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Dentistry/to root canal or not to root canal ?


QUESTION: hello,
I might have to have tooth #31 extracted,( going to the endo next week to see if the tooth can be saved),how far along must a crack  be to be disqualified for a root canal?
If the tooth cannot be saved must i have an implant or bridge? CAN I LEAVE IT BLANK? Iam currently missing teeth#1,16,15,17.


ANSWER: Cadouri - A tooth cannot be saved if a crack has occurred that goes below the bone.  If it stops above the bone, the dentist can usually removed the broken part or he can place a filling to seal it off.  

If the tooth cannot be saved, replacing it is important if the tooth that is lost is supporting the bite.  Usually these are the molar teeth.  It seems that you still have tooth #32, the wisdom tooth behind #31. If so, it might come forward when #31 is extracted.  If there is no wisdom tooth behind and nothing above, then the loss of #31 might be appropriate, but if there is a tooth above that would bite on it, trying to save the tooth or having an implant or bridge is important to support the bite.  

If tooth #31 does have an infection and the dentist is not able to do a root canal treatment and rebuild the tooth due to a fracture below the bone, then an implant or bridge would be important.  If you have additional questions, feel free to contact me again.

---------- FOLLOW-UP ----------

QUESTION: dear Dr. Teig,
I was able to do a root canal on tooth #31. I finished it on May 4,2015.I guess the crack did not go below the bone. I also had/have? slight movement of tooth. Yesterday,I went to see a prosdodontist ,and he suggested a gold onlay.
I agree with the gold part, but I thought a crown was indicated. When he checked my tooth, and put some air on it ,  I was a little sensitive, but did not say anything. He mentioned this was a pristine tooth and an onlay is in order.I said that it had a crack but this did not change his recommendation.I am running out of time,but my gut is telling me a crown, not an onlay.
WhAT DO YOU THINK?The onlay is not as protective,is it? ALSO IAM GETTING MIXED messages of how long i have to crown it?WHAT shouldI do?

         MANY THANKS,  

Cadouri-I totally agree with you.  A tooth that has undergone root canal treatment is more brittle than teeth without root canal treatment, because the tooth is no longer vital.  A non-vital tooth can become more brittle.  For that reason, a tooth that has undergone root canal treatment needs support from the outside of the tooth with a crown, versus a hard inlay filling within the tooth.  So I agree that the tooth should be crowned and not have an inlay.

If you have additional questions, feel free to contact me again.


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Joel S. Teig, DMD, Diplomate ABOMS, retired


I am a board certified oral and maxillofacial surgeon and I am available to answer questions related to tooth extractions, implant insertion, facial recontruction, facial and oral tumor removal, TMJ dysfunction and various successful treatments, including surgery if all else fails, and occlusal discrepancy requiring orthognathic or jaw surgery.


Board Certified Oral and Maxillofacial Surgeon practicine for over 20 years. Assistant Clincal Professor and State University School of Dentistry.

American Dental Association, American Association of Oral and Maxillofacial Surgeons, American Board of Oral and Maxillofacial Surgeons

BA -University of Connecticut DMD - University of Pennsylvania School of Dental Medicine

Awards and Honors
National Honor Society (OKU), Philadelphia County Dental Society, Mosby Book Award, Oral Surgery Honors, Summa Cum Laude

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