In most cases a crown is a highly successful treatment option and helps to prolong the longevity of the teeth for a few years, however as with all dental procedures not all teeth respond as favourably to the treatment as we would wish.
Risks and complications although rare may still occur.
The main risks are outlined and explained below.
As a specialist in prosthodontics, I am trained to identify and minimise the risks associated with this treatment. The following may be inherent potential risks related to the proposed treatment:
1) Pain, swelling, numbness and/or tingling sensation in the gum or parts of the mouth, sometimes as a reaction to local anaesthetic although I will use the utmost care to avoid this with good and slow injection techniques.
2) Reaction to injection, these are rare but can result in jaw muscle soreness and stiffness, again avoided by using the nerve blocks and I usually use a very local infiltration method with a more potent anaesthetic so the risks are minimal.
3) Sensitivity of the tooth after preparing the tooth, it may exhibit some mild-severe sensitivity which can last a short period or sometimes for much longer. If it is persistent you may have to notify us and we may have to identify and treat the condition sometimes resulting in root canal treatment.
4) The tooth may develop a condition called pulpitis; the tooth may have been traumatised by a previous accident, deep decay, extensive preparation for the crown, and multiple preparations of the tooth for crowns. These may make the tooth become non-vital/dead; it may be necessary to do a root canal treatment (removal of the nerves from the roots of the affected tooth). Infrequently the tooth may have an abscess or otherwise may not heal which may require root surgery or even extraction.
5) Soreness or irritation of the gums can last up to a few days especially if we use a retraction cord to hold the gum back to get a good impression of the margin
6) Fractures or chips to the porcelain may occur, small fractures can be repaired, and large fractures may require a new crown.
7) Dark lines may appear on the edge of the crown, if the gum recedes after placement the metal/root may show, sometimes this can be corrected, we try to avoid metal margin along with the visible areas of the mouth but it may be needed to preserve tooth structure in compromised teeth or areas.
8) Recurrent tooth decay may occur under crowns, this can be prevented by good oral hygiene and routine hygienist care, if these occur, this could be corrected with a filling or a new crown may be needed.
9) Food impaction may occur in-between crowns if the tooth is already tilted or the teeth on either side are not well-formed, this may be unavoidable so good oral hygiene is required.
10) Temporomandibular joint dysfunction may occur due to the change in the bite following a crown, this can usually be cor
rected, in rare occasions this may require more extensive treatment.
11) Unhappy with the aesthetics of the crown after it has been cemented. We will check with you that you are happy with the colour and shape before it is cemented. We also plan (where required) using wax-up mock-up and temporary crowns, but after it is cemented we cannot make a lot of adjustments and may require a remake - which may incur charges.
Most complications are always pre-empted and tried to be avoided
I will carefully study the way the teeth meet , the x-rays of the teeth,the proximity to the nerves, the presence of any habits like nail biting /grinding , but how the body reacts is very difficul to predict as so we will have to take each tooth as it comes.
It differs from person to person , and also tooth to tooth.
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