Dr. Crapo: I had a frightening and frustrating experience on my holiday this past summer. On the second day of my trip, I was eating an egg salad sandwich when all of a sudden, I felt something hard in my mouth. I quickly spit it out into my hand and it was a tooth – my tooth! On closer examination, it looked like a front tooth so I ran to the mirror – it was my left front tooth! I called my dentist (yes long distance) – I must have sounded hysterical – in a country where I didn’t have service I could trust and how could he fix it? It didn’t hurt; it was just broken clean off at the gum line. The crown was done about thirty-five years ago so I never thought anything would go wrong. He was at a loss at what to tell me, so he said find a denturist and have him make you a flipper so I’d have a tooth and wouldn’t have to hide out for the rest of my holiday. Why did it break? What’s going to happen? How do you attach the crown back, or can you? Will I need a new crown? Will the tooth have to be pulled out and an implant put in?
It’s very traumatic when something like this occurs in a location where you feel powerless to fix the problem. There are a number of ways to fix the problem and sometimes a palliative or temporary fix is just fine. Suggesting a removable tooth for the short term (the flipper) will work. To someone who’s never had a removable tooth, it may be annoying or feel unstable.
If you’re in a first world country, most dentists can bond your porcelain crown tooth to the adjacent teeth. When this is well done and if you’re not a horrific grinder, it can give you months of service. This may fix the problem without noticeable esthetic concerns. If the break occurred above the fitting line of the crown, you will be able to reuse it after your dentist has built up the tooth.
The reason it broke may be from stressful function over the years and perhaps even death of the nerve. If the crown can be used again, make sure your dentist tests the tooth for vitality (is the nerve still alive). Often the nerve in the tooth has quietly died. In this case, a root canal may be necessary and probably a new crown. If the root is still in good shape and the bone around it is healthy, you’ll be able to keep your tooth. Though it sounds disastrous, careful dental work could make the crown just as strong as when it was done thirty-five years ago.
If we can help, we’d like to. Call 778-410-2080 for a consultation.