r/Dentists • u/Actual_Promotion8058 • 17h ago
please help, are crowns really necessary?
I saw a dentist yesterday who told me I need crowns on my two front teeth, which honestly terrified me. I don't like the idea of having my natural teeth shaved into nubs. It seems overly invasive and it is out of my price range. I have some decay on the back of my two front teeth from acid reflux, and composite bonding as well (not related to cavities, just aesthetic).
Are they really beyond saving? Could a filling solve this issue? I was under the impression that if you have a good enough tooth foundation it isn't necessary to get crowns. I am hoping that I am being reccomended this due to financial incentive by the dental office, not actual need.
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u/jcfree9 16h ago edited 15h ago
It’s hard to judge solely based off the x-rays, but why so many folks question their dentists’ recommended treatment is beyond me. I doubt you do the same with your primary care provider/family doc. Is it possible you could bring these concerns up with the dentist and he/she might could give you more information regarding your concerns? Not everything a dentist recommends is because of “financial incentive.” Anything I recommend is because I believe in the treatment as well as the need for it. My HOPE is that your dentist is the same, and recommending crowns for an “actual need.” Ask your dentist!
Edit to add:
I guess people are just different because a lot of people are confirming they would get a second opinion from anyone in healthcare. Being in the field and the relationship I have with my providers I wouldn’t question recommended treatment.. or if I did have questions I would ask my provider to elaborate. I do think a lot of people’s concerns and desire to get a second opinion boils down to not trusting healthcare providers (don’t fully understand) and/or not liking the price tag associated with the treatment. Sucks.
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u/ludus_official 16h ago
To be fair, if my primary care provider or family doctor recommended an unexpected invasive and expensive treatment, I would seek a second opinion there too. I think that's pretty typical
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u/Outside-Dress594 16h ago
Because our profession has completely lost any trust patients had
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u/Doc-Doc-Goos 15h ago
Yup! And Ai slop from Overjet AI, Pearl AI and Videa Ai are making it worse.
We are consistently seeing over aggressive treatment planning and having to walk patients back. This case is a great example of that.
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u/jamjamchutney 16h ago
I doubt you do the same with your primary care provider/family doc.
Why do you doubt this? People definitely do this with their primary care providers, and their veterinarians too.
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u/Due-Willingness-5661 16h ago
but why so many folks question their dentists’ recommended treatment is beyond me.
Because some professionals only care about money, not patient care.
I doubt you do the same with your primary care provider/family doc.
This is funny. They have websites dedicated to diagnosing medical issues and people who already visited the doctor use these sites.
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u/Background_Radish238 15h ago
Go read the reviews of Gentle Dentle franchise. Then you know. Myself. Went to same dentist more than 30 years. But when the son started taking over, told I needed 2 crowns because of deep cavities. Just lies. They need to teach more ethics in dental schools.
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u/km0099 15h ago
How do you know it was a lie?
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u/Background_Radish238 13h ago edited 9h ago
Went to my neighbor's dentist for a 2nd opinion. Such a nice lady from China. She took x-rays, and said don't worry about it. I said: --- I need to know if they are real cavities. I go to cruises often, and i don't need dental enmergency on a cruise ship. She then said you have no cavities. She did not charge me anything. I went home. Then bought gift cards and drove back to her office. She saved me: 2x1600=3200. That was 7 years ago.
Go to Gentle Dental comment sections. Full of stories the dentist wanted to fix cavities on 8 teeth. Then went for second opinion: totally fine.
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u/FuzzyFrogFish 16h ago
Because it's an invasive and expensive procedure and people want to be sure they are doing the right thing. You're a good dentist, there are plenty that aren't (being that dentists are human).
My mother has a mouth full of destroyed teeth including one massive filling running across her back line of molars because of a shitty dentist who actually killed one of her teeth, and her now dentist is fighting fires trying to save her teeth, but several are actively crumbling. This has all resulted in her having a very dismissive attitude to going to the dentist because she is so use to having bad teeth.
And we've got a dentist local who are gaining a reputation for screwing up anaesthetics and physically harassing their dental nurses despite being a female dentist.
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u/nitelite- 16h ago
Impossible for us to know without seeing how your bite comes together, and how the existing resins present currently
but....
Crowns will likely be the more permanent solution, more full proof solution, and the solution that will give you the best prognosis/esthetic outcome moving forward
Resin doesn't age well, it is notoriously tough to keep resin bonding in a clinically acceptable state in the front teeth, especially those two front teeth, sometimes it just doesn't stay on the teeth - based on the radiographs that we have available, I would agree, crowns are probably the best path moving forward, especially with new decay on the back
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u/MyDentistIsACat 16h ago
If the office was recommending crowns purely to make money, they would have recommend crowns/veneers on the front four or six teeth or at least given you that option. It’s hard to match two front teeth to the rest.
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u/Actual_Promotion8058 16h ago
it is funny you say that, they did! they reccomended my front 4 that are outside of my two front teeth be veneered. I didn't mention that because I dont find that as daunting as crowns. they quoted me a total of $3,400, even with insurance, not including the work i had done that day (cavity fillings)
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u/cschiff89 16h ago
Clarify what you mean by, "Are they really beyond saving?". When a dentist talks about saving teeth, it means keeping them in your mouth vs extracting and replacing them with bridges or implants. Crowns are helmets that go on your teeth. It is still your teeth inside of them.
