Dr. Soheel Hussain Zargar
Dentistry
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I had a crown for my upper front teeth. The back of the crown was oversized near the gums and caused noticeable speech issues. The dentist ground the excess, which did not help and made it uneven. We are planning for a new crown. Is there any particular shape for the back teeth? Are they bulb-like towards the gums and need to be appropriately sized? When the impression is taken, do I have to bite down naturally with the front teeth slightly forward when compared to the lower, or do I try to bring the lower teeth forward to line up the top and bottom? I am thinking of instructing the lab to make the backside as evenly flat and thin as possible. Is this fine?
Hello,
Welcome to icliniq.com.
I read your query and can understand your concern.
This problem is due to technical errors in crown fabrication, tooth preparation, and placement. Furthermore, grinding will worsen things, and in the end, you will not get proper occlusion. I suggest you ask the dentist to remove the crown and fabricate a new crown.
Thank you and take care.
Patient's Query
Hello doctor,
Thanks for the reply.
I understand it is a technical error. So on the next try, before the new mould is sent to the lab, I want to inform the lab through the dentist to make the back of the crown as flat and thin as possible while maintaining the structural strength. Do you think making the backside as mentioned would generally be fine?
Hello,
Welcome back to icliniq.com.
I read your query and can understand your concern.
Tell the dentist to record the bite properly and create sufficient space between upper and lower back teeth so that teeth can adequately fit, and ask them to do a try-in with a coping before fitting a final crown, which will sort out the occlusal issues. Moreover, ask the dentist to call the technician during impression making and try in. This will help to design a proper crown.
Thank you and take care.
Patient's Query
Hello doctor,
Thank you for the reply.
The crowns were zirconia with no metal inside. Do I have to do the same for the next try? I also had a bridge in the lower right molar tooth and sometimes feel the gums have become sensitive around the molar bridge. I just got it done, so I am giving it a week or so to see if things return to normal. Can I expect this to return to normal? And the hard edge of the impression tray made a little tear in the gum tissue at the back of the mouth, and it is not healing. Eating a particular food on that side inflames and creates a terrible feeling. It feels like a big polyp that hardens the ridgeline at the back. Could it be an infection? I have used warm salt water rinses, but it does not go away. Is the polyp due to the tear during the impression procedure?
Hello,
Welcome back to icliniq.com.
Zirconia crowns have a warranty, so you need not worry if it is to be replaced. Yes, sometimes placing a bridge can cause gum soreness, so you can wait for one to two weeks to see if things improve.
I suggest you apply a Kenacort gel (Triamcinolone gel) topically three times daily for five days on the injured site.
Thank you and take care.
Patient's Query
Hello doctor,
Is there a sure way to get rid of the whiteness in the back of the tongue? I have lots of it and tongue scraping, mouth probiotics, etc. have not helped. Kindly suggest.
Hello,
Welcome back to icliniq.com.
If there is no visible whiteness and lacking from other areas of the mouth, then there is no issue. However, if there is gross whiteness, then we have to look into it. Like teeth, debris also collects on the tongue, which may cause reactionary hypertrophy causing whiteness. Can you kindly send a clear photograph of the area so that all apprehensions can be sorted out and accordingly you can be helped?
Thank you.
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