Second Opinion – New but Bad Fitting And Painful Crown

Case Report:

This young lady had this crown placed within the last year and has had constant pain since placement. Went back to see her dentist several times for “adjustments” without relief. Finally, after loosing confidence in her dentist she sought a second opinion.

After a thorough exam it was determined that the crown did not fit well – it did not seal around the tooth. Having not resolved the bad fitting crown in time it is very likely that she now will also need a root canal treatment as the tooth is dying because of the poor fitting crown.

The kicker is that when we requested the existing x-rays from the dentist who made this crown it was clear on those old x-rays that the crown did not fit. This is very disappointing to me as we, as a profession, need to strive for excellence at all time. This problem could have most likely been avoided had the x-ray been read properly and the bad fitting crown replaced sooner. Now the patient needs a new crown, with more cost, as well as probably a root canal treatment and a core buildup, both not the most comfortable procedures at times and expensive!

If you have a problem with recent dentistry that is not resolving, seek out a second opinion. Don’t just have a root canal treatment performed without discovering the actual cause of the problem. In this case, if the patient would have followed the recommendations of her old dentist she would have gotten the root canal treatment they prescribed and not redone the crown. This would have been a fatal mistake as the bad fitting crown would continue to decay and cause even more significant loss of tooth structure!

Keep Smiling.

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47 comments on “Second Opinion – New but Bad Fitting And Painful Crown

Unless the decay was present at the time of the insertion, the crown was ill fitting but not necessarily caused by the crown itself. Unfortunately, the tooth preparation has a lot to do with the symptons of pain. Shoulder and beveled preparation used to be more in use in the past than the present. This type of preparation was and is the best uniformally to support the crown. Current preparations are either full shoulder, champfer or modified champfer. These type do not adequately support a crown because the stresses are at the occlusal point of the preparation. The only other problem might have been the crown was high to begin with.

Thank you Nick for your feedback! It always is good to hear from a dental lab owner.
Design of the tooth is critical. Too many dentists simply chop the poor tooth down to bits and then expect a lab technician to mask it all with a beautiful crown. That simply won’t do. The support of the crown comes from the design of the tooth below it.
If more dental laboratories felt the way you did then we would have a significant increase in the quality of dental care. Most labs are afraid of telling the dentist that the design of their tooth prep is wrong and the impression poor – I guess there are too many other labs hungry to work have more work regardless of the quality.

Keep smiling,

Dr. Chris

Please help. I’ve had 4 root canals. My first dentist was amazing but retired. This new dentist is terrible. I’ve had 3 root canals from them and my teeth look like marshmallows. You can also see metal near my gum lines where the crowns are and I have constant pain where my crowns are. I just recently got another crown and it doesn’t even look like the tooth that’s on the other side. I also am not able to floss cause there’s left over cement and I have calcification on my teeth. My front teeth- you can almost see through them because they’re mostly cement from a cavity in between my two front teeth and I also have 8 more cavities to be done. I am 24 and I have very bad teeth. I really wanted to go to college, but I’ve spent all I can afford on my teeth and it wasn’t even worth it. Can someone please help? I willing to travel for a second chance. I’m always in pain and I just want to have healthy and happy teeth. My teeth depress me.

Dear Patsy,

I am surprised that at your young age you have so many dental issues. I strongly believe the best anti-dentist medicine is exquisite home care and proper nutrition. I see too many people these days that live in an acid world (soda, sport drinks, flavored water, you name it)….not to say that this is you, but I would take a strong look at why this is happening to you! What in your world is causing this? Take a look at this blog post and read about the dental cycle:

Now, if your dentist is not able to help you avoid these issues and you are unhappy with his/her work, go find another dentist, there are many out there that would love to help you.

I always give free second opinions, so if that is what you need, let me know.

Keep smiling,
Dr. Chris

hi chris, thanks so much for helping everyone.

my back molar was extracted and the one next to it had had a root canal for now 4 years. I desperately need a crown for it. I was gonna do it last year but another one of my tooth broke so I had to spend my money on that one! Now I bought this deal to get a porcelain crown for AUS$499. Since it’s a back tooth with root canal and only one “neighboor” I don’t think much can go wrong. What do you think? should I ask what metal it’s made of? What metal should I avoid?

