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Avatar universal

Cracked Molar options?

Hi. I'm at a loss about what to do here. I have my top right molar second to last (#3?) that had a hairline crack after a deep filling 8 years ago. Sadly I never dealt with it, and I'd was difficult to chew tough things on that side. I did have a couple dentists look at over the years, one adjusted the bite, and none ever saw any decay. My current dentist wants to just crown it. But if it's cracked, won't it still hurt when I chew?? He says we'd have to see, which seems like an expensive wait and see idea! He has never once opened it up to check for any decay. I'm worried that he is rushing through and doing the crown. I also hAve bad TMJ, probably from chewing on the left for do long!
Thoughts?
Thanks in advance!!!!
11 Responses
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540545 tn?1377622918
MEDICAL PROFESSIONAL
How much pain or problems is the crack tooth giving you?

The crack won't fix itself.  So if you don't treat it, it could potentially worsen and crack further, resulting in more pain and possibly a bad enough crack where the tooth may not be save-able.  

I would probably follow the same treatment course as your dentist, which is to place a crown on it with the potential need for a root canal or possibly to remove it.  But again, it depends on the severity of the symptoms.  Can they see the crack at all?  If they can, a filling may be possible if its not too large.  But cracks are hard to see/identify
Helpful - 1
Avatar universal
Since the tooth only hurts when chewing, is their a chance the crown will fix that?
Helpful - 0
540545 tn?1377622918
MEDICAL PROFESSIONAL
Well cracks are probably one of the harder things to predict and treat.  The symptoms and treatment depend on how deep the crack goes and its not visible on an x-ray most of the time and we can't see how deep it goes until we start removing the damaged tooth structure.  So getting a simple answer is tough because we don't know.

I've had patients who have had cracks and fillings work.  Sometimes they need a root canal and a crown.  Sometimes the crack is so severe that it needs to be removed.  But cracks don't fix themselves so so type of treatment would probably be better rather than wait til the pain worsens since that means the crack may be getting larger.
Helpful - 0
Avatar universal
Thank you for your feedback.  My dentist decided to refer me to an endo.  The endo said "it might be wise" to do a root canal, as the large filling seemed to have compressed the canals, making them appear to be starting to calcify.  He said if they calcify, I'd need a root canal anyway.  But, would they automatically calcify?  Should I try just the crown first like my dentist suggested or go the route of the endo.  I have read that root canals can't kill all the nerves, because there are thousands of tiny offshoots where the endo can't reach, so they tooth is always leaking bacteria.  I feel like I'm out of luck either route I choose.
Helpful - 0
540545 tn?1377622918
MEDICAL PROFESSIONAL
I usually don't recommend a root canal treatment if its not necessary.  I think the endodontist is saying that it may be a good idea to prevent future problems by doing the treatment but you could possibly not have any problems with just a crown.  But no one knows for sure.
Helpful - 0
Avatar universal
The X-ray shows no infection and I'm not sure if my current dentist can see the crack. I know it was small years ago and filled. Is the pain I feel when I chew from the crack shifting and how will a crown help that?

I appreciate your answers. My dentist is very abrupt and u will be switching soon. I like things explained and he seems inconvenienced by my questions.

I just don't want a jaw infection! Which is what comes up when I google.
Helpful - 0
Avatar universal
And is it better to do the crown and see at this point? I can't really afford to do both right now anyway, so I may have to do the crown and see.
Helpful - 0
540545 tn?1377622918
MEDICAL PROFESSIONAL
That would be my approach as well.  Do the crown first and just know you may potentially need a root canal.  But when you need the root canal I don't think anyone will know
Helpful - 0
Avatar universal
Alright.  Did the permanent crown last Friday.  Getting it adjusted today, I think it's too high and my mouth is super sore.  I can chew a bit better than normal, but it does still hurt somewhat.  ALSO, I never had hot/cold sensitivity on that side, but since the permanent crown, I totally do!  What does this mean?
Helpful - 0
540545 tn?1377622918
MEDICAL PROFESSIONAL
So it feels worse after the permanent crown was placed?  Could need some time to adjust, especially if the bite was off and causing some trauma to the area.
Helpful - 0
Avatar universal
I've decided to have a new dentist consult on my two teeth, the one that was just crowned without a root canal and the one next to it with an old root canal. My tooth still is sore, and I cannot chew any better on that side with the new crown. I'm worried I have an underlying infection no one is catching. I have a slightly swollen gland in front of my right ear, same side as crown, and I now have sensitivity to cold that I didn't have prior to the crown.  I'm thinking it probably needs a root canal after all. Thoughts?
Helpful - 0

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