Crown for an rct tooth

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Joined: Fri Dec 08, 2017 1:38 pm

Crown for an rct tooth

Post by pshadow » Wed Jan 10, 2018 2:47 pm

If I have to get a crown for a lower molar that had an rct and core build done almost two months ago would I still require local anesthesia for crown prep? Are the shots likely to be as extensive (i was given multiple blocks) as during rct or something lighter like just a lingual infiltration?

Also would dentist skill come into play for not affecting the proximally contacting pre molar? I mean is the technique basic that most would have mastered.

Thanks Doctors!

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Re: Crown for an rct tooth

Post by mbornfeld » Wed Jan 10, 2018 4:16 pm

would I still require local anesthesia for crown prep?
Because the use of anesthetic has as much to do with subjective matters of comfort than anything else, whether to administer and how to administer anesthetic is discretionary. An endodontically treated tooth cannot perceive pain itself, but the gum tissue surrounding it can. Depending on how your dentist prepares your tooth, anesthetic would be more or less appropriate. In most cases, crown preparation is extended to or slightly below the gum line, which would ordinarily favor the use of an anesthetic. Block anesthesia would not be required; a local infiltration on the inner-facing (lingual) and outer-facing (buccal) gingivae would suffice.
Also would dentist skill come into play for not affecting the proximally contacting pre molar?
Does skill enter into the picture when driving? Even an experienced driver can pay a heavy price for a moment's inattention. Skill is always a factor.
Mark Bornfeld DDS
Brooklyn, NY

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Re: Crown for an rct tooth

Post by pshadow » Sat Jan 13, 2018 12:10 pm

Thanks for your help.
mbornfeld wrote:
Wed Jan 10, 2018 4:16 pm
Skill is always a factor.
Well with due respect to 'skill', I am kind of looking to see if while prepping for crown my virgin second bicuspid in proximal contact with the prepping tooth is not even scraped. Is this kind of like bicycling skill that is kind of automatic for dentists or... Well I don't find the putty impression for tooth experience to be pleasant, so am kind of hunting for a dentist with intra oral dental scanner (kinda rare in my city). If dentist's skill vary widely that the proximal contact is a problem for most... I might decide to ditch my comfort and go for an experienced dentist.

Please note: The dentistry practice here is more like everybody does everything (that is very rare referrals to specialists ). Also I would understand if you don't want to respond.

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Re: Crown for an rct tooth

Post by sbornfeld » Sat Jan 13, 2018 12:51 pm

It is reasonable to assume that there is a minimum requisite skill a dentist will possess that will allow him/her to perform all phases of dentistry offered to patients. This includes preparing a tooth for a crown with minimal damage to other structures. In some circumstances (for example, a patient with limited jaw opening, or severe dental crowding) this might be quite challenging. Of course, there is a whole spectrum of competence that can be found "out there", so you should ideally aim to find the most experienced and competent dentist you can.
And as a long-time avid cyclist, I can assure you that there are people out there riding their bicycles "automatically" who most definitely should be addressing their movement with more thought.
Steven Bornfeld, DDS
Brooklyn, NY

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