Invisalign With A Crown – The Final Steps

Where was I? All those months ago when I last filled you in on how my teeth were progressing I felt like I was almost at the end of this momentous tooth journey, but things have changed a lot since then. So much so that I feel I need to write a few posts to help you catch up with everything that has happened.
As you may or may not remember, my top teeth, as far as Invisalign were concerned, were essentially finished. There was just one problem though. However technically straight they were I still had that revolting front crown that had moved during treatment and which spoiled the effect of all the treatment. Invisalign with a crown is more complicated than standard Invisalign. You can see it clearly in this picture here.

So, after a lot of nervous procrastination I took a very big gulp and a large dose of valium and headed off to a prosthedontist to try and get my crown fixed. In case that word is new to you- it was to me- a prosthedontist is to crowns, what an orthodontist is to braces. Crowns, posts, implants and all that scary stuff are pretty much all they do. I asked around for the best prosthedontist in Brisbane, but in the end it came down to who was available- some of these specialists have months and months of waiting list.

Also, let me tell you these people are not cheap. As well as being more technically difficult, Invisalign with a crown adds to the expense too. I can’t remember the final bill exactly, but there wasn’t a lot of change from $4000 to get the crown sorted. Gulp. So I really wanted someone who would do a great job, as at that price, I would only be doing it once.

Before I went I had several fears. First, that they wouldn’t be able to get the old crown off… it had been there since I was 18, I felt like almost twenty years later it must be well and truly stuck. I had visions of my tooth being pulled out, and being left with a bloody, unfixable hole in my gum.

My second fear was that the prosthedontist would find a secret abcess hidden on the root of the tooth. I knew that before I had the original crown, some hideous procedure had happened that involved drilling through the root and putting a metal post in. It was all spectacularly vile, especially for someone as afraid of dentists as I am. Now, I had visions of him removing the crown only to find some hidden horror that would make my whole head cave in… ok, well not exactly, but something terrible.

Thirdly, I was terrified, truly terrified, that he would say I needed a dental implant. The kind that are drilled into your jawbone. Somehow, this seemed more terrifying than anything. Teeth are one thing, but messing with a jaw bone that is part of your skull- that’s horror movie style.

So, to say that I was nervous, would be the understatement of the year. Fortunately, the doctor I chose, whether the best or not, did have a fantastic bedside manner. I explained my fears at his insistence (the shaking gave me away) and one by one he explained why none of them would be a disaster. He then took lots of photos of my face and took me to his office where he pulled them all up on screen.

It was at that point that he explained to me that giving me a new crown would be easy, but that it would never look right as my gum line was not right. In order for teeth to look symmetrical the gums have to be right. You can do whatever you want to the teeth, but great teeth always have a great gum line. I sat there hyperventilating for a moment, then plucked up the courage to ask whether that meant… that I would need my gum lasered to give it the right shape. He frowned looking at the screen, and said “No, your gumline is too bad for that, to fix yours I really need to drill away a bit of the jawbone before I can reshape the gum.”

I let it hang for a moment before having a full blown (internal) panic attack. He gave me a few minutes to think about it and left me there whilst he went to get a coffee.

It took me five minutes of standing in front of the mirror in the bathroom splashing my face with icy water to keep myself from passing out before making my decision. I was going to do it. After all the time and money I had spent on my teeth, I wasn’t going to let one rogue gumline muck it all up. So, I walked back to the chair and asked him to do it as quickly as he could before I could change my mind.

The first part was numbing. This was horrible, purely as I am one of those people that truly believes that local anaesthetic (along with many, many other things)is likely to kill me. So as my mouth went numb, and part of my throat too, I was convinced I would die, and twice had to sit up in the chair to make sure I could breathe. Unlike a filling, when they will drill your bone you have to be very numb… so there were a lot of injections involved.

Once I was numb, breathing, and heart still beating in my chest, we moved on to removing the crown. This was really fairly simple. The prosthedontist simply drilled away the old crown, leaving what I’m afraid I can only describe as a stump.

Next came the scary part- the gum line alteration. Having my head lower than my feet and a mouth full of tools I’m not exactly sure what happened, but I am certain that it involved the cutting away of some gum with a scalpel,  then the peeling back of the gum and the drilling of bone. Actually, if you could get it out of your mind that someone was at that moment drilling your jawbone, it really wasn’t any worse than a large filling. It just felt like when one of the larger drills vibrates through your head, no more. I suppose this part lasted ten to twenty minutes, although judging time when you are as panicked as I was is not easy.

Then came the stitching up, which was fine-the numbness took care of that, and the shaping of the “stump” with drills etc. Finally a temporary crown was fitted. Surprisingly this looked pretty good already, and despite my abject terror during the procedure I walked out of the room happy that I had done it. This is what I looked like when I walked out. (The squeamish amongst you should look away now)

It was then a waiting game. The orthodontist wanted me to wait at least three months for the gum to settle. Gum heals quickly, but it also regrows to an extent. If you fit a new crown too soon, it can grow back, or recede and leave a black line along the edge of the tooth, meaning it needs to be redone. So, I waited five months (it’s good to be sure about these things, right!) During which time the temporary crown fell off once – horror story time and on a Thursday too, when the prosthedontist office wasn’t open again till the following Monday… you can imagine.

When I started this whole Invisalign process I wasn’t sure that Invisalign with a crown was even possible. I spent many hours googling the term ‘can you have Invisalign if you have a crown’ and there wasn’t complete consensus. Ultimately though, I am very happy with the end result which you can see below and happy to report that Invisalign with a crown is possible. The difference was worth the fear, slight pain and the money. I think!

Invisalign With A Crown Before & After Pictures