Thank’s again, dentistery is so important, expensive and confusing, we definitely need more website like this one.


Hello Freddie 🙂

First, let me answer your question – if you are going to chose a crown that is “metal” I would highly suggest you tell the dentist you want “high noble gold”, so either a full gold crown or a porcelain fused to gold crown with high noble gold as a substructure.
But, for the “deal” price I don’t think this will be an option. Regardless, there are great porcelain crowns available now that most people prefer anyhow.
It has been my experience that that most reliable type of porcelain crown has a zirconium core. These zirconium core crowns are cemented vs. bonded which is much easier and harder to mess up 🙂
The key is to make sure it is not a huge, poor fitting crown, and that is tough to find because the dentist needs to prepare the tooth right, which is easier with a root canal treated tooth, and then send it to a good lab. You should not have many problems because the tooth has no feeling/nerve, but the crown needs to fit right around the tissue.
Lastly, It is a very important tooth specifically because there is no tooth in front of it! You need this tooth…consider a “bridge” to close the missing tooth gap or even better, and implant in the future. Ask your dentist about these options. Since I believe the cost of either right now is too much for your budget I would plan for an implant in the future.
Lastly, make darn certain you figure out “why” your teeth are breaking!!! Is it diet? (soda, sugar, flavored water, et.) or is it function? (do your teeth work correctly?) or is it periodontal disease or old dentistry…you need to figure out why and treat that asap!

I hope this helps 🙂

Keep smiling,
Dr. Chris

Dear Dr. Chris,
I am so bummed I did not find your website before I had crown and bridge work. You are doing an excellent job answering questions and I wished I would have found your website sooner. I have always had excellent teeth and have been missing a molar since I was 18 when I didn’t have dental insurance. I am 52 years old and about 6 weeks ago I woke up with mild tooth ache. I went to dentist and he said I needed root canal to remove a root tip and recommended a crown & bridge.

Over the last 6 weeks I have been to dentist nearly 6 times because the temp they place kept coming off. After multiple re-cements, my crown finally came in and the work was finished. I told the dentist and his technician that it feels too high as when I bite the new crown touches first and on my right side, those teeth do not feel like they are touching. They kept filing and using the bite paper and the dentist insisted that it is right height and he permanently fitted the crown/bridge. It has been two days and I still feel the left bite is higher than my right bite. I also cannot chew on the left side and there is some small sensitivity. This morning I went to dentist and his hygienist did a cleaning and she said everything is fine and I just have to get used to the new crown/bridge.

I am concerned if the height is wrong, what are the implications further down the road? Can I live with it like this and not do anymore damage to my teeth? What about only chewing on my right (original molars) side? Is this wise to do?

I am not in pain and the crown looks like my teeth, essentially my only complaint is when I bite down, the left side touch first and I don’t feel the right side touching at all and I am having trouble chewing with new crown/bridge.
Thanks for your time!

Dear Nancy,

Your bite needs to feel normal! Simple as that. There are many reasons why your bite could feel wrong, but regardless, it needs to be adjusted correctly or you will have significant future issues.
The bite paper is not nearly as accurate as your “feeling”, and if you feel the bite is off, then it is off 🙂
This is exactly how patients end up with more and more problems down the line. The bite shifts, teeth fracture, joints become inflamed and on and on. Simply put, it has to fit and function correctly.
IF you dentist is not able to do this correctly, then you need a new dentist. Look for someone that will listen to you and has the training to back up his/her talk. I would recommend an AACD Accredited dentist because they really worked hard to achieve a higher level of competency so they work hard to live up to that level of quality. Go to the AACD website and “find a dentist” near you.

