Dental implants or dental crowns for worn down molars
December 1, 2016 2:16 PM   Subscribe

Over the years I have worn down my back teeth due to Bruxism (I'm 63). My dentist recommended crowns on the back teeth to build them up so that my bottom teeth don't cut into the roof of my mouth, but I am thinking dental implants would make more sense. Any thoughts?

I am thinking that implants would last longer than crowns and the type of tooth with the implant would be more durable and resistant to the grinding down effect of Bruxism. I *will* start wearing a bite plate (I have been negligent in wearing one because I have nightmares that I'm chocking when I have one in my mouth).
posted by ConnieL to Health & Fitness (15 answers total) 3 users marked this as a favorite
New machine carved crowns are significantly more durable than porcelain fired crowns used on implants .
posted by hortense at 2:25 PM on December 1, 2016 [3 favorites]

Dental implants are dramatically more invasive. With a crown, they cover the remains of an existing tooth. With an implant, they drill into the bone. If things go badly with a crown, you can just have the tooth pulled. If things go badly with an implant, the tooth is already gone and now you are talking bone loss.

Implants also seem to cost scads of money, based on figures I saw when I used to process insurance claims.
posted by Michele in California at 2:34 PM on December 1, 2016 [3 favorites]

Don't pull teeth that are intact in order to get implants. Get reinforced crowns. I'm 20 years younger than you and have 4 crowns on teeth that have significant cracking damage due to bruxism. I have zirconium crowns (much stronger than porcelain) with metal underlay for strength. They're holding up great. I wear a night guard every night, but I had to try several to find one that I didn't spit out and could sleep with comfortably. It took a lot of dedication to get into the habit of wearing one. But, now I can't sleep without it.
posted by quince at 2:50 PM on December 1, 2016 [6 favorites]

I am 15 months into the dental implant process for one front-ish tooth that broke and didn't leave enough healthy tooth behind to put a crown onto. It's an expensive, invasive process and since your teeth are still intact, I would never, ever, EVER recommend this process for that.
posted by kimberussell at 2:55 PM on December 1, 2016 [5 favorites]

I'd say crowns. As long as everything else is healthy, usually the more original tooth that is kept, the better.
posted by pearshaped at 2:57 PM on December 1, 2016 [1 favorite]

Implants also rely on bone density and healing to properly set in place. There are no guarantees that they will anchor adequately, so they can fail through biology rather than their material integrity. This isn't a concern with crowns.
posted by late afternoon dreaming hotel at 3:00 PM on December 1, 2016 [2 favorites]

Implants are like a last-line thing. They take FOREVER to heal. Even if you get the screw placed right after the tooth is pulled, it takes like 12+weeks for your bone to heal before you have a tooth. Otherwise it can take even longer if you let the bone heal first then drill into it.

Get the crowns. It's like a week or two for them to machine the permanent crown and in the meantime you'll have a temporary which will get at least somewhat useful, rather than a healing throbbing hole in your jaw. You can get an implant after a crown but you can't put a tooth back in. Plus it's way less painful, especially if they're capping versus doing a root canal.

I have a crown and I have an implant post (without a tooth) so just ones less tooth in the back of my mouth. I'd much rather have done a crown on that implant tooth. My crown was placed on a tooth that had cracked and was developing damage along the repair line. Then I had a root canal done through the crown and the crown (3 ish years later) is still fine. It may break at some point but can be replaced.
posted by Crystalinne at 4:16 PM on December 1, 2016 [1 favorite]

Regarding the bite splint, ask your dentist about getting a different style than you used to have. My first one was hard plastic and really bulky. It similarly messed with my dreams, and I'd end up taking it out in the middle of the night and find it on the floor (gross!). The one I have now is a soft, rubbery material. I have to get it replaced every few years, but it's much less invasive and more comfortable.
posted by radioamy at 4:59 PM on December 1, 2016 [1 favorite]

If the root and tooth are otherwise healthy, absolutely keep the tooth and crown it.
posted by cecic at 5:01 PM on December 1, 2016 [1 favorite]

I am a dentist and everyone here who has recommended keeping your own teeth has given you good advice.
posted by OHenryPacey at 8:07 PM on December 1, 2016 [8 favorites]

this is not your question, so please forgive me if this is unwelcome, but some people have found taking magnesium citrate to be very helpful with bruxism; it helps relax the muscles which cause you to clench your jaw. this will not fix your tooth loss but might help to slow the process? anyways, it's a cheap supplement and might be worth a try.
posted by andreapandrea at 9:33 PM on December 1, 2016 [2 favorites]

I'm 47 and about to get my third implant. They are a great alternative to *bridges* which are required when a tooth gets pulled, but not to *crowns* which is a bit of the same idea as implants except that rather than be embedded in your jaw by a screw, they're embedded in your jaw by the natural underlying tooth structure.

Keep your teeth! Get some crowns! Implants are 3-5K per, are a three month long process minimum, and involve removal of the tooth, healing, placement of the screw and/or a bone graft if the screw can't be embedded right away, healing, fitting for a crown, temporary crown, final crown.

My new one is going to be a complete process in three months, but my first took a year. It depends on what process they're using and how much bone structure they have to work with but it's really not something you'd do casually when there's a less invasive, expensive, and tedious way to do it.

Also, if you aren't aware having not previously had the pleasure: getting a tooth yanked is not the world's least graphic or most pleasant experience.
posted by A Terrible Llama at 6:31 AM on December 2, 2016 [1 favorite]

Anecdata: I don't have bruxism, but I have crowns that are almost forty years old. They can last a very long time.

I have one implant. As said many times above, that's a much more invasive, lengthy, and expensive process.
posted by FencingGal at 6:58 AM on December 2, 2016 [1 favorite]

Keep your own teeth for as long as you can. If they decay have them filled, if they die have them root canalled, if they wear or break have them crowned. Seriously. They are the perfectly designed system for human mouths. Unless you are in daily pain then keep your teeth!
posted by intergalacticvelvet at 7:45 AM on December 2, 2016 [1 favorite]

Wow, thanks everyone! Some *really* helpful advice here! :) I will ask for the soft bite plate, I've already ordered the Magnesium and will defiantly go with the crowns. You guys rock!!
posted by ConnieL at 11:05 AM on December 2, 2016 [4 favorites]

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