Expert: Mark Bornfeld DDS - 9/25/2007

Question
Hi,  I had a root canal on a tooth maybe 2 or 3 years ago. I have several teeth with root canals. My one tooth, the last tooh on the upper left side, is all broken and cracked. The denist a while back tried to put a temporary filling in but it fell out right away. I did not have the money to get the crown or cap. Now I had pain in the gum around the front of the tooth and the denist said it was infected and gave me antibiotics. I finished them. The denist told me after he took an exray that there was a fracture in my tooth and I should have it extracted after the infection is gone. it has been about 3 weeks and now the gum hurts on the back of the gum on that same tooth. My question is, when you have a fracture in a tooth is there any hope of saving the tooth and not having it extracted? I ask because my dentist who by the way I do not like said he would be afraid if he put a cap or crown on it it may come out when I'm asleep and I might choke. Is this a real possibility? I am going for a second openion. THANKS TERRI

Answer
Dear Terri,

A fracture may or may not allow salvage of a tooth, depending on its extent and orientation. For example, if the crack is limited to the visible part of a tooth and doesn't end too far beneath the gum line, it is often possible to restore the tooth. Sometimes this requires additional adjunctive services, such as the placement of a root canal post or surgical removal of gum tissue to expose more of the tooth.

However, vertical root fractures that extend deep beneath the gum and bone often leave no option other than extraction.

There are some cases that are equivocal, and then it becomes necessary for the patient and dentist to honestly decide whether the effort and expense is justified by the uncertain future of the tooth.

You are doing the right thing by getting a second opinion...

Mark Bornfeld DDS
www.dentaltwins.com
Brooklyn, NY