cracked tooth - sorry it's long...

[monkeyflower]

I'm almost 39, and apparently now clench/grind my teeth at night, which is why I broke off half of a porcelain crown a couple of months ago, and why I just cracked another tooth completely in half. Which brings me to my question :-)

As background, that tooth had a very deep cavity that had been infected back in June. I took antibiotics and then had it filled, complete with pulp cap if that helps. It continued to be tender and feel weirdly tight, though, until about two or three weeks later when it suddenly just "popped". The pain instantly went away, leaving me with a funky taste in my mouth and a sharp edge on my tooth. I saw the dentist who'd filled it, and he said it was severely cracked but could be salvaged. He wants to remove one half and then crown it, although if it broke off at the root during extraction he would need to pull it entirely.

However, my new dentist (I was in the process of changing when this happened) says that he only sees a crack this bad every three or four years, and it can't be saved at all. He also said I have a deep, chronic, long term infection and a deep drainage hole in the tooth. He wants to refer me to an oral surgeon to have the tooth extracted, and since the two molars surrounding it are virgin teeth, to do some bone preservation so I can get an implant instead of a bridge.

So, what to do. I'd like to keep my tooth, but I also don't really trust my former dentist. From this info, do you think it can be saved? Or does it warrant a third in-person opinion? Thanks!

[monkeyflower]

Thank you both so much! I like and trust my new dentist so much more than my former dentist, and your responses made me feel even more confident in his advice. Thanks again :-)

[Jerome Bogin, D.D.S.]

I can't tell whether the tooth is salvageable. From your description and the opinion of dentist no. 2 it does not seem to be. If it has to be extracted then I do agree with the diagnosis of placing an implant rather than involve virgin teeth. The predictability of implants are excellent.

[mike1105]

hard to tell without seeing films. But......... here's some food for thought. SAving half of a tooth is called a hemisection. It is NOT done that much anymore because it is NOT highly successful (in my experience) and involves alot of work and cost. (cutting the tooth, extraction of half of it, root canal, gum tissue repositioning, a post, and a crown.) Common sense should tell you that after doing all that, how strong can what is left be??? And since there are teeth to either side you can almos guarantee food will get caught under it when all is said and done because half of the roots are gone !! It is much easier (on everyone involved) and more permanent (as well as simply "better") in my humble opinion to extract a tooth like this  that needs all this work, and replace it with an implant-- which are used so commonly these days they are the standard of care in replacing teeth in many cases---especially when the teeth adjacent are, as you say, "virgin" teeth. The oral surgeon may even be able to place it at the time of the extraction. Restoring it later on (ie puttin a tooth on the implant) is usually a piece of cake. It sounds to me like the plan to hemisect the tooth is not a good one, although again I have not seen you or your films so I cannot be sure. It sounds to me like the tooth wants to say goodbye.