The Need to Replace a Restoration on a Front Tooth – Arlene’s Story

By: Dr. Elizabeth Eggert

How did this start?

Arlene is a patient of Dr. Elizabeth’s and suffered trauma to her front tooth over 40 years ago.  Because of the history of trauma, the tooth had a crown placed about the same time as the accident.  Over time restorations wear and tear and it is common that they have to be replaced.  The crown on her front tooth had been replaced once in 40 years and because of decay, it needed replacement again.  Insurance companies will tell you that an average lifespan of a dental crown is 5 years.  However, at Eggert Family Dentistry, we find that most commonly our crowns are lasting 15-20 years, assuming proper maintenance.  Proper maintenance means daily flossing and twice daily brushing, avoiding decay causing food and drink, and keeping forces on the teeth reasonable and even.  As a crown ages, the potential for problems gets greater and greater.  An aging crown can decay, break, or wear out.  Dr. Elizabeth was concerned about the decay starting on Arlene’s tooth under her crown and recommended a new crown.

What was involved?

In this case, and all cases involving only one restoration of front teeth, color matching can be the most difficult thing.  Arlene has crowding of her front teeth and her biting forces are not even, this also complicated her case.  Dr. Elizabeth talked about the pros and cons of doing more than one crown for color matching and to give the illusion of straighter teeth.  Dr. Elizabeth also talked with Arlene about changing her bite and alignment with orthodontics.  Arlene was not interested in these treatment options and elected to only replace the one crown.  She understood that the color may not match perfectly and was willing to take that chance.  She had also been living with an existing crown that was lighter in shade than her natural teeth because it had been done at a time in her life where the other teeth were lighter in color too.

After removing the existing crown on Arlene’s front tooth, Dr. Elizabeth noticed that the decay was much more extensive than she originally thought.  Dr. Elizabeth had to help Arlene understand her options, which included:

  • keeping her original tooth and only adding a new crown
  • having a root canal completed and a post added for retention of a new crown
  • having the tooth extracted and an implant or bridge placed. 

It was important to Arlene that her original tooth stay in her mouth, but she didn’t like the thought that the tooth didn’t have much retention due to the extent of the decay and that it was at risk of breaking at the gumline if she chose the crown alone.  Arlene needed some time to think about her options so Dr. Elizabeth made a temporary crown while Arlene had appointments with a root canal specialist and an oral surgeon to learn more about her other options.     

After careful consideration, Arlene elected to attempt to save the tooth over an extraction and implant, and had the root canal treatment completed in order to allow for a post that would add better retention for Arlene’s new crown.

To help with the color matching of this single restoration against Arlene’s natural teeth, Arlene made a trip to the dental lab for a custom shade appointment.  She thought it was just a “delightful” experience.

What does Arlene think?

Arlene was expecting to simply replace her existing crown.  She didn’t anticipate running into complications so she noted that the whole process took longer than she would have liked, but she was happy that it “definitely took less time than getting an implant!”

She is very happy to have her natural tooth and hopes it will last for many more years.  She knows to be careful with the tooth and use it guardingly when biting into foods like carrots, apples, pizza crusts, and anything else she might eat in the end-to-end position.

Arlene is lucky to still have her tooth after it was traumatized over 40 years ago!  Her story is just one of many others who have also experienced magnificent results with Dr. Eggert at Eggert Family Dentistry of North Oaks.  Crowns can yield beautiful and predictable results for accomplishing an improved smile!  At Eggert Family Dentistry, we love providing “Dentistry for a Lifetime of Smiles” – thanks Arlene for trusting us to help you continue to smile big and confidently.

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