I hope this helps.
Keep smiling,
Dr. Chris

I had my bottom molar fillings replaced and i was in pain later that day just biting was excruciating , i called the dentist and he said to come in and they would put a medicated filling and see if the pain would go away. It didn’t and I ended up with a root canal, and a crown on it. When I try bitting on it i still feel a little pain, and my crown fell off today, I also feel pain on the molar next to the one that I got the root canal on. He replaced the filling on that tooth too does that mean I need a root canal on that other tooth. He also left my bite high on another tooth and now I have a toothache and a lump on top of my tooth it doesn’t hurt but makes my tooth feel sensitive to the touch. This is truly a nightmare!!!

Dear Mayra,

Sounds like you may need to get a second opinion…sorry. Why do I say that? Well, the last straw was when the filling was too high and you are working on killing another tooth because the bite is off. You should not have new crowns coming off like that and root canals don’t “just happen”, they are a last resort. Warranted I don’t know the entire situation, but you should have been informed that there may be a crack or that the need for a root canal treatment was possible…
Let me know how it goes.
Keep smiling,

Dr. Chris

Just a quick hello to say “where have you been for the past year and a half of my life?!!”
I’ve been going around with my dentist about how my bite is completely off since he put my crown in. 1st he tried to blame the root canal work for my feeling anything on the crown, because as he said “you shouldn’t feel anything, the root is gone.”
The fact is, the crown LOOKS way too big, bigger than any other tooth in my mouth, I haven’t been able to close my jaw completely for a year and a half and my speech is affected!
My dentist worked on both sides of my mouth essentially at once. On the right, he filled a molar in my back and did not carve it to fit. The he went on to put the crown in on my left back molar thus making me move my jaw to the left ( to avoid the clump in my right tooth filling) to be able to close my mouth enough to bite down on the crown for placement.

He’s refused to remove the crown he sayed if he can’t see my teeth marking on that silly old carbon paper he could not do anything. I can see where my teeth hit each other, yet I can’t put my mouth/jaw in that position for him to get a mark. I want the crown out and I feel like he’s just jacking me around until I give up.
I just can’t believe that dentists like this exist!! He obviously does not THINK about the issue at hand he just looks at what he knows and what doesn’t fit and send his patients “down a garden path”
Sorry for the rant but it’s been 1/2 of my life and I’ve been made to feel like I’m exaggerating, how many other patients will not be as insistent and will walk around with teeth breaking for “no apparent reason” because a dentist is too prideful to admit he made a mistake.

Apparently I have a hyper-mobile jaw

Dear Chryssoula,

Sorry to hear about your issues…Here is my opinion.
First, the mouth is an incredibly complex mechanism and anything we do as dentists usually has a pretty significant effect. In your case it sounds like your crown is a bit “big” which to me usually screams cheap lab, but I can not really comment on that as I have not seen it. Anyhow, if your bite feels different then it IS different. Simple as that. The crown may not be hitting at all and your bite can be different, and here is why: The tooth needed a root canal treatment, correct? Well, the tooth could have been hitting very hard and the tooth could have been killed for that reason, so the dentist takes the tooth and puts a crown on it. Then he removes all contact and says his carbon paper shows no marks, but your bite has dramatically changed since the tooth was hitting too heavy before. So, you need to look at the entire mouth function, not just one tooth!
This equilibration of the mouth is essential to prevent further breakdown of your dentition…I hope your dentist has the experience to do this, if not, you need someone who does.

Keep smiling,
Dr. Chris

I am also having issues with my crown. About a year ago, my dentist said my tooth was cracking (had a big filling that last 30 years) and needed a crown. The crown was never comfortable that I was using my other side to chew. When I chew on the side where the crown is placed, there is a dull pain and after much chewing there is soreness in the area. I have gone for adjustments a couple of times, but it is still painful when I chew. The tooth doesn’t hurt when I don’t chew, but sometimes that area is sensitive to heat or cold. My dentist says I will need a root canal. Would that really fix the chewing issue? I guess at this point I lost my confidence in my dentist and am wondering if I should take more treatments per his suggestion.
I am in mid 40s and had no issues with my teeth other than fillings done in my early teens. I have been getting my teeth checked/cleaned religiously every 6 months for last 20 years.
Thank you in advance,

Dear Jean,

The tooth should feel normal/natural after having a good crown placed. If the tooth was cracked due to the probably silver mercury filling (they crack teeth all the time) then it is possible that the crack extended down the side of the tooth to the root. A root canal treatment would not 100% of the time fix that.
I would suggest a second opinion to check out the fit of the crown and the function asap.

