[bmbleb18]

So not sure where to start. Dentist did an RC. Ground away my tooth (molar). Tells me I need a crown lengthening procedure. I looked into it and saw that most times this is not a necessary procedure. I had a post & core done on a front/top tooth which broke up to the gumline after the first crown was placed and have had no problems with it. Why can't/WON'T he do a post & core? Why is he pushing on this procedure that my insurance won't cover? He also, refused my treatment (at appointment) because I refuse to do something like this procedure. Any insight? Please help me!

[flossie]

I don't know why he is refusing to do the crown. Your dentist should be sitting down with you to explain his reasons for his treatment plan. If you feel uncomfortable with what he wants to do perhaps it's best to go for a second opinion.

Crown lengthening is usually recommended when there isn't enough tooth above the gumline to cement the crown to. Having more tooth exposed will also help you keep the crown clean and reduce the risk of getting decay under it. The treatment plan is usually based on what would be the best outcome for the tooth. Even with a post you need some tooth structure to cement the crown to.

[KISS]

To add: Crown lengthening is dental surgery. Have a second opinion by a peridontist and have it done by the peridontist if required.

It's used to eliminate too much gum at the tooth line which can lead to a painful crown and decay later on. The ins. Company may just require more documentation to be able to approve it.

[Sparkk3223]

When placing a crown the dentist requires what is known as ferrule. Ferrule is 1 mm of sound tooth structure fully around the margin of the crown prep. So placing a post and core would not help increase where the ferrule on your tooth would need to be placed even if it does help with the retention of the crown. Simply cementing a crown on what is present may not be possible because it could encroach on what is known as the biological width. To prevent future periodontal disease and bone loss around the tooth, there needs to be at least 3mm between the margin of the crown and the crest of the bone. 1 mm for the periodontal ligament (the fibers that connect the tooth to bone), 1 mm for the sulcus (the area between your teeth and your gums) and 1 mm for the ferrule. To simply place a post and core in the tooth and crown it without taking the biological width or ferrule into consideration would be against the standard of care. I know it seems like your dentist is simply being stubborn, but if you ask him/her to explain the reasoning behind the treatment plan I'm sure he/she would gladly explain.