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Can a "cast post and core" be done by a general dentist?
Sent to Dental Experts October 01 03:08 PM

I have had 2 root canal's and a retreatment on tooth # 9 over the past 20 years. The dentist is telling me she can not replace the crown on this tooth because I need a "Cast post and core" She can not do this in her office. She is a general dentist. She referred me to a prostadontist, which my insurance will cover NONE of. Can this "cast post and core" he done by a general dentist?

 

Customer (name blocked for privacy)
Status:  Closed   Value: $9
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October 1 5:17 PM (2 hours and 8 minutes and 42 seconds later)
         
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October 1 10:07 PM (4 hours and 50 minutes later)
         
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A cast and post are usually done in a general practitioners office. These are not uncommon and are done when there is not enough tooth structure left to secure a crown. Rarely is this procedure referred out to a specialist. A dental implant is an entirely different procedure and is done afer the tooth and remaining root has been extracted.

Before a cast and post is done, a good root canal must be done in the tooth. The post extends down into the canal. This requires removal of some of the root canal filling. It is possible that your dentist wants to refer out your case because of problems with the root canal. After retreatments, there may be some problem that your general dentist feels are beyond her expertise. A tooth that has been retreated twice for a root canal does not have a good prognosis. If your insurance does not cover a prosthdontist, but does cover an endodontist (root canal specialist), perhaps you could see the root canal specialist to have the post space prepared and readied for a crown, and then the general dentist could finish the job. I would not pressure a general dentist to do a job that they prefer to send out to a specialist. It means that they do not feel that they can do a good job, considering the complications. You should see an endodontist for an opinion on if the tooth is a good candidate for a post an crown. It may be better to have it extracted, if it is in such poor condition, and have a bridge made. This would also most likely be covered by your insurance.

I hope this helps.

Sincerely, Jewel Simpson

1 Other Expert Agrees with this!
Jewel Simpson, DDS -- Dentist -- 100% Positive Feedback on 2 Dental Accepts
DDS, UCLA School of Dentistry, 1973, 35 years of private practice, 10 years of holistic private prac
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October 2 10:26 AM (12 hours and 18 minutes and 22 seconds later)
         
Reply to Jewel Simpson, DDS's Post: My first root canal was when I was 8 after I broke my adult tooth. The second root canal was when I got my braces off and the dentist was preparing the tooth for a perm crown. I have had this crown for 13 years. I had to have a retreatment of the root canal because there was an infection. My general dentist sent me to an endodontist and he performed the retreatment and sent me back to my general dentist. After looking at the x-rays from the endodotist she refered me to a prosthdontist. Once at the prosthdontist they informed me the retreatment looked great and then told me it would $2200 to fix this tooth, none of which is covered by my insurance. I called my general dentist back and explained and asked if this could be done by a general dentist and she said yes but she had no suggestions as to who to refer me to. I just feel very uncertain because so far the dentist I have spoken with were not very informative once they found out they couldnt help me or I couldnt afford to pay their cost. I just wanted to be certain this would be something that a general dentist was familiar with. So, if both the general dentist and the prosthdontist said the root canal was in great condition I shouldnt worry about having another dentist do the cast post and core? Now I am worried about asking for implant information???
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October 2 11:03 AM (37 minutes and 15 seconds later)
         
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Jewel Simpson, DDS -- Dentist -- 100% Positive Feedback on 2 Dental Accepts
DDS, UCLA School of Dentistry, 1973, 35 years of private practice, 10 years of holistic private prac
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October 2 11:23 AM (19 minutes and 54 seconds later)
         
Thank you! Your information was very helpful. The endodontist did refer me back to my general dentist and she looked at the x-rays and referred me to the prosthdontist (which happens to be her friend)

My insurance will not cover work by a prosthdontist, he is the one who quoted me $675 for the cast post and core, $300 for a provision crown, $950 for the permanent crown and $200 for the lab work. $2220 total for cast post core and crown???? Is this portional with other specialist cost?

However the cast post and core and crown would be covered by insurance if I were to have it done by a general dentist on my DMO plan. I have made an appt with another dentist (in the same group as my first dentist) for a second opinion. This dentist/oral surgeon extracted my wisdom teeth a few months ago and he just wasnt available when all this came up a few weeks ago. I should have trusted my instincts and waited for him. I do have the x-rays from the endodontist and a set from the prosthdontist. So hopefully this should be sufficient for the second opinion. If he tells me to have this done by a specialist I will feel more comfortable with his decision and firgure out a way to pay! Again thank you for all of your help!
Customer (name blocked for privacy)
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October 2 11:30 AM (7 minutes and 24 seconds later)
         
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Jewel Simpson, DDS -- Dentist -- 100% Positive Feedback on 2 Dental Accepts
DDS, UCLA School of Dentistry, 1973, 35 years of private practice, 10 years of holistic private prac
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October 2 2:57 PM (3 hours and 27 minutes and 21 seconds later)
         
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Jewel Simpson, DDS -- Dentist -- 100% Positive Feedback on 2 Dental Accepts
DDS, UCLA School of Dentistry, 1973, 35 years of private practice, 10 years of holistic private prac
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