Keep Smiling,

Dr. Chris

Thanks so much for your reply. I had saved the site but then lost it so I hadn’t found it til now. While I’m here I thought I’d give you an update. Soon after I commented I finally stopped going to that dentist.
The thing is with hyper-mobility syndrome is that my joints are very forgiving so that in the case of my crown, it’s too wide so I move my jaw over to accommodate. I’ve got new wear where my teeth have been hitting, I’m biting “end to end” as one endodontist put it, some have chipped (a tiny bit) and I know one of my bottom teeth cracked days after the placement of the crown. When I addressed these things he essentially ignored each observation of mine. Right down to my pointing out an area on my jaw with pain and his answer was “oh, yeah, there’s a muscle there.” He finally suggested I see a “tmj doctor”. I did not have a problem with my temporomandibular joint before. I kind of feel held hostage by this tooth. How do I achieve equilibration? Who should I go to? Do they shave off your natural teeth to fit things? Or will they be able to actually find the issue and fix it?
Thanks again for taking the time to read and answer you blog. This time I’ll be notified of your response so this time it won’t be another year 😉

Sorry, it’s me again. What I had wanted to add as an update was that when I finally did make an apt. with a new dentist, they called me back and said given my story and the fact that the dentist refused to remove the crown, I should contact the Ca. Dental Assoc. and that they would be cancelling my apt. As it turns out it would have taken 6-8 months to go trough this process and it was just to get my $ back. Which isn’t necessarily what I’m after. I want my bite back 🙂 not my $.
I had read about it sounding like a bad lab job before as well. I was googling why I felt like I was buck-toothed now.
I did some research and realized I probably needed a neuromuscular dentist. When I went in for the apt. the did a thorough job of imaging from every angel but never let me talk. The dentist came in with his plan to help me which involved over a year of wearing a night piece. That’s all fine IF that’s what I need. I don’t feel confident that I do.
I feel as though if they would hear my side and maybe LISTEN to what I have to say about my Hypermobility syndrome things would make sense to them. I’m sure they don’t have much experience it since it is somewhat of am “invisible disease”. When I share the nuances of it and how it impacts me, they shrug it off as me being too sensitive or asking too much. And in the back of their mind they’re saying “That’s not how the human body works “lay” person but I know what’s going on so I’ll just continue doing things the way I do for ALL my patients…but you talk your little heart out if it makes you feel any better”
I think that’s where my ego comment comes in. Doctors and dentists don’t know everything they are people too. You’d think collaboration would be a good thing with an illness they may never have dealt with.
And lastly how can I get this crown out of my mouth??
The cosmetic dentist wants to re-shape my jaw and the other dentist I tried to make the apt with doesn’t want to just take it out. I don’t want to go back to the org. dentist, as we got nowhere and I don’t think he wants to remake the crown. Too cheap to do so? IDK.
What do you suggest?
Sorry for hogging up your comments section but you seem to have intelligent opinions and to be thinking a person. So, thanks again;

Dear Chryssoula,

I am going to try to help you as best as I can from here 🙂
First of all, we are all always learning! Nobody knows it all. We learn mostly through experiences and the only I can do when something I try does not work is try to make it better (redo, etc.). That being said, your case is somewhat new to me. This is how I would approach it:
1. You felt fine before the new crown. All issues arose after the crown. So, take the crown off, place a temporary crown made out of acrylic that can be adjust until you are comfortable again.
2. There are many different types of dental philosophies…neuromuscular, Dawson, etc. They all work in their own way. I have my own that leans more towards the Dawson side 🙂
3. Over thinking problems can cause even more problems! Start with the simple solution presented in #1 above, you can always do more!

