It has been a couple years ago now that I had a full smile makeover done. It ended up being quite extensive with 12 of my upper teeth having work done and 10 on the bottom. When the permanent crowns were placed, I kept feeling a sharp pain on teeth #5 and #13. I went back in and the dentist re-adjusted the crown work. It didn’t help and I ended up going back multiple times. Finally after five adjustments, the pain subsided. But, after that I ended up getting a tooth abscess on both of those teeth in the next month. So, this time when I went back in, the dentist informed me that the nerves had died. So, it was time to get root canals done. This was very upsetting after having so much work done. I never knew root canals were a possibility. I had no idea nerve damage was a risk. I specifically remember asking the dentist about possible risks with the porcelain veneer crowns. He assured me there were was no risk. I am confused because the x-ray very clearly shows that the nerve is damaged. Can you help me better understand what has happened?
The dentist said that it very rarely happens to end up needing root canals and that I must be unlucky. That bothers me. I feel like he should have better prepared me for the possibility, if it was even a slight risk. Next, he sent me to an endodontist to have the root canals done. When I was in for that appointment, the endodontist performed tests on several of my other crowned teeth and found that after the cold test, I had more teeth that were problems. In total (so far) I have ended up having four teeth with root canals. That doesn’t sound rare to me. And he said I likely will need another one. My original dentist is helping cover the cost of the root canals, but it is still a lot of money. Will all of my crowned teeth go bad as time goes on? Not only is this a huge financial burden, it is stressing me out and causing me pain. Do you have any tips on moving forward?
-Ben in Texas
There are a couple clarifications that need to be made regarding your case. You are referring to “veneer crowns” and also porcelain veneers in your original question. However, porcelain veneers and porcelain crowns are quite different. The preparation for each of these procedures varies significantly. For a porcelain veneers, a very tiny bit of the tooth enamel (surface of the tooth) is shaved down slightly. It ends up being maybe half a millimeter of the structure of the tooth that is removed. This is done so the porcelain veneer, a thin shell of porcelain about the thickness of a fingernail, can be permanently bonded to the front of your teeth. Porcelain veneers are used frequently in a complete smile makeover whenever possible to transform the look of you smile.
In regard to a porcelain crown, much more of the tooth structure is removed. Not much will remain of your natural tooth in this procedure and the crown (cap) fits over top of the tooth. The preparation goes much deeper into the tooth. Here is a diagram to illustrate the preparation required for a dental crown. Since so much of your natural tooth structure is removed, there is a greater risk for nerve issues because the pulp is exposed. And if the nerves are bothered too much, an infection can result.
Based on what you have described with your case, it sounds like you had porcelain crowns done and not veneers.
It is possible that your teeth had large fillings or decay that required porcelain crowns to be done and porcelain veneers weren’t an option for you. And if that is indeed the case, it is not too surprising that you ended up with several root canals that were required. When a tooth has a large area of decay or other problems, the possibility for the pulp to become infected is possible. It sounds like you had a full mouth reconstruction versus a smile makeover. Porcelain veneers are used in a smile makeover more frequently. And for a full mouth reconstruction, crowns are usually used.
Either you dentist was much more aggressive than needed, or he failed to inform you of the risks with as much work that was required. Porcelain veneers are much less invasive and are used more cosmetic purposes.
Cosmetic dentistry is like an art. Some dentists may not have the proper training or experience and decide to do crowns since they are more familiar with the procedure. Porcelain veneers are not taught in dental school and require quite a bit of extra training to make them beautiful and natural-looking.
Unfortunately, at this point, your options are limited moving forward. It sounds like the crowns have been done, which has left you with very little natural tooth structure left on the crowned teeth. If they do require root canals at this point, that really is the best thing to do in order to save the tooth.
It’s interesting that your original dentist is offering to help cover the cost of the root canal treatments. You have to wonder if he is feeling bad about the situation and speculate that he may have been in over his head with this amount of dental work.
The next few months will be telling for you. Most problems should arise sooner than later regarding the possibility of root canals. Hopefully, the others stabilize and do not require any further treatment.
Sorry you are having to go through such a painful and expensive ordeal. Thank you for your willingness to share your story. Hopefully, it is helpful to others to better understand the differences in crowns and veneers.
This post is sponsored by York PA dentist Donald H. Currie, DMD.