Broken Front tooth - root canal for crown??

ianhobo

Hi everybody,
I'm look for a bit of advice regarding crowning and possible root canals

Basically, I broke a front tooth in October, which I had emergency filled at the dental hospital.
There was no bleeding from the tooth, and virtually no pain or sensitivity.
The break was quite high, and the dentist in the dental hospital was about to start a root canal until he asked me had I experienced pain or "much" bleeding. When I said none of either, he replied (with a shocked look! ) oh ok, that's unusual, maybe you won't need a root canal. He said it was unusual for a break that high to not expose or damage a nerve, and said I should keep my eye on it.

I made an appointment for my own dentist in Blanchardstown, where I had a "temporary" fake tooth put on. A "stock" tooth which was just bonded to mine, with filling put on the back.
Again, because the break was high, a lot of filling had to be put on the back of the new tooth to bond it to my remaining original tooth. The result of this is that I can't completely close my jaw naturally the way I used to. Its a little "off" if you know what I mean.

I would like to get the tooth crowned as I believe? it will be a longer term stronger solution? (i'm terrified of the temporary one breaking off)
But my dentist has said that if he crowns it, I should get the root canal done.
Not that I don't trust him, I do, he is a nice man, and very capable.
But its hard to ask all of the questions and get all the info quickly just standing in the surgery (theres always a queue of people waiting to come in )

Both my dentist and the dentist at the hospital said that I've been very lucky that my tooth hasn't died and that I've had no pain or complications of any kind as a result of the break.
Based on that, I am reluctant to get a root canal done on what appears to be still a relatively healthy (nerve wise) tooth.

Why would my dentist recommend I get a root canal before crowning if there are no signs of the nerve dying or dis-colouring? also considering he too said how lucky I was that my tooth hadn't died.

I really don't want to get a root canal, but i do want the crowning.
I would just like to make the most informed decision that I can.

Also, how long do the "temporary" ones last? (it looks great for only €50!! and I'm quite happy with it)

Thanks everyone

btkm8unsl0w5r4

Cant really answer you questions becase we have not seen whats happened, suggest you get a second opinion if you are worried.

ianhobo

Ah I see ok thanks. I appreciate that.

Speaking in very general terms though, if I developed nerve problems which would typically be solved via root canal AFTER I had it crowned, but that be a substantial difficulty for a dentist (and me! ) to try and solve?
I imagine a crown is a rather secure bond....>

No worries if you can't feel like you can comment.

Cheers

Ian

Incubu

Ianhobo, fitzgeme is far better qualified than myself to comment on this sort of thing but I'll try to give you some general advice.

Firstly, I'm sure that you're dentist is very busy but it's really important that you have the chance to ask about the pros and cons of the options available to you. Don't worry about asking questions. Your dentist would much prefer you understood the true implications of anything he/she did rather than have you disillusioned and complaining after the treatment had been completed.

You also mentioned that you couldn't close properly due to the temporary restoration that had been placed. You should see your dentist about this. It may mean that the repaired tooth is bearing the brunt of your bite force. If this is true the lifespan of the restoration will be shortened and you risk inflicting more damage on this poor beleaguered tooth.

As fitzgeme said it's hard to know exactly what your options are. Let's assume that you're happy with the appearance of the tooth. Depending on the type of restoration your dentist did for you it may be perfectly viable to just leave it as it is. Why get a crown unless you have to? Also, one of the toughest tasks for any dentist is to match the shade of a central incisor with it's unrestored neighbour.

With regards to the root canal issue, I think your logic is perfectly sound. However, your dentist had very sound reasons for suggesting you get root canal treatment before having a crown fitted. Even in healthy teeth the trauma of crown preparation causes a small percentage (4-6%) of teeth to develop problems with the nerve (pulp). The chances are that this percentage would increase where the tooth had been previously damaged. Futhermore, pulps are unpredictable, especially when they've been injured. It's possible the nerve may begin to die off despite the fact that it appears healthy now.

If the tooth had been crowned you could still do the root canal treatment. You'd either have to remove the crown or drill a hole through the back of it. If you choose the former option access to the root canal(s) is optimised and the structural integrity of the crown wouldn't be comprimised. On the other hand you risk fracturing the tooth itself and damaging the margin of the crown. If you choose the latter it's more difficult for the dentist to establish the correct orientation for the access cavity, the strength of the crown is greatly reduced and the seal of the access cavity is often less than ideal. This method, though, minimises the risk to the remainder of the tooth.

Sorry for waffling on.The bottom line is you need to talk to your dentist. Make a short appointment to discuss your options and have the bite adjusted. Then you'll be in a better position to make the right decision.

belleray

Hey if you do decide to go with the root canal or want a second opinion I highly recommend the endodontist in Blanchardstown village - above the ink place the entrance has the yellow doors, I've had to have a number of root canals due to nerve damage when I was a kid and she was wonderful - the root canals were completely pain free, she was relaxed, helpful with questions and the whole experience was extremely positive.

PM if you've any questions

ianhobo

Hey, first off, thank you very much for the detailed reply! You have pretty much answered all of my questions, I really appreciate it.

Incubu wrote: »

You also mentioned that you couldn't close properly due to the temporary restoration that had been placed. You should see your dentist about this. It may mean that the repaired tooth is bearing the brunt of your bite force. If this is true the lifespan of the restoration will be shortened and you risk inflicting more damage on this poor beleaguered tooth.

Yep, I asked him about this last time I was there (a filling just before christmas) and he said what you said basically, but warned that thinning it out to relive the bite pressure may cause it to break as it he though it would be too thin.

As fitzgeme said it's hard to know exactly what your options are. Let's assume that you're happy with the appearance of the tooth. Depending on the type of restoration your dentist did for you it may be perfectly viable to just leave it as it is. Why get a crown unless you have to? Also, one of the toughest tasks for any dentist is to match the shade of a central incisor with it's unrestored neighbour.

ok cosmetically, I'm quite happy with what has been done so far! It's only under close scrutiny can a difference be seen. Others say they can't even see a difference! The colouring is also more than acceptable

Why get a crown? Well that's just it really, I don't know, hence the questions! I guess I assumed it was just what you did. I guess my main motivation for a crown is just a fear of the temporary restoration work breaking, and then having to wait a month for a dental appointment

With regards to the root canal issue, I think your logic is perfectly sound. However, ............................

Understood thanks for that, that's basically what I wanted to know! If I recall correctly, my dentists reply to why a root canal was preferred for crowning was simply that "it would be best" I was too nervous that evening to follow it up there and then

Sorry for waffling on.The bottom line is you need to talk to your dentist. Make a short appointment to discuss your options and have the bite adjusted.

Thanks for waffling on
It's much appreciated and I feel much better now, I'm back on thursday for a review and a minor filling so I was starting to get quite anxious
Thanks again everyone

Ian

Jeapy

I have no dentistry education but only experience...when i was 8 or so, i broke BOTH front teeth. I had them capped but these kept breaking off. I then had them crowned- one broke again so eventually i got porcelain veneers (300-400 per tooth) and theyre much stronger. Ive had them years with not even a chip and nobody can ever tell theyre not reall! I think theyre def worth it.
I was at a check up recently and he checked to make sure my left front tooth was still viable :eek:. "why didnt you check the right one too?" i wondered! He told me he had done a root canal on it before putting the veneer on. I never even knew! My point? Even if you have to have it done, it shouldnt hurt- hell i didnt even know i had it done!
Good luck with everythin!