I hope this helps,
Dr. Chris

😀 Thanks a bunch!!
That’s exactly what I’d like to do. I guess after being turned away from the 1st dentist who recommended the Dental assoc.and 2 subsequent neuromuscular who wouldn’t listen, I felt as though no dentist would shape &/or remove another dentists crown. Phew!! Good to know that’s not the case. Ah, back to a world that makes sense.
If only my original dentist would have been so kind.;)
Thanks again Dr. Chris;
Chryssoula 🙂

Hello Dr Chris!
Just wondering if you might have a suggestion. A few years ago I had a root canal and crown fitted to my upper left canine. It never felt “right” and looks nothing like the canine on the right. I mentioned it to the dentist and was told that the tooth was mad to look as it should (I was at a guard at night for teeth grinding, so the tooth had been ground down quite a bit due to grinding) not as it did when it was capped. The fact that I grind has loosened the crown to the point of falling out several times. Should the crown not have been fitted to the same size as the other side so that the grinding didn’t affect the fit? It is bothersome while eating, feels way to large for the space and just doesn’t feel right over all. I’ve had another crown fitted long before this one and never had this weird feeling of it not fitting properly. Now my insurance has changed and the dentist who did the work on the crown causing problems doesn’t accept my new insurance and won’t see me with out an outrageous office charge. As I mentioned it when it was first done I’m confused as to why this is still an issue an wasn’t fixed or if he was correct that should have been fitted as it should have be structured instead of how it actually was structured.

Please help. I’d be less concerned by it’s right up front and falls out all the time exposing the metal post especially when I smile.

Thank so much for any insite,

Hi Dr Chris,
So glad I found this website. I have all the exact issues described in your post.
I had a band on a very slightly cracked tooth (probably amalgam filling causation) for about 3 years with no issues whatsoever. My dentist suggested I should get it crowned before the band came off at an awkward time. I didn’t think it was absolutely necessary but preventative restoration might be ok, as ‘the Dr knows best’.
The temporary seal after preparation was too high and did not seem to keep the crack clamped tightly, so I was in sleep depriving agony for 2 weeks. They ground the temp down a bit and I was on antibiotics for another 2 just in caution to make it settle. It did a little.
The crown was put on and it was too high so not only was it ground back to the metal, the dentist also ground my upper molars until the bite was ok. I was immediately concerned as none of this should have been required if it was a proper fit. Especially grinding down perfectly good teeth!
I then discovered that the margins are still exposed and causes hot/cold sensitivity. The crown also seems to have not ‘clamped’ the crack sufficiently so there is also still pain on biting and chewing. What a disaster! It is now worse than when I had the band.
I sought a 2nd opinion, and whilst he wouldn’t outright say I got bad work done, he did advise that I would need that crown off, may as well get root canal whilst it’s exposed just to be sure and then get a new crown.
So now I am up for more than double the cost of the original crown.
So the lesson is, make sure you see a quality, skilled dentist. I thought my original dentist was relatively competent, but it appears not so after all. She should have admitted within minutes of the crown fitment that it was wrong, too high and exposed margin but instead chose to try and fix bad workmanship with grinding down of good teeth! The exposed margin should have also been immediately obvious, it certainly is to me.
Thanks, now I know what to do in future, as you note I will try to get it resolved sooner rather than later before I end up with a condemned tooth. Thousands more dollars it will cost, unfortunately.

Dear Rich, you have a sad but common story. Quality is key in Dentistry and none of us are perfect! If the crown does not fit, send it back! If it is adjust down to the metal (who uses metal these days anymore anyhow?) then that alone is reason to redo it. Also, why not adjust it to fit perfect BEFORE you cement it? All this points to a lack of experience and expertise and you just need a new dentist.
Now telling a patient you may as well get a root canal is simply ridiculous. If there truly is a fracture then a root canal will not fix that. A good crown is the best option but constantly stressing out the tooth with bad fitting crowns that are hitting to heavy will simply kill the tooth and spread the crack resulting in the tooth being lost.
I know quality dentistry is expensive, but think about it. A good crown costs about 2000 dollars. That is less than the cost of a bad crown plus a root canal which is bad for your health. Plus, imagine all the wasted lifetime and worry, pain and suffering and future issues you will have because of the “cheaper or insurance” crown. Is it really worth it?
I know you will make good decisions in the future and I appreciate you sharing your story!

