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Dr. Crapo

Question:

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?


Answer: 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 or visit us today.

 

Based on actual patient cases

© Calvin Ross Crapo

Victoria Implant Centre 778-410-2080




Q: Life is really three steps forward and two steps back. Try as I might I can’t seem to get my teeth fixed and they stay fixed. Over the years, I had decay then root canals and crowns. Then they said I had a hard bite because my crowns started breaking off and then I’d lose a tooth. I got so frustrated that I stopped going to the dentist even though I had missing teeth on the top and needed a bridge for each side.


After years of poor chewing I went back because I had a toothache and didn’t think I could lose another back tooth. The dentist was very helpful and the root canal went so well I decided to do a bridge on one side and an implant on the other. That was two years ago since that bridge went in and I’m ready for the implant. The dentist took a 3D picture of my upper jaw to know how much bone I had for the implant. When he took the 3D I asked if it would show the bridge. He said “yes” and so I said, “I felt a twinge on the bridge, could you check it out?” 


He did and we were both surprised to find a crack had occurred on one of the bridge teeth about half way up the root. I was so frustrated. The dentist has been good about understanding but it’s a here we go again moment. The dentist said the root of the root canaled tooth he’d done was very small and thin and my hard bite may well have been the culprit. I really don’t know what to do. The fractured tooth is in the middle of the bridge and if it comes out, which it must, the bridge fails and I’m out – again.  

 

A: I feel your pain – I really do. In the day – years ago – we didn’t have many answers as dentists. With implants, it’s almost always possible to use implants to replace the bridge or replacement teeth and then put crowns on them or create a new bridge. It takes time and specific experience to do that but the skills are more available now then they’ve ever been.  


Sometimes a middle tooth that helps support a bridge can be removed along with that section of the bridge, leaving the ends still crowned. 


Grafting may have to do done and then implants placed which will give you the needed strength for you hard bite. Speak to your dentist. He may be able to help with the financial aspect. Don’t give up, there are strong lasting solutions.  


If we can help, we’d like to. Call 778-410-2080 for a consultation or visit us today.

 

Based on actual patient cases

© Calvin Ross Crapo

Victoria Implant Centre 778-410-2080

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