anything related to size prior to grinding my tooth.

    3. Is a dentist qualified to do a crown lengthening? Or is it better to go to a periodontist?

    4. Where can I find more information regarding crown lengthening pros and cons, both critiques and recommendations?

    Thank you for your time and help.
    I just came from my dentist yesterday morning and she did the same thing as you guys described. Stated I only needed root canal and then drilled away my tooth and ooppsss surprise surprise! Suddenly I needed all these $859 worth of dental procedure. Where the heck did that came from? Like I have a choice now?? They drilled it all away what choice do I have. I called my insurance and now a grievance have been filed because according to my insurance it was supposed to be a surgical procedure and the only thing the dentist used was the drill...
    flossie's Avatar
    flossie Posts: 1,903, Reputation: 181
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    #8

    Jul 24, 2007, 03:38 AM
    Here's a website that may be of interest to all of you. It's a shame that none of your dentists thoroughly explained to you what MAY need to be done BEFORE they started treatment. "Informed consent" is VERY important before starting any kind of treatment whether it be by dentist, doctor, chiropractor, your pets veternarian, etc.

    Clinical Crown-lengthening

    If you don't have a dental professional that gets informed consent I'd say find one who does!
    sweetlove76ers3's Avatar
    sweetlove76ers3 Posts: 1, Reputation: 1
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    #9

    Aug 5, 2007, 11:57 AM
    Well, if it makes anyone feel better, I just recently switched dentists because of the poor work that was being done to my mouth (i.e. horrible looking root canals). It had been 18 months since I had gone and in the last 4 months, 5 teeth had partially broken, all of which had work done to them before... and I needed 4 root canals and crowns, crown lengthening AND repairs (more crown lengthening) done to most of my other teeth. Apparently, that "free" dentist via insurance had F*ed up my teeth and now I was going to pay---BIG TIME. It was $20 k worth of work. My insurance covered a whopping $846 and the place gave me a discount for 10%... so it is only going to be $16 k in loans!! That is as much money as my student loans. I am beside myself at the thought, but I realize that in order to save my teeth now, I really have no choice. My ENTIRE mouth gets done this Thursday in an 8 hour appointment. I might be a little more scared now that I read this page since everyone seems to think it is a wast and a painful procedure :(
    nramhd's Avatar
    nramhd Posts: 1, Reputation: 1
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    #10

    Nov 11, 2007, 10:01 PM
    Hello, I had same situation. After taking like 10 x-rays from the tooth that
    dentist had worked on root canal, dentist gave me a x-ray and address of the doctor
    I should go for Crown Lenghening.

    I did instead ask my friends for a good dentist and went to that dentist . I did not
    mention that I had been asked to do CL. New doctor said everything looks good
    and that he imprinted me for the crown.

    Please please eveytime you are asked to do surgery (and CL is a surgery which
    I heard sometime its even hard to stop bleeding from it) get a second opinion
    and even third. Its your health , use your wisdom. This is not the first time I
    asked to go to same periodo.. by this office. First time was about gum surgery which
    instead I bought a good quality waterpik and used it daily and my gums improved.

    Best of luck
    markemarc1's Avatar
    markemarc1 Posts: 1, Reputation: 2
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    #11

    Dec 19, 2007, 10:58 AM
    Let me start by saying I am a licensed general dentist and I am currently practicing. I want to give some insight into the crown lengthening procedure and why it is done. When a tooth is in need of a crown, the tooth is "prepared" or cut down to a certain shape, leaving a precise margin, or border around the gumline of the tooth. A crown will then fit over the prepared tooth, encircling it 360 degrees. The margin of the tooth is where the crown meets the natural tooth. This usually happens right at the gumline, or just below it, in order to conceal that margin. That same margin MUST be on healthy tooth structure. A lot of times when a tooth has a large cavity, the cavity will invade an area on the tooth that will make it impossible to leave a clean, cavity-free margin at or just below the gum. Therefore, the margin must be deeper on the tooth, down below the gum, sometimes several millimeters. This usually cannot be determined until after the tooth is prepared and the decay is cleaned out. (Hence the reason it may not have been explained prior to starting the procedure).

    Think of the tooth and surrounding components for a minute... You have the tooth (2 parts, a crown part and the root). The root is buried and surrounded by bone. On top of the bone is the gum, all of which encircle the tooth. There must be a distance of AT LEAST 2 mm, preferably 3 mm of space from the height or top of the bone that surrounds the tooth and the margin of the crown. This distance is called the Biologic Width. When there is not at least 2mm of space (deep cavity involving the margin), crown lengthening is then indicated. The crown of the tooth must be lengthened somehow... The CL procedure removes some of the bone surrounding the tooth, and in essence, lengthens the crown of the tooth, (or lowers the gumline) creating that 2 mm of Biologic Width.