dr. Chris

Thanks Dr Chris,
The cost is an annoyance indeed, but good dollars spent on quality workmanship is paramount, I agree. We only have one set, requiring best care and treatment for our modern, long lives.
Thanks for your note on possibly unwarranted root canal, I had my doubts, I think my 2nd opinion dentist, after hearing my woes, just wants to make as possibly sure there are no ongoing issues.
I will request just a new, quality crown and we’ll leave root canal for the worst case scenario. Fingers crossed.
Interesting about the metal being outdated, I never knew.
Much appreciated, you’re on my Xmas card list ! 🙂

Your welcome Rich :). If you need anything else like maybe a good dental lab recommendation, let me know!

I had all my front teeth crowned in 2011. Two teeth snapped at the gum line within the first 8 months. The dentist removed all caps, dent a FULL crown lengthening and put a dental splint on. After about 6 months , they took the splint off and put all new caps on. One cap/tooth was very wiggly. Dentist shrugged it off. Within 6 months, 2 caps/teeth broke again at the gum line. I have no money to have all the damage reared. The last set of caps were put on in 2013, and fell off in 2014. I asked them to please fix my teeth and they said no. I am devastated .


Dear Toni. There has to be a reason for the front teeth breaking that is being missed. Often the lack of back teeth support results in too much stress on the front teeth. Having worn down the back teeth too much also puts too much stress on the front teeth. The key is to understand that the front and back teeth work together and if one of the two components is not functioning correctly the other one fails. Secondly, almost every one of my patients wears a properly adjust hard night guard to distribute forces and manage function at night. This is something you need to look into as well.
Please get a second opinion from a dentist that has advanced training such as the Pankey Institute, they will better understand your situation.
Dr Chris

hey , do not go cheap….I fell for a “sale” on crowns….got 4 at once…what was I thinking….does price make the only difference…dentist super nice and tried super hard by bad lab work and bad cement and pain….do not risk it people….but how do you know good work? price alone? How do you find a good dentist?

Hello Donna. You are right, quality dentistry costs more for everyone including the dentist. Most dentists mean well but may not have the necessary experience, training and labs to deliver too Dentistry. I am disappointed at what I see what several dental schools are considering “good” dentistry theses days. How can a young dentist aspire to deliver beautiful quality dentistry when their “gold standard” is so low? USC, my dental school, set the bar so high that I daily hear my instructors in my head making sure I do things right.
Finding a good dentist is tough. I believe one of the best ways tondo this is to call a top quality dental lab and ask them who gives them quality work! For that reason I will soon write a dental blog on the labs I have used and trust and why they make me a better dentist 🙂
Keep smiling,
Dr Chris

Problems after dental work new crowns lowering of jaw with 4 false teeth on bottom after 8 months still painful no pain before having work done

If the new crowns are still painful then you need to have this looked at. I can’t give much more information…sorry

This is exactly what my crown looked like yesterday after final cementing, I’vehad the image of the two voids (one on each side of the tooth) stuck in my head. Should I get a second opinion? The doctor looked directly at the x-ray with me and said it was OK…I should have opened my mouth then but didn’t.

Absolutely yes Cody. Don’t live with it and you are welcome to send me the x-ray plus your written HIPPA approval to check it out for my free second opinion 🙂

Yes! Get a second opinion.

Hi Dr. Chris – thanks so much for your work here in answering questions!

I have a new crown, my dentist is having me wait 8 weeks before permanent cementing because my gums were ‘irritated’ and he wants to be sure it’s a good fit. He seems good at what he does, but doesn’t communicate well.

My new crown doesn’t fit into the opposite molars above it well, and I have food get stuck in both upper tooth and lower crown – more than I can sweep out with my tongue. So now I’m picking food out of my my teeth! Fit on the sides is great, feels good on gum, bite feels normal. Is this cause for concentration before I get permanent cementing?
Should I go to a different dentist and ask if it’s a good crown?

