This summer we had a patient call our office. She asked if she could set up an appointment to have her tooth looked at. She noticed that a piece of her tooth was missing, and she didn’t know if a piece of the tooth had broken off, or a piece of the filling was gone.
After looking at the tooth, The filling looks pretty much intact. The way I see it, a piece of the tooth broke off. If you look closely at the tooth you can see other cracks. The tooth does have the potential of more pieces breaking off. The patient wasn’t having any discomfort or pain, and so, for the sake of completeness, we asked if we could take an x-ray of the tooth.
I remember looking at this x-ray thinking, that’s too bad. Tooth number 15 needs a crown, because of the root canal treatment. Anytime a back tooth has a root canal, it’s recommended that a crown be placed. It can be disheartening to go through with a root canal, then lose it, when the tooth splits in half. The crown prevents the tooth from this occurring. The patient needs two crowns.
Unfortunately, it was tooth number 14 that was breaking down. The patient needs two crowns, one for #14 that is breaking down, and another crown to protect #15 after the root canal.
Dr. Medina, I can’t afford two new crowns.
Tooth #15 had a root canal done quite some time ago, maybe we could leave it alone a bit longer until it can fit into the dental budget. We then explained the two ways that we could repair tooth #14. We could repair the tooth with a crown, and the advantages of the crown would be that all four cusps would be protected, less chance of the tooth breaking down any further.
Options further explained for tooth #14
The downside to repairing the tooth with the crown would be the cost. The second way to repair number 14 would be to replace the broken, missing part of the tooth with a filling. The advantages of this type of repair would be to keep the cost down. The one downside of repairing the tooth with a filling is that the potential exists that another piece of the tooth could break off in the future.
The patient, due to finances, elected to leave tooth #15 alone and repair tooth number 14 with a filling.
This is how tooth #14 looks like after the repair, with a tooth colored filling.
Tooth #14 after repair
Another photo of Tooth #14 with a large filling.
The situation may not be optimal, but overall it looks good. Hopefully, we have bought some time where the patient may save up for the crowns. The patient was advised be careful with hard crunchy foods, such as ice cubes, or corn nuts.
Do you have a tooth that is breaking down? Are you interested in knowing what your options are? Give us a call at Seasons of Smiles Dental.
Norman Medina DDS, graduated from Loma Linda University Dental School in 1994. He has been practicing dentistry in Midcoast Maine since 1994. He and his wife Lanita have four children.