    Why is that needed? If you don't maintain that 2 mm of Biologic Width, the invasion of that width will be a constant source of inflammation, i.e.. Bleeding, red, constantly irritated gum tissue. It will bleed when you floss. And, (more importantly for a front tooth)... the gums will recede on their own and expose that new crown's margin, possibly jeopardizing the new crown.

    So, crown lengthening allows for a clean margin of tooth while simultaneously preventing future irritation and preserving the biologic width.

    Does every tooth that needs a crown need crown lengthening? Absolutely not.

    Hope that helps.
    smookl's Avatar
    smookl Posts: 7, Reputation: 1
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    #12

    Dec 23, 2007, 06:37 AM
    Ok folks.. an answer from a periodontist here, in practice for over 30 years. The usual indication for crown lengthening, is when there isn't enough "sound" or solid tooth structure available above the gum line to secure a long lasting crown or other restoration. Often the tooth structure that is removed by the dentist initially, is decayed or soft, leaving the remaining tooth at or below the gum surface. Failure to do the procedure often leads to recurrent (or new) decay getting in under the crown and the need for additional work, or worse, loss of the tooth. The $750 fee is not out of line in most parts of the country. In NYC where I am located and rent and overhead is sky high, the fee is closer to $1200.
    Tolon Rex's Avatar
    Tolon Rex Posts: 1, Reputation: 1
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    #13

    Jan 25, 2008, 12:09 PM
    Just to be fair.. let a dentist answer this question. As a dentist I am always trying to save teeth AND people money. I am not hear to suck every penny out of people. Many times I do free work because too many people just don't want to prioritize their spending on their teeth. That being said, crown lengthening is only justified when enough tooth structure is not present for a crown. When a person comes to me with a badly broken down tooth, many times the amount of tooth structure that is sound is hard to evaluate at the root canal visit. I always tell people when it is a close call. Often it is hard to tell if you need crown lengthening or not until after the root canal is finished and the cast post and core or crown procedure is scheduled. We use digital radiographs ( x-rays), and I don't like doing the procedure; however, sometimes you need to do this or the crown will not fit at all or a person may have a chronic periodontal problem. Western society is filled to the brim with decay, believe me.. there is so much work to restore people. Dentists don't have to create work.
    kimgvlsc's Avatar
    kimgvlsc Posts: 4, Reputation: 1
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    #14

    Mar 20, 2008, 08:15 PM
    I have been told that I need a crown lengthening too. I already have a crown and have had it for a few years. I don' t understand why I need it because my gums are not inflamed or irritated. My pain is in the tooth when I chew. The dentist and Periodontist said that this procedure will fix it. Has anyone had this kind of pain before and been told that a crown lengthening will take care of it?
    flossie's Avatar
    flossie Posts: 1,903, Reputation: 181
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    #15

    Mar 21, 2008, 12:59 PM
    Has the tooth that is giving you the pain had a root canal already?
    kimgvlsc's Avatar
    kimgvlsc Posts: 4, Reputation: 1
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    #16

    Mar 21, 2008, 08:43 PM
    No root canal. I told the dentist about some sensivity to heat and cold on the tooth. He told me that since the pain went away relatively quickly, it did not need a root canal. He said that if the pain lasted for a while, I may need a root canal.
    flossie's Avatar
    flossie Posts: 1,903, Reputation: 181
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    #17

    Mar 21, 2008, 09:10 PM
    Usually if a tooth is sensitive to heat and biting it indicates a problem with the nerve. Did the dentist take an x-ray to check for infection at the tip of the root?
    I've never heard of crown lengthening being needed because of sensitivity to chewing.
    kimgvlsc's Avatar
    kimgvlsc Posts: 4, Reputation: 1
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    #18

    Mar 23, 2008, 09:15 AM
    Neither the dentist nor the periodontist took an x-ray. I think my dentist stated that there could be some decay under the crown. I think after your helpful information, I should get a 3rd opinion. Do you suggest the opinion from a Periodontist or another dentist?
    Thank You!
    flossie's Avatar
    flossie Posts: 1,903, Reputation: 181
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    #19

    Mar 23, 2008, 09:58 AM
    I'd go see another general dentist. If there is decay under the crown, crown lengthening will not help the discomfort you are having. Perhaps the crown should be removed, decay fixed and new crown placed? An x-ray should be taken to be sure the tooth is not dying.
    kimgvlsc's Avatar
    kimgvlsc Posts: 4, Reputation: 1
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    #20

    Mar 23, 2008, 07:16 PM
    Thank you very much for your help!

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