Dear Andrew. I will try to understand the problem. You are getting food stuck on the “top” of the tooth? Temporarily cementing a tooth usually is done to see if the tooth will live, not for the gums. If you are getting food stuck between the teeth then the crown probably does not fit right – does floss snap between the teeth or is there an open contact between the teeth? Open contacts are not acceptable. Let me know and I can help more once I have that info.

Floss does snap – I believe it to be a good fit (great even) between the two adjacent molars (29 and 31 I think.)

The crown is firm and feels good at the point (with some ache when chewing hard and some increased cold sensitivity, which was already a problem). No food there.

But the crown (bottom right, #30) does not fit into the molars above it. They don’t occlude well. Where I used to be able to get food out of the valleys in the molar surfaces with my other molars, I can’t now. Food gets stuck readily, and compacts in the valleys of the crown and the tooth above it. Is THAT normal? Unacceptable?

(he said the gums were irritated, and wanted to wait 8 weeks to go permanent… So, I guess that sounds a but abnormal?)

Dear Andrew. We can polish and adjust the top tooth surface to reduce getting food suck in it unless, as I believe the case is with you, there is no contact. The polishing still works and helps but contact is important for function…you will have to weigh how “open” the occlusion (how the teeth come together) is. Often over time the teeth will move together and the problem goes away.
Temporarily cementing a crown in not unusual, but a good fitting crown will be nearly impossible to remove, even with temporary cement.

Thanks so much for your time and thoughts!

Hi Dr. Chris – I had a thought about the lack of contact from my new crown (30) to my upper molar: the outside ridges of the crown are (very) smoothed over. They don’t peak at all. The inside ridges are high and ‘peaked’ like a normal tooth, but the outside (which would fit into/occlude with the upper molar) is rounded.
I asked my dentist about this, and he said ‘well otherwise it would cut you and you’d come in here complaining and calling me a jerk.’ the language isn’t flattering, I think he was being humorous, but I didn’t understand him. I asked if he meant cut my cheek – he said yes and moves on. (he’s not big on communication, to be honest. Am I right to be thinking that is what I’ll be looking for in my next dentist? Or is it more normal?)

My question: should a crown have rounded ridges on one side? Or did someone get carried away with a grinder and he’s not admitting it?

Hi Dr.Chris,

First of all thank you so much for your time and answering all the questions.

I have root canal done on upper left tooth(24) and large filling on the tooth next to it(25 I think) and few minor fillings after first ever visit to dentist. I did get second opinion before I got the first root canal. But ever since I got the root canal plus crown(for 24) and filling done on 25, the tooth 25 was feeling high all the time and they adjusted so many times, I was told that it needs root canal because it is feeling high even after so many adjustments, this time I trusted them and did not go for a second opinion. I got a root canal done and had crown in place. Bite still feels high and off Infact they can see that the I’m biting high on crowns they adjusted so many times and still wasn’t feeling right, on top of that I was getting constant headache in my right temple, but I didn’t think headache would be related to bite.

Earlier they have suggested me to use night guard ordered one for me ,so I went to get a night gaurd at that time and I mentioned to the dentist I was seeing on that day about my headaches he looked at bite on my left and right side , said I’m biting high on couple of lower teeth adjusted on both sides. Ever since than my bite feels so weird and my headaches didn’t get any better , so I asked other dentist in their group to have a look and she said she can not see anything but smoothened that tooth on lower right. Still nothing changed.

So I mentioned to them about it and then they send me to some in their group who is specialized in bite and he checked my bite and looks fine , I’m biting bit high on of crowns. When I mentioned to him about feeling high lower right he has done some adjustment to upper right, After that my headaches are getting worst and my right jaw and temple hurts when I bite and I’m having neck pain as well. I was told to use night gaurd strictly for a week but it doesn’t seem to help either. I feel some pressure in the very back when I wear it and when I wake up my bite feels so different/ weird and always feeling high where the crowns are when I bite feeling pressure on tooth behind new crown, having constant jaw pain , headache.

I feel very unfortunate with these bite issues and feel like I should have never went to the dentist. Now I’m very afraid to let anyone touch my teeth.

