Crown broken twice in two years - replace or get tooth extracted?

zepman

Apologies if this is too long.

2 years ago, I had a root canal done on my lower left second molar. Within the following month or so, I also had a crown fitted on the tooth.

About 9 months later, the crown broke while I was having my regular meal. So I went back to the dentist who said it was probably weakened when I got the adjacent impacted wisdom tooth extracted (4-5 months after the crown was fit). She then replaced the crown in a couple of weeks.

Last Friday (about a year and a half after the crown was replaced), a corner of the crown broke off (while eating a scone). Took an appointment to see the dentist the same day. Had to see a different dentist in the same clinic since my regular one is away until January. After a quick checkup, she said that since the crown has broken a second time, she would have to think about the next steps.

I had a longer appointment this afternoon, during which she took a mould of my teeth for a nightguard, removed the broken crown, and placed a temporary crown. She said that she wanted to see how the temporary one fares over the next few weeks, and to think about other solutions in the meantime as simply placing another crown would be pointless if it's going to keep breaking. She spoke about bite adjustment etc, which would have to be done by my regular dentist who is an expert in the area. Basically, she wanted to buy more time until my regular dentist is back.

I knew I had to be careful about what I ate with the temporary crown in place, so I only had soft, almost liquid food today that I didn't have to chew much. Whatever little I did chew, I did so on the other side of the mouth. But, the temporary crown came off while I was drinking water. So it only lasted about 6 hours.

This is causing me so much distress. The clinic was close by when I used to live in South Dublin 2 years ago, but I moved to the North side last year and it's now a dreadful 1-hour drive away. I have continued to go there merely because of this crown issue since they didn't charge me for the first replacement, and also didn't charge me on Friday or today. I was told that the nightguard would be €250 if I wanted to go for it, but I decided to give it some thought first.

Would it be better to have the tooth extracted?

Crown fractures are rare, two suggests occlusal/bite problems, or, in an effort to retain as much of your weakened natural tooth as possible, the Dentist may have done minimal reduction of the tooth, as a result the porcelain may be thin.

At this stage I’d be considering a cast gold crown rather than a porcelain one, and the bite guard is a must afterwards if your teeth show evidence of wear due to clenching/grinding.