Expert: Frederick R. Liewehr DDS, MS, FICD - 2/21/2009

Question
This morning I went in for a routine cleaning and the dentist found a crack in one of my molars. It does not hurt and is not sensitive to the cold. He said it did not run below the gum line, but recommended getting a crown to prevent it from getting worse and possibly needing an implant. Is this a common prophylaxis? Any figures available on how likely a crack is to progress? I am 62 years old and in good health. Thanks.

Answer
I couldn't tell you without seeing you. Many teeth appear to have crack or craze lines but are perfectly solid. Others split and need to be extracted. Generally "cracked tooth syndrome" portends potential split. The symptoms are pain on biting and pain to cold. If you have neither, your dentist should have you bite selectively on different cusps. If this is not painful, I wouldn't prep it with a crown, because that can create its own problems. If he understands occlusion, he should be able to reshape the tooth to eliminate what are called balancing interferences which are the most likely to split your tooth.