Question:

My dentist said that a crack in my tooth does not favour root canal treatment. He favours an extraction. He said this is because the crack in the tooth extends down under the gum line. Should I get a second opinion? I would like to save the tooth. It is the tooth next to the eye tooth towards the back. The next tooth along has already been removed.

Answer:

Generally, when a crack in a tooth extends below the gum line, then it renders the tooth prone to bacterial infiltration through the gum crevice. Ultimately this can lead to infection of the pulp (nerve) and further progression of the crack all the way through the root. It can also lead to loss of gum attachment to the tooth and eventual fracture of the root.

While you can slow down the process by undergoing a root canal treatment and a crown (you will need both), this is a significant investment for a tooth that will have a poor prognosis in the long term.

It is significant that the next tooth along is already missing. This means that if you wanted to replace this tooth, you can't depend on the cracked tooth to support a bridge, as it will be extremely compromised and stressed.

In recent years, there has been a shift in logic that steers away from heroic measures to prolong the life of hopeless teeth and replacing these with dental implants that are safe, reliable and permanent.

In light of the above, it is worth considering the removal of the tooth and replacement with a dental implant. You can use the opportunity to replace the adjacent missing tooth with an implant simultaneously.

There is no harm in having a second opinion from a restorative dentist for your own peace of mind. It is important that you get all the facts and perspectives of a dentist you can trust before making an informed decision on the best treatment alternative for you.

For more information please visit Dr Angelo Lazaris's website.