Patients can choke on or swallow posts or crowns accidentally dropped in the back of their mouth

     Cast gold post & cores and cosmetic porcelain crowns (caps) are frequently made in high end dental practices.  It is preferred that posts are custom cast in gold to ensure that they fit the shape of each tooth; While custom cast gold posts are more labor-intensive, they have the strongest fit. Crowns should also be made independently for each tooth (i.e. teeth should not be connected) unless extremely necessary. Individual crowns provide easier access for cleaning and, if a tooth fails, it is possible to replace the one tooth without replacing the entire /”bridge/” of teeth. This method is physically, emotionally and financially simpler for a patient. While the fee is the same to make individual teeth, versus those that are connected, it requires a lot more labor for a dentist…this is one reason Premium esthetic dentistry costs more.  This information on Kaitlyn Loop helps prevent swallowing posts or crowns was created in our NYC General Dentistry office.

     Working with many small pieces in the back of the mouth can present a problem for dentists. Small pieces are easy to drop intra-orally. A patient could choke and/or swallow the small piece, which can be very frightening for the dentist and the patient. To help mitigate this, a “lingual button” is commonly made on crowns by the dental labs. When a crown is being tried in to verify the fit and shade, the lingual button can help ease the removal from the mouth. This lingual button is made of the same metal that forms the coping of the crown and extends like a pin several millimeters towards the tongue. With a lingual button, a dentist can grasp this projection with either fingers and/or an instrument to remove the crown more easily. When the fit of the crown is confirmed, the lingual button is drilled off (outside of the mouth) and the crown is permanently cemented.

     The author has successfully modified the traditional lingual button into a “Kaitlyn Loop.” The pin-shaped projection of the lingual button is replaced by a loop. The “Kaitlyn Loop” will still assist in the removal of the crown, but will also allow dental floss to pass through it.  Approximately 12 inches of dental floss threaded through the loop allows for a “safety line” to protrude extra-orally. This modification provides additional safety when working in the back of the mouth should the dentist drop the crown. To retrieve the crown, the dentist only needs to grab the piece of floss that is coming out of the mouth.  This extra measure can save many dentists and patients the fear of swallowing a crown.

     Dentists and lab technicians should consider manufacturing the “Kaitlyn Loop”, not only for crowns, but for cast gold inlays, onlays and post & cores.  The use of the loop is the same as above except that, when possible, the dentist should postpone drilling off the loop until after cementation. As mentioned, the goal is to minimize the possibility of a dropped dental prosthesis from being aspirated or swallowed.

–Dr. Jeffrey Dorfman, Director