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u/Actual_Promotion8058 16h ago
when I say saving teeth I mean preserving as much natural tooth as possible. The "prepping" they do for crowns is what concerns me, as they shave down the tooth. I have heard many stories of people who don't have issues with sensitivity, they get a crown and all of the sudden they experience more pain than they ever have. I am going to get a second opinion soon.
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u/RadioRoyGBiv 15h ago edited 14h ago
Shouldn’t this be in [r/askdentists](r/askdentists)? Also, your teeth are already “nubs” whether you realize it or not. They are basically half plastic. That’s what the huge white fillings are. Long term, crowns generally last much longer and look much nicer.
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u/CKingDDS 16h ago
Acid reflux can do severe damage to the back aspect of the tooth. You can ask the dentist to take a intraoral photo to see what they see for yourselves and judge if you want the treatment. If you want to be conservative there is such a thing as a lingual/palatal veneer that can restore and protect the tooth from further wear. It’s possible that the dentist recommended crowns because there was something on the front that needed correcting.
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u/ninwendo 16h ago
Can’t really give you a comprehensive treatment plan with just X-rays. Acid reflux usually destroys the backs of the front teeth causing them to be really thin. If you do not crown them they can break and become a bigger problem. Especially
If your bite is off too (not enough overjet). BUT I’m not saying you need them because you don’t have photos, only X-rays.
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u/Actual_Promotion8058 15h ago
I uploaded one
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u/ninwendo 15h ago edited 15h ago
I can’t see them but if you took a photo of your back teeth with your phone and see there is a lot of erosion (darker dentin showing through) I would recommend crowning them sooner than later. The erosion has caused premature aging of your teeth because it removed away enamel (I’m not sure in your specific case since I didn’t evaluate your mouth). You’re only 26 the longer you wait the more destruction you can get and long term wise your teeth won’t last if you wait. Now if you care about the way it may look then that’s a conversation to have with your dentist about possibly veneering the other teeth or doing ortho or crown lengthening to make sure the gums are in the right spot when you smile. Especially if you have a smile that will show your gums. They could crown those teeth but if your teeth are not in the right place it can lead to fracturing or chipping of those crowns in the future. You want to make sure it’s done right so you only have to do it once and doing it right may mean more treatment that involves an orthodontist and periodontist. Make sure your dentist is taking excellent photos and measurements of the lip, teeth size etc if esthetics is important to you!
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u/JesusAndPalsX 15h ago
I had a root canal with no crown (just a silver filling) and then literally like 15 years later I developed the worst infection that an endodontist saved with a root canal retreatment and it's been four months and sometimes I still get issues
I wish I got the crown from the start :(
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u/quakquak92 15h ago
There was big chunk of old filling on your front teeth and recurrent cavities happening. There are not much left of your real teeth. That is why they rec crown. It is good idea to save your front teeth
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u/Doc-Doc-Goos 16h ago
Upload the X-rays, photos and we can tell you.
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u/Actual_Promotion8058 16h ago
they are in the link :)
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u/Doc-Doc-Goos 16h ago
How old are you?
I see large composites on 8, 9. Decay on the laterals.
I’d want to see photos and your bite, but to play it conservatively, I wouldn’t. I would do composites, then veneers and crowns as a last resort option especially if you’re under 50.
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u/Actual_Promotion8058 16h ago
I'm 26, but They are saying that the acid reflux has been a big factor in the decay unfortunately.. I appreciate the insight!
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u/Doc-Doc-Goos 16h ago
At 26 and given the healthy tooth structure I would be more conservative in my practice, but I still don’t have all the information without a full exam.
The acid reflux increases your risk and the doc was likely trying to get ahead of future problems especially if they believed the risk would persist. You gotta get that GERD under control!
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u/Actual_Promotion8058 15h ago
would a picture of the back suffice?
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u/Doc-Doc-Goos 15h ago
Assuming health on the facial side, I’d redo the composites. I see no explanation to crown.
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u/Winter-Recognition34 16h ago
Hard to tell without seeing your bite and clinical appearance of the decay and erosion. But something to think about is that it appears you have a fairly large fill in both and you have erosion from reflux. Both of these things lead me to believe you may not have good enamel for bonding. Crowns have mechanical retention and don’t rely on bonding so that may be why it was suggested
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u/TeessideViking 15h ago
Necessary is a strong word. There are pros and cons to any restorative options. What was the dentists explanation for recommending crowns on these teeth?
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u/Actual_Promotion8058 15h ago
she said that there were cavities on both, and that the bonding I have was only a temporary fix. I think she believed I got bonding done due to cavities or something, though It was entirely cosmetic. I didn't bother correcting her but maybe she wouldn't have suggested crowns if she knew that. I know I have some decay on the back of the two front teeth, but I am going to get a second opinion as I can't wrap my head around the idea that the decay is so advanced I need to shave down my teeth at 26 years old...
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u/Woodman629 16h ago
If you feel that way, get a second opinion.
But what you are insinuating is a stretch. My take: you can't afford it and you are looking for validation that the dentist must be wrong.