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Dentistry/Bad taste and a loose (portion) of a tooth


Last week I was eating a piece of bread when all of a sudden I felt something break off my tooth.  I unfortunately swallowed whatever it was that broke off, but it was from an upper molar that has previously had a filling.  I went to see a dentist, about it but strangely enough, all he said was the filling was there and everything was all good, and quickly shuffled me out the door.  Later I have found that the tooth has a foul bitter taste to it, and the back half of the molar seems a little loose while the front end is stable.  The tooth itself does not cause me any pain unless I try to eat on that side.  If there is pressure on that tooth, I get a sharp, searing pain that immediately goes away once i take pressure off.  So, in short, what I have is a tooth that tastes rancid, is partially loose, and will cause pain only if pressure is applied to it.  What on Earth could possibly be going on?  Thanks for your time.

Hi Martin and thanks for your question.

While it is very difficult for me to give a definitive diagnosis without being able to physically examine and evaluate your situation, from what you have explained me, I can offer the following:

I suspect that you have either fractured part of your tooth, which was probably heavily filled at some point, which may or may not include part of this filling as well.  Depending on the position and depth of this fracture in relation to the nerve of the tooth and on the degree of mobility of the fractured section if it is still in situ, your symptoms would vary. What we usually see, is one of the supporting walls of a tooth breaks away under the constant stresses and strains of function, especially if a tooth contains a large restoration which decreases the overall compression stress that a tooth can be exposed to. Any filled tooth is always considerably weaker and more prone to future fracture than an unfilled tooth and for large part, it is sometimes a waiting game until this eventually happens.

There is a possibility that this tooth has had a root canal treatment done on it previously, which would certainly explain the absence of intense and chronic pain symptoms.  Root canal treated teeth should always be crowned within 6 months of completing the root canal on them, because by removing the nerve and blood supply form within the tooth, it inherently becomes more "glassy", brittle and prone to future fracture. The fact that you do not have any obvious pain without function, is therefore not remarkable and this must not deter you from having this properly treated, because leaving this tooth as it is, could land you pretty serious medical problems if you develop an infection and it spreads into your sinus cavities. Bare in mind that there is only a thin bony plate between the nasal and sinus cavities and the brain and any infection will have little problem gradually dissolving the bone until communication is made with your most important organ of all...

Depending on the depth and position of this suspected fracture and the integrity and health of the remaining tooth structure, the remainder section of tooth in your mouth could be crowned if your dentists feels there is enough viable tooth structure on which to construct a sturdy core. However, majority of tooth fractures, especially those which involve the deeper sections of the tooth under the gum line and which extend in the root of the tooth, have a less than hopeful prognosis and the best option is to extract the remaining section of tooth and then decide on an appropriate way to close the gap up after the area has healed with a fixed or removable prosthesis.

If I was you, I would most certainly find a new and caring dentist who actually knows what they are doing and why they are doing it - one who cares about their patients and their general health and can diagnose, treat and if need be, refer patients for appropriate treatment if they feel their patients needs would be better suited elsewhere.  Most definitely not allowing a patient, such as yourself, to walk out the surgery after they had presented for treatment and advice with an existing and obvious problem. I am not one to advocate this, but in the best interest of the dental profession and in the hope of ensuring an acceptable and safe level of patient care internationally, a code which all clinicians should be aware of an adhere to according to our Hippocratic Oath, I would consider reporting this matter to your local Health Authority.  Of course, if you have a follow appointment with this dentist in which treatment is to be done, then rather hold off on this. It could so have been that time and pressure did not allow for full and proper explanation of your immediate situation and this would hopefully take place before any treatment is started on this tooth, so that you have the choice of which treatment option suits you best.

I hope this helps and wish you all the best further - but what ever you do, do not dismiss this as unimportant and please get this tooth treated appropriately by a clinician who cares about your mouth as much as you do. Take care

Kind regards
Dr Craig Peck


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Dr Craig W Peck ( B.Med.Sc., B.Ch.D., Clin. Botox, Cosmet. Derm.)


I am a General Dental Practitioner, with special interests in Cosmetic Dentistry & facial aesthetics and Periodontology, placing a strong emphasis on the establishment and maintenance of a healthy periodontium (the support structure of the tooth) before cosmetic options are considered. I uphold all principles of prevention above interventional treatment and try as far as possible, to remain conservative in my approach. I believe in detailed, open and honest patient discussion, establishing what the patients expectations are and what the reality is of achieving this and involving the patient at every level of the treatment. I have strong principles on ethical treatment and appropriate patient management. I have chosen to treat and rehabilitate many nervous and phobic patients, who, for whatever reason, find it impossible to take part in the very important task of even a routine check-up. I will accept questions relating to general and cosmetic dentistry (in conjunction with the use of facial cosmetic procedures) and dental fears/phobias. I will be more than willing to answer any academic questions in dentistry, biology, physiology, psychology and health sciences in general. As most dentists will tell you, there is often not only one way of dealing with a dental issue - so very often, there is no precise right and wrong way of approaching the problem. All clinicians vary when it comes to treatments and what works best in their hands is often the treatment that is advised. Be understanding of this and bear in mind that nothing lasts forever! Patients are happy to accept only a one-years warrantee when buying a new car, but seem to expect that dental work is going to last them their lifetime.


I have worked for many years in the UK and RSA as a general dental practitioner - within the NHS, private practice and the government dental health services. I am certificated for the administration of Botox and Dermal Fillers for facial lines and wrinkles as I have attended further courses in minimally invasive facial cosmetic procedures. I started seeing an increasing number of patients who presented with severe to moderate dental fears, even with full-blown phobias, so I started with the slow and patient task of tackling this problem and have successfully rehabilitated many patients. The key is good, effective, concise and understandable communication, shifting control from the dentist to the patient in order to slowly, but confidently, regain their trust back in dentistry, thereby giving them the feeling of achievement and this self-empowerment which drives them to the next level of treatment.

Academy of General Dentistry. American Dental Education Association. IAPAM (International Association for Physicians in Aesthetic Medicine). Professional Speakers, Writers and Managements Consultants in Dentistry. The British Dental Association. UK Aesthetics Group. ARC - Aesthetic Professionals. Botox. Aesthetics & Beauty. American Association for Dental Research. FDI - World Dental Federation. SOURCE1uk. World Dental Hygiene Forum. ProDentalCPD. Public Health Dentistry. Dentist Network. LinkedIn. Who's Who of South Africa.

B.Med.Sc. Degree (Medical Physiology and Medical Virology; Physiology Cum Laude; Stell 1994). B.Ch.D. Degree (Bachelor of Dental Surgery; Clinical Dentistry Cum Laude; Stell 1997). CPR and CPR-Advanced Courses (2000/2001; UK). Clinical Botox (UK, 2001). Cosmetic Dermatology (Botox and Dermal Fillers; RSA 2011).

Awards and Honors
Placed on the Dean's List at University for academic achievement (1994). Highest achievement in the subject Dental Materials. Medal from 3M and the Radiology Association of South Africa for highest achievement in the subject Dental Radiology and Imaging. Medal from The Periodontal Association of South Africa for highest achievement in the subject Periodontology. Highest achievement for Oral Medicine. Highest achievement in Oral Pathology. Received the DASA (Dental Ass. of South Africa) Gold Medal for highest achieving dental student across the 5 1/2 years of the Degree. Passed the subject, Clinical Dentistry with distinction in final year.

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