Fillings, Crowns and Labs… What you need to know

Injection of local anesthetic is common for most procedures: It provides patient comfort during restorative dental care. Two or three injections are often needed with normal effects ranging from 2 – 12 hours post injection. It is okay to eat and drink, but keep in mind that sensation to biting forces and temperature is impaired. Please be careful. Almost all discomfort associated with dental procedures postoperatively is due to the injection/s and not the actual procedure. Swelling, bruising and generalized discomfort at the injection site as a result of soft tissue trauma are common for up to 10 days. The discomfort may radiate and spread. Most patients feel little or no discomfort by the following day.

Before a filling is placed; cracks, decay and all old decay and all old defective restorative materials (usually amalgam, gold, ceramic or old composite) are completely removed. Dental composite (white filling materials) is placed over a bonding agent, which bonds composite to tooth structure. Sensitivity is normal and can last for 2 – 3 weeks following fillings, however 1 – 2 days is more common. Dental composites, similar to enamel, are very susceptible to acidic environments, and their lifespan is largely dependent on clenching/grinding habits, oral hygiene habits and oral pH. Similar to enamel, items with low (acidic) pH such as coffee, soda, tea and wine, greatly affect the lifetime serviceability of restorations. Because patients are often “numb” when the bite is checked, fillings may feel “high” once the anesthesia wears off. In case, please call and return to the office for a bite adjustment.

The Crown and process:
The purpose of a crown is to replace the structure, function and esthetics of a damaged or defective tooth. This protects the tooth, and often nerve, from future damage. Crowns are all-ceramic (highly esthetic restorations), porcelain fuse to a gold alloy, or all gold that fully cover teeth. To prepare a tooth for a crown, the visible portion is reduced in all dimensions (360 degrees) by 1 – 2.5mm. All damaged tooth structure (including decay, fractures and old fillings) is removed. Sometimes, fractures decay and old restorations extend under the gum line. In this case, a laser is required to remove the gum tissue so that healthy tooth structure can be exposed and prepped. This process is called a “gingivectomy using a diode laser.” Tooth structure that needs to be replaced, to aid in the retention of the crown, is called the “buildup.”

Temporary crowns are temporary! They protect the tooth and prevent space closure prior to final crown cementation. Temporary crowns can be in place for weeks to months. The temporary crown should not feel “high” and will not feel like a natural tooth or like the permanent crown. We recommend brushing the temporary crown as usual. To avoid pulling the temporary crown off while flossing, pull floss “down” between teeth then pull floss out to the side and remove. Avoid sticky or hard foods, like caramel, chewing gum or nuts. If the temporary crown comes off and you have a scheduled appointment to have the permanent crown cemented within a few days, do not worry. You will not hurt the tooth underneath. If you are not going to have the permanent crown cemented soon call the office and arrange to have the temporary crown recemented to avoid tooth movement.

** For your comfort, we strongly recommend that all patients who are not contraindicated to use 600 – 800mg of ibuprofen (Advil, Motrin, etc.) every 8 hours for as long as 5 days following crown and filling appointments. It is best to take the first dose of ibuprofen before the anesthetic wears off. **