Expert: Gary Backlund, DMD, MSD - 6/20/2005

Question
I had a filling put in my #31 tooth about 3 months ago. Shortly afterwards I began experiencing pain when chewing & now I have pain when anything cold touches it. My dentist sent me to an Endodontist. He says I have a cracked tooth and need a root canal & a crown. The crack cannot be seen even on an x-ray. Could there be a problem with the filling & not my tooth? Do I need a root canal if the tooth is cracked or will a crown be enough to fix the problem?

Answer
Hi Margie,

WOW...sounds like things got complicated quickly. Cracked teeth are one of the MOST difficult things we, as endodontists, deal with. There just simply is no right way to handle things and that can be VERY frustrating for the patient and the dentist.

That said, it sounds like your symptoms are consistent with a cracked tooth. I doubt there is anything wrong with the filling...it just doesn't happen that way. When you have chewing AND cold sensitivity, it is almost always a crack and will need at least a crown. Then the question becomes, "do I need a root canal first?" The answer is...it depends. If the pain is ONLY when you chew or have cold, there is a possibility that placing a crown could solve the problem. In my office, we often suggest that the patient have a good fitting temporary crown made and wear it for 3 months. If the pain goes away, then just get the fianl crown. If it doesn't, then a root canal will be necessary. Obviously, this means the patient could have to put up with symptoms for up to 3 months. If the pain is bad, it isn't worth it and it is better to just do the root canal and move on. The choice is left to the patient since they are the ones living with the problem.

As I said, there is no right answer. Hopefully this will help your decision. Good luck!

Gary Backlund DMD, MSD