Do you think crowns are causing these bite issues? if the bite is high on left side Can It cause headache on right temple? Can nightgaurd fix the bite problem? Please let me know your opinion. Thank you so much in advance.

This is a sad situation but an incredible good learning experience for everyone reading this. Let me address one issue at a time.
First, the fact that the dentist said you need a root canal since the bite is high is not only not true it is ludicrous. If you went to the dentist without a bite issue and they placed a bad crown then doing a root canal due to the bite now being wrong is in my opinion unethical.
The second crown still was wrong and they never were able to correct the bite. This essentially means you need a good dentist to do it right. Getting the bite right is not rocket science.
Third, making a nightguard before fixing the bad crown is also a bad move. When you mentioned you are hitting on the back teeth with the biteguard in I can clearly picture the type of nightguard they made…it needs to be adjusted to fit correctly or it is just an expensive piece of plastic. You are clearly hitting on the back teeth first due to the nightguard which is making the situation worse.
You need to leave that group and find a dentist that puts you first, has experience and can solve your problem.
I am happy to help by looking at “new” X-rays of the crowns and photos. Ask your Dentist to take bite wings and send me the originals via email. Photos help as well. This will let me determine the quality of the work real quickly. I do free consults like this all the time so people can be helped and not neglected anymore. All information for free consults should go to info@idealdentistry DOT COM (spelled out to prevent spam). Sorry for your trouble.

Thank you so much for your prompt response and thoughts. Looking at X-rays would be greatly appreciated, I will email the new x-rays and I will ask them about bite wings. Thank you so much again Dr.Chris.

Hi Dr.Chris,

I have emailed you x-rays and photos of teeth. Could you please review and let me know your thoughts upon your convenience. Thank you!

I had a bridge put in and have been in excruciating pain since day 1 and it’s been 6 weeks. First he said the bite was off, today it was I found some cement in there, should feel better tonight. I looked at the pictures he took and noticed the margin was off and I could see my the crown, my tooth then the gumline. I pointed it out and he claims the margin is fine. 6 hrs later and I’m still in pain . Almost feels like the tooth is swollen which I realize a tooth can’t swell but I don’t know how else to discribe it .

Feel free to send me a photo/x-ray to review. A new bridge should not hurt a lot – a little sensitivity at first is ok.

I have 2 temp crown and perm crown on my back left molar 2nd to last. The temp kept coming off and always felt loose. The 1st came off and had replaced it came off. Never did feel right. The old crown nerve was a problem dr just said it was leaking from Etsy. So finally perm crown came in. It never felt like it was secure on my molar and felt like square peg in round hole. No pain just not right and always feeling strange in my mouth and ruff. I went back to densist and had tenement take it off. She said she did build up on tooth got another temp crown and it feels like it is not glues down and illl fitting. I think they are making the new tooth too small. Afraid new crown is just going to be a repeat. Please advise.

Quality in dentistry is key. If this is an “insurance” crown at a lower cost office then oh may be experiencing the effects of that. Find a quality dentist and have them evaluate before you end up with a poor crown. It will cost a little more up front but it will save you a ton of pain and suffering down the line.

Dr. Chris,
Thank you , thank you , so much good info for us who are having problems and questions .
I got a new crown that is obviously missaligned . How can a dentist not see that ? She had to grind it quite a lot to make the surface level . I was wondering how can it be that despite computer scanning and 3D printing my crown is inward on one of its ends. Feels wide there and I blamed the architecture of the crown. Then I noticed a lousy rough line on the outside where the crown sits. I learned that a quality crown sits seamlessly any imperfection is bad on long run.
After looking at the crown , flossing around it and putting the puzzle together I realized that the crown is sitting 10-15 degrees turned from where it should be , turned inwards . I have to go back and ask to have it done properly . That is always hard because I am not a dentist . If I go to other dentist I will have to pay again , if I go back I already do not trust them , I will go back it is one month since and ask her to fix the crown . Do you have any advice for me what to ask particularly ? Frankly she should print an other crown etc for free . Any advice is welcomed .

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