Cracked tooth

crótach

Hi folks,

About 4 weeks ago I cracked a tooth, the bottom back molar (number 5), by biting on a popcorn kern. The tooth had a filling in the middle and as I bit on the kern it hit the filling and the impact has cracked the tooth but left the filling intact (brilliant).

I went straight to my dentist and he replaced the amalgam filling and sealed the cracks with an epoxy resin filling, went for a checkup 2 weeks later and it still wasn't good, so he filed the tooth down a bit to keep the bite off it.

I'm going again this week and after 4 weeks the tooth isn't much better. I can't chew food on that side of the mouth at all, and even something soft like chewing gum causes pain. The tooth looks aesthetically fine but it's obviously not working out.

He suggested last time that if the pain wasn't gone he could take out the new filling and replace it again, looking for possibly more cracks in the tooth that he didn't manage to seal. And he mentioned crowning it in case that doesn't help.

I don't particularly want to go through another 4 weeks of this, but at the moment I don't see what else I can do.

Is there anything I should be asking my dentist? Or anything that he should be doing?

I read up about it on the internet a bit, and it sounds like neither the filling nor the crown are going to fix it if the crack has gone below the gum line, which I have no idea. Absolutely last thing I want to do is spend months and thousands of euro trying to save a tooth that is beyond help, only to have an abscess form in the tooth a year after the crown and have it taken out, or something like that. Google is a bit of a scary place to look for information, at least half the sites tell you that you have cancer or try to sell you stuff. :P

So I'm hoping for some advice, or feedback if anyone's gone through something similar. Thanks!

BryanL

Sounds like your dentist is trying to avoid the most expensive option, a crown, once the crack doesn't go too deep it'd bind the tooth together to stop you getting pain on biting etc.
Sometimes even with a crown the nerve doesn't recover from the irritation of being cracked and dies, requiring the tooth to have root canal treatment as well.
I agree Google is a shocking place for info.
Bryan

crótach

I was wondering, if he suggest a crown this time (I'm going to see him tomorrow) would I be better off asking him to do a root canal treatment first?

My worry is, if he crowns the tooth and the nerve still dies, will he then have to destroy the new crown in order to do root canal treatment on the tooth, and then put a new one over it?

You can probably see where I'm going with this... the dentist is trying out the least expensive options first, but if I end up paying for two fillings, two crowns and a root canal treatment in the end, then it won't be all that cheap after all.

And if the crack went under the gum line, is there any point in doing any of this? Can it still be saved with RCT and crown, or is the only option there an extraction?

BryanL

yeah i know where your coming for,
if the tooth is crowned you've about a 6-1 chance the nerve will need a root canal later( this can be years later)
If a crowned tooth has to be root treated you can go through the crown without destroying it and placing a new one.
Doing a root canal treatment followed by a crown is certainly the way to ensure no further problems. But in most cases it would be over kill by a dentist and hard to defend against allegations of profiteering( which pop up quite often on boards!)
so the question is do you feel lucky?
Bryan

georgieporgy

Crotach, if your tooth is sensitive to temperature (esp cold) it is best to go ahead and have root canal prior to crown. I mean quite sensitive, not a vague sensation.

If it only hurts when biting then most likely a crown is all you need. Root canals are great if you need them. However your tooth will be stronger/healthier/better without root canal. And one thing you certainly don't need is a botched root canal, esp if it wasn't necessary in the first case.

Your dentist is being conservative to avoid excessive treatment. That is good. He obviously has your best interests in mind.If his first attempt with a filling hasn't worked just let him know you want to go ahead with a crown it if that's what it needs.

please keep in mind I haven't seen your tooth and have no wish to second guess your dentist. You need to tell him/